HSE targets four pharmacies over Lloyds-style overclaiming

Four pharmacies are being pursued by the Health Service Executive for allegedly overclaiming dispensing fees.

The HSE claims the four businesses, which include chains and individual outlets, incorrectly claimed fees in the same manner as Lloyds Pharmacy.

Lloyds, the State biggest pharmacy chain, has made a €12 million payment to the HSE in settlement of a year-long dispute over fees.

Lloyds significantly boosted its dispensing fee income by claiming multiple payments from the State for single prescriptions presented by medical-card holders.

The dispute was first revealed by The Irish Times in August 2015. The HSE claimed the practice constituted fraud and ordered the chain to cease it immediately in all outlets.

Asked whether it intended to refer the matter to the regulator, the Pharmaceutical Society of Ireland, or the gardaí, the HSE said it was reserving its position.

In correspondence sent last year, the HSE claimed the practice by Lloyds of claiming multiple phased dispensing payments in situations where a prescription is dispensed on a single occasion was “endemic” across all its outlets.

It said the level of claims was “staggeringly high” and raised concerns about patient safety.

Lloyds denied any wrongdoing in relation to phased dispensing and said it fully adhered to the HSE’s own phased dispensing guidelines, agreements and processes.

It claimed the HSE was interpreting these differently to the understanding of the wider pharmacy sector.

However, the HSE responded that Lloyds was a “significant outlier” in terms of claims for phased dispensing.

In a statement on Wednesday, the HSE said a “satisfactory resolution” had been reached. It did not name the company involved.

Lloyds said in response to queries about the dispute: “The matter has been resolved between the parties.”

MyMed

Lloyds operates a system known as MyMed, which involves putting a patient’s monthly medication into four separate compartmentalised trays, one for each seven-day period.

The drugs are supplied to a patient in a single visit to the pharmacy. It says dispensing in this way involves significant additional resources and dramatically improves a patient’s adherence to medication.

It claimed it was entitled to both the first dispensing fee of €5 and three additional phased fees of €3.27 each.

The HSE says when all medication is dispensed to a patient on the same date, Lloyds is entitled only to the initial €5 fee.

A MyMed patient increased dispensing fees by 66 per cent and was worth up to €600 a year more to Lloyds than a regular customer, the company told its pharmacists.

Lloyds aimed to increase the number of patients for whom it claims phased dispensing fees from 9,600 to 11,800 by March.

Every pharmacist in each of its 90-plus branches was given individual monthly targets.

“The more you pack, the more you get paid,” an internal guide advised.

“MyMed is one of those projects that tick all the boxes. It’s unique to us, it makes a real difference to patient health, it generates margin . . . it’s in all our interests to stay focused on growth,” it claimed.