2 DFómh 2014, 13:44
The HSE must work harder on risk profiling so that compliant medical card holders are not subject to extensive review, according to a report by the PAC published this afternoon. The Committee is gravely concerned at the waste of money of the current extensive reviews, given the known level of eligibility in the system.
2 October 2014
The report suggests that a more robust system of risk profiling can be delivered through better use of the HSE’s centralised database, which contains information on the almost two million card holders in the State. It says that a comprehensive Risk Profiling system should be developed at the HSE’s Primary Care Reimbursement Service as a matter of top priority, incorporating information on earnings from the Revenue Commissioners and from the Department of Social Protection.
The key recommendations of the report include:
- Those medical card holders who have a high risk profile should be priorities for review purposes.
- The HSE should examine ways of extending medical cards automatically for the 80% plus cohort of card holders, whose eligibility is in little doubt, having regard to their low risk profile.
- The HSE should review its control procedures so as to devote the majority of its available resources to the initial award process and to the focussed reviews.
- The HSE should conduct an exercise in the case of persons with a long term medical condition or disability which would compare the costs of granting those persons a medical card as against reimbursing their costs under the long term illness scheme.
- The HSE should conduct random audit of its medical card base which will give an indication of the extent to which excess payments are in the system and it will also over time allow the HSE to assess the effectiveness of its own control measures.
- Given the evident anxiety of the medical card holding population arising from the review process, the HSE should review its communication strategy and engage in a public awareness campaign to coincide with any future reviews.
- The HSE needs to review its customer care practices at the PCRS so that complex cases are dealt with by a specific team where the card holder can deal with one official who will become the case manager.
PAC Chairman John McGuinness TD says: “The medical card scheme is extremely important in making medical care assessable to those who cannot afford it. It is clear from the PAC examination is that the vast majority of the card holding population are, following review, eligible to retain their cards. The focus of our report therefore was on examining ways in which the HSE can be more efficient and effective in applying control measures so that only those who have an entitlement hold a medical card. The report also calls for better systems of communication between the HSE and card holders so that the reviews do not end up frightening people into thinking that a review equates with losing their entitlement to a card.”
Access Report.
Ends
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Committee Membership
Deputies:
Áine Collins, Fine Gael
Paul J. Connaughton, Fine Gael
Joe Costello, Labour Party
John Deasy, Fine Gael
Robert Dowds, Labour Party
Seán Fleming, Fianna Fáil
Mary Lou McDonald, Sinn Féin
John McGuinness, Fianna Fáil (Chairman)
Eoghan Murphy, Fine Gael
Derek Nolan, Labour Party
Kieran O’Donnell, Fine Gael
Shane Ross, Independent