The Health Service Executive operates under the legislative framework of the Health Act of 1970, as subsequently amended. In the interest of probity, the HSE is obliged, irrespective of the age of the person, to ensure that a person's eligibility is correctly recorded in line with the eligibility legislation and the national guidelines. The HSE aims to ensure that every person who is entitled to the medical card schemes is given the opportunity to avail of their entitlement.
The current structured processes in operation in PCRS concerning medical and GP visit card applications, reviews and appeals must be supported with a range of documentation, as outlined on the application forms. Where such supporting documentation is not supplied, or is incomplete, to enable the assessment of an application, in accordance with the National Assessment Guidelines, the HSE will issue correspondence to the applicant, specifying the additional information required to progress the assessment of their application. Clearly, the processing time for incomplete applications is dependent on the furnishing of the required supporting documentation by the applicant.
Any medical card holder undergoing a review to renew a medical card, who genuinely engages with the HSE, will not have their entitlement withdrawn before the review is complete, regardless of the expiry date shown on their medical card. In cases where a decision is made not to grant a medical card, the applicant is informed of the decision and is notified of their right to appeal this decision. Contact details for the appeals office are provided to them. Where a person submits an appeal to a decision not to renew a medical card within 21 days of that decision, he/she also retains the medical card or GP visit card until the appeal is decided.
Towards the end of 2013, the HSE announced a communications campaign designed to raise awareness of the rules governing eligibility for medical cards. This included providing extra resources to the national Call Centre for public enquiries, a public information campaign through media advertisements, the development of a key new Information Leaflet, improved support on the HSE website, and included wide ranging training for front line staff. Given, also, that over 40% of the population, or nearly 2 million people, qualify for a medical card or GP visit card, the scale of the administration of the general medical services, GMS, scheme is significant. Over 700,000 individuals were assessed by the HSE in 2013 and well in excess of 95% of applications were processed within the target of 15 working days.
The HSE is now completing medical card reviews for approximately 86,000 individuals per month. It is expected that increased data sharing between Revenue, Department of Social Protection and the HSE has the potential to further reduce the level of documents and information required from families as their eligibility status is reviewed. In view of the assessment processes involved, I am satisfied that every effort is made to assist, support and facilitate persons undergoing review and in the most timely fashion.
Each week the HSE publishes the turnaround time for medical card processing and this data is available on the Primary Care Reimbursement Services website: https://www.sspcrs.ie/portal/medapp/turnaround.jsp.