HSE recoups €3m for care of deceased medical card-holders

The Health Service Executive has recouped more than €3 million paid to doctors for taking care of people who were dead.

But the HSE is due another €2 million in “ghost payments” from GPs who had received capitation fees in respect of medical card-holders who were deceased.

Following the centralisation of the medical card scheme to the Primary Care Reimbursement Service (PCRS) in 2009, some 20,000 card-holders were removed when it was discovered that they were deceased.

The HSE had continued to make capitation payments to GPs in respect of these cardholders after their deaths.

The value of these ghost payments was estimated to be approximately €5 million.

However, more than €3 million has now been recouped from GPs relating to the period between 2005 and 2012.

The figures have been uncovered by former mayor of Galway Cllr Pádraig Conneely, who has raised the matter with the HSE Regional Health Forum West.

Responding to a written question submitted by former chairman of the Forum, Cllr Conneely, Kieran Healy of the PCRS said that the issue of ghost payments had been raised by the Public Accounts Committee in 2012.

But the issue of recouping capitation payments erroneously paid to GPs was complicated by the lack of a centralised system and a correlative issue of underpayments to GPs resulting from delays in registering new-born babies, he said.

Legacy issue

“Both of these issues have now been addressed following the centralisation of the medical cards system. The HSE has also undertaken a number of additional actions to address the issue of legacy overpayments and underpayments,” added Mr Healy.

“The capitation amounts recouped in respect of clients who died, covering the period 2005 to 2012 is €3,095,180.30,” he confirmed.

While he welcomed this progress, Cllr Conneely said that it was unacceptable that ghost payments of up to €2 million should remain unclaimed by the HSE.

“It made a mockery of the entire system that millions of euro could be paid out to GPs to look after patients who were already dead. There isn’t much that they can do for them at that stage,” said Cllr Conneely.

“As a country, we barely have enough money to take care of the people who are alive without squandering vast sums on people who are dead. The full amount should be recouped and the HSE shouldn’t rest until this is the case,” he added.