Irregularities found in claims for cross-Border health scheme

The Health Service Executive (HSE) says it has discovered irregularities in claims submitted by some healthcare providers for reimbursement under a cross-Border health scheme.

Probity checks are being carried out on the authenticity of documents submitted after concerns were raised recently by patient groups, it says.

The EU Cross-Border Directive gives patients the opportunity to access care outside their normal jurisdiction where delays are experienced in the domestic health service. The patients pays for the treatment and then claims reimbursement from the HSE for the cost of the treatment abroad or in Ireland, whichever is the lesser.

Some orthodontic treatments funded by the HSE under the scheme allegedly took place in this jurisdiction and not Northern Ireland, the Medical Independent has reported.

The HSE says it has done everything in its power to implement protections for patients including the introduction of application forms to ensure the patient has information on the cost abroad, and a cooling off period in which to make a decision on the treatment abroad.