Dispute over pharmacy dispensing fees settled in court

HSE had claimed Hickeys pharmacy group was overcharging for fees

Photograph: Alan Betson / THE IRISH TIMES

Photograph: Alan Betson / THE IRISH TIMES

 

A dispute in which the HSE claimed a leading pharmacy group was overclaiming for dispensing fees has been settled at the Commercial Court.

The HSE had alleged it was owed between €5 million and €7 million from the Hickey pharmacy group for non-compliance with dispensing rules between June 2011 and August 2016.

The case involving the HSE and DGM Pharmacies Ltd, which operates the Hickey group, was heard before Mr Justice Michael Quinn for 11 days until a settlement was announced on Friday.

In 2016, the HSE was paid €12 million by Lloyds, the State biggest pharmacy chain, in settlement of a separate dispute with that company over phased dispensing. It then widened its investigation into other operators within the pharmacy sector.

The HSE alleged the chains wrongly claimed multiple payments from the State for single prescriptions presented by medical-card holders, by phasing the dispensing of the medicines involved. The companies said it was done to prevent excessive or incorrect dosing by patients.

The test case over dispensing fees claimed by one of Hickey’s pharmacies in Navan, Co Meath had opened before the court late last month.

In outlining the claim, Eileen Barrington SC, for the HSE, argued the pharmacy had received more than €419,000 in fees for phased dispensing that it was not entitled to.

The claims were denied.

The case was regarded as a test for 29 other cases initiated against DGM Pharmacies in relation to the system of phased dispensing fees.

On Friday, Nathy Dunleavy BL, also for the HSE, told the court the case had settled. Counsel said the sides had agreed the court could make a declaration on consent.

The judge made that declaration which stated that, under the 1996 Community Contractor Pharmacy Agreement, phased dispensing fees were, and are, payable for GMS patients only where an item on a single prescription form is dispensed across multiple supply occasions.

Mr Dunleavy said there were 28 other sets of proceedings dealing with similar issues and they could also be struck out.

Previously, the court heard phased dispensing is generally used to prevent excessive or incorrect dosing by the patient. Instead of giving patients a month’s supply of their tablets, they are given one week’s supply at a time. When the patient or a family member visits the pharmacy weekly, the pharmacist can check on their adherence to their medication.

In a grounding affidavit, Anne Marie Hoey, HSE assistant national director of the primary care reimbursement service, said it had emerged from inspections of pharmacies within various groups, including the Hickey group, claims were allegedly made to the HSE for phased dispensing claims where supply allegedly occurred on a single occasion.

The Hickey group’s standard operating procedure for monitored dosage systems stated a month’s supply would usually be provided to the patient by way of a blister pack and yet fees were charged by it for phased dispensing, she said.

The HSE alleged non-compliance with the phased dispensing rules, resulting in the payment of pharmacists for services they did not provide in circumstances where the HSE believed phased dispensing had taken place.

Ms Hoey said it would appear the Hickey group had taken remedial action so as to no longer routinely claim for phased dispensing when it provides blister packs with a month’s medication to a patient.

Separate proceedings by the Hickey group against the HSE over allegedly wrongfully withholding payment for phased dispensing as of October 2016 have also been struck out as a result of today’s settlement.