Dáil Éireann debate -
Tuesday, 12 Jun 2001

Vol. 537 No. 5

Written Answers. - Health Insurance.

Minister for Health and Children (Mr. Martin)

I propose to take Questions Nos. 286 and 288 together.

Funding for MRI scanners in public hospitals is provided on the basis of clinical and service requirements for the care and treatment of public hospital patients. The recognition of MRI scanners by private health insurers, for the purpose of benefit payments under their plans, is an entirely separate matter and is a matter for decision by the relevant insurer.

The Health Insurance Act, 1994 (Minimum Benefit) Regulations, 1996, set down a level of cover which insurers are obliged to provide as a minimum under each health insurance contract. The regulations recognise that insurers should be in a position to determine which service providers are to supply services to their members, as it would be disproportionate to require insurers, or any particular one of them, to include all service providers in their arrangements to cover the health care costs of members.

With regard to the Voluntary Health Insurance board, in addition to the generally applicable health insurance regulatory framework, section 2 of the VHI (Amendment) Act, 1996, sets out the statutory position concerning the making of arrangements between VHI and service providers. This gives the board explicit powers in relation to entering into, or refusing to enter into, agreements with health service providers.

Inquiries have been made of VHI about the position concerning cover for MRI scanners. It has advised that the board recently considered a number of applications for insurance cover in respect of MRI scanners, which included an application for an MRI scanner located at St James's Hospital. The board has not accepted St. James's case for cover in respect of out-patient MRI scans. It has, however, decided to provide insurance cover for MRI scans performed during medically necessary in-patient stays. This involves providing insurance cover for professional fees in accordance with VHI's schedule of benefits for professional fees and is subject to finalising the operational arrangements with the hospital.