Dentists have been warned they may face sanction if they attempt to apply for eligibility for treating their clients under the State’s dental benefit scheme without the customers’ permission.
The issue has arisen over the past few days as dentists have begun to respond to changes to the scheme announced in the Budget.
It has emerged that a number of dentists have essentially sent lists of hundreds of patients to the Department of Social and Family Affairs seeking clarification that the customers are eligible for treatment benefit. In some cases, the customers had not given their permission for the dentist to contact the Department on their behalf.
In other cases the customers about whom they were inquiring had died.
From January 1st, the dental benefit scheme will provide cover for a dental examination only. Previously, those who paid full social welfare contributions were entitled to a certain amount towards dental treatment, such as cleaning and fillings.
In a statement, the Department of Social and Family Affairs reminded dentists that only customers with confirmed appointments can apply for treatment under scheme.
It said that only those patients who by the year-end have confirmed appointments to see their dentists will have their eligibility considered under existing rules.
It said that in recent days, “a number of incidences” of dentists applying on behalf of multiple customers, without their knowledge or permission, have come to light.
“The Department has a number of cases where enquiries from practices have been made seeking approval in respect of hundreds of individuals, including enquiries about deceased people.”
It is understood that in some cases dentists have sought confirmation from the Department of the eligiblity of as many as 700 clients.
“The Department is following up on these cases and will take appropriate action where it is found that the practice has acted without the knowledge or prior approval of the persons concerned,” a statement said.
It said all dentists have been written to about the changes to the treatment benefit schemes.
“It was also pointed out to dentists that their customers had to have agreed to treatment before an application was made on their behalf. Any such breaches of the correct procedures will be notified to the Data Protection Commissioner.
“Dentists need the permission of the insured person in order to make enquiries on their behalf. The Department will undertake all necessary checks to ensure that the personal data of customers is not used without their knowledge and approval.”
Irish Dental Association chief executive Fintan Hourihan said the association had made it “very clear” to its members that they needed to have the agreement of patients, or a confirmed appointment, before they could check an individual’s eligibility for the scheme.
“The patient does clearly need to confirm they want to visit the dentist.”
He said the confusion was “the consequence of introducing such radical change” at three weeks’ notice.
Under the changes to the scheme, treatment currently in progress, but which will not be completed until after January 1st will be covered, provided eligibility has been established before December 31st 2009.
Almost two million insured people will continue to be covered for an annual free examination under the changes. The Department estimated 400,000 people are likely to claim for an examination in the coming year at a cost of €13.5 million.
A spokesman for the Department said: “Only those patients who have confirmed appointments with their dentist and have their eligibility confirmed by the Department on or before December 31st 2009 will have their claims approved under the existing arrangements.
“Customers applying on or after 1st January 2010 will have their claim processed under the revised conditions.”
Approval for treatment will lapse if it is not commenced within three months of the approval date and treatment must be completed within six months of commencing, the Department said.
The abolition of dental and optical treatment benefit was recommended in the McCarthy report on public sector spending and numbers. It estimated that dropping the treatment schemes would save the Exchequer €92 million a year.