Dáil Éireann Debate, Thursday - 19 December 2013
388. Deputy Lucinda Creighton asked the Minister for Health if there are any timetables for the delivery of medical cards which the Health Service Executive must follow; if he has given any consideration to imposing guaranteed timetables for the delivery of medical cards as a way of ensuring citizens receive their entitled services in a timely manner; and if he will make a statement on the matter. [55119/13]
Amharc ar fhreagraThe Primary Care Reimbursement Service has a target to have 90% of properly completed medical/GP visit card applications processed within 15 days. The current turnaround is 95.7%. within 15 days.
The length of time that it takes for applicants to receive a decision on their medical card applications depends on whether a completed application form was submitted, and if not, how quickly the applicants respond to the subsequent request for additional information. Applications that remain in process outside of the 15 day period due to incomplete applications, and where the applicant is engaging with the process, are facilitated so that eligibility may be retained in the interim. Once the documentation is received, their assessment is prioritised without delay. This process applies to renewal applications also.
If a person is a new applicant presenting with an urgent medical need or an urgent medical need in respect of their dependant(s), the HSE will facilitate a prioritised assessment of eligibility, once the applicant has provided all the information necessary.
All medical card and GP visit card holders are subject to a periodic review of eligibility to determine continuing eligibility. Each month, the HSE analyses the Medical Card Register to identify those medical/GP visit cards which are scheduled for review within three months. A review notification will indicate the card holder should complete a self-assessment or request the card holder to return evidence of household income, assessable outgoings and medical circumstances to enable a full review assessment be conducted by the HSE. The HSE has increased this time line to four months in respect of those clients who were granted eligibility on the basis of discretion to allow an additional month to ensure that all pertinent medical and other data is provided for inclusion in the assessment process. All customers scheduled for review are notified and a balance of either full reviews or self-assessments is conducted.
A reminder letter is issued a month later if the requested review form details have not been returned at that point. If a person does not return the review form within the time specified, continuing eligibility cannot be confirmed and the medical card cannot be reissued. In these circumstances, or where the review process establishes that a person no longer holds eligibility, the eligibility ceases. Persons are requested to return their completed review forms at least one month in advance of the due expiry date of their existing eligibility, in order to give the HSE sufficient time to carry out the review and/or to get back to the individuals, if the application is incomplete or requires any further details to be furnished.
Where a review form is returned, but not fully completed by the expiry date, it is HSE policy to extend the eligibility of the client for a reasonable period of time until the review is carried out and a final decision made on the person's continuing eligibility, once there is appropriate communication from the client. Medical card holders who genuinely engage with the review of their medical card eligibility will not have their eligibility withdrawn before that review is complete.
GPs are advised three months in advance of the review dates of their patients’ GP visit cards/medical cards and, subsequently, the following month and the month after that, if the patient has not returned the review form by that time.
GPs have full electronic visibility of the medical card panel of patients available to them and have the facility to electronically allow temporary extension of eligibility for expiring cards where a sensitive renewal is appropriate. The temporary extension may also be allowed where they are aware that a person is still availing of services but there may be something that prevents them from carrying out a standard review, e.g. a blind person with little family support. GPs can also add new babies to existing cards. All GPs have appropriate electronic access to the medical card eligibility database and they do not have to confirm medical card details by contacting HSE PCRS.
It should be noted that each person who has eligibility to a medical card/GP visit card receives a plastic card on which a 'valid to' date is printed. This is the latest date that a review may be conducted in respect of that person. Notwithstanding the 'valid to' date printed on the card, the HSE may also carry out random reviews of continued eligibility, to ensure that people who hold cards are still eligible, based on national guidelines.
