Dáil Éireann Debate, Tuesday - 5 November 2013
1020. Deputy John Deasy asked the Minister for Health the checks he has put in place to ensure that doctors cannot overclaim for medical card patients who have died or emigrated; if his Department has a fraud control system similar to the one operated by the Department of Social Protection; and if he will make a statement on the matter. [45607/13]
View answer1144. Deputy Patrick O'Donovan asked the Minister for Health if the attention of his Department and or the Health Service Executive has been drawn to payments continuing to be made to GP's for the administration of the medical card scheme for persons who are deceased; if such payments were made known to the Health Service Executive during the years 2012 and 2013; if the HSE recouped the moneys paid; if he or the HSE deemed it necessary to have any such payments investigated by the relevant authorities including the Gardaí; and if he will make a statement on the matter. [46385/13]
View answerI propose to take Questions Nos. 1020 and 1144 together.
Capitation fees are paid to General Practitioners where a person has eligibility for a Medical/GP Visit Card. Fees are not paid where eligibility no longer exists e.g. following an assessment of means, emigration or death. Under the Health Act 1970, there is an obligation on all card holders to notify the HSE of any change in their circumstances, which would put them above the Medical Card/GP Visit Card income guidelines.
In addition to the review of eligibility on expiration of a medical card, targeted reviews of eligibility were introduced during 2012, in relation to medical cards which had been inactive for more than 12 months. In such cases, medical card holders were formally contacted to confirm that they were still resident in the State. In cases where no response was received, eligibility was removed and the payment of capitation fees ceased.
In 2012, the HSE introduced data sharing with the Death Events Publication Service (DEPS) operated by the General Register Office (GRO). Death notifications are received by the HSE from the GRO on a weekly basis and payments to the GP are ceased immediately.
Where there is a delay in recording a death with the GRO, any amounts paid to GPs between the date of death and prior to the notification of the death to the HSE are recouped from the GP immediately the death information is received by the HSE.
In addition, GPs can update the database to reflect the death of patients on their GP list. In 2012, GPs made 4,400 such amendments and in all of these cases payments to the GP are ceased immediately.
