Private hospitals group says health insurers should meet Covid test charge

Mater Private group claims insurers have generated large savings on claims when private hospitals were under State control

The largest health insurers, VHI, Laya and Irish Life Health, have all indicated  they are in talks with private hospitals over the charges. Photograph: Getty Images

The largest health insurers, VHI, Laya and Irish Life Health, have all indicated they are in talks with private hospitals over the charges. Photograph: Getty Images

 

The Mater Private Healthcare Group, which has come under fire for the introduction of new charges for Covid-19 tests for patients treated in its facilities, has criticised health insurers for failing to meet these costs on behalf of their subscribers.

The group, which includes the Mater Private hospitals in Dublin and Cork, said in the absence of an agreement with health insurers it had no alternative other than to bill subscribers directly for the costs.

The group suggested that health insurers had generated considerable savings on claims over recent months when private hospitals were effectively under State control.

The Mater Private Healthcare Group said on Tuesday it had put in place charges of €275 for people undergoing an in-patient day procedure and €75 for a diagnostics out-patient test.

“The Mater Private Healthcare Group have recently introduced a series of additional quality, safety and risk management measures to protect patients and staff as part of the response to the Covid-19 pandemic. One such measure is the reconfiguration of our facilities to minimise unnecessary contact with other patients while attending appointments.

“Another is the introduction of a robust Covid-19 screening service (which all attending patients will undergo); and in some cases further testing thereafter (which only some patients will have to undergo).”

It said these additional measures had come “at considerable cost to the hospital, including operating longer hours, reduced capacity, additional cleaning and purchase of personal protective equipment”.

“As a result the costs of running our services, whilst simultaneously ensuring the safety of our patients and staff, have increased. These are costs that we believe should be absorbed by the health insurers as part of insured patients’ policies.

“The health insurers have experienced a significant drop year to date in the number of claims for private hospital services due to the Covid-19 pandemic, including zero claims during the three months the private hospitals were used by the State during the Covid-19 pandemic at no profit to the private hospitals. The number of claims may decrease further as Covid-19 operating guidelines reduce our capacity to deliver treatments and procedures.”

The Mater Private Healthcare Group said it had “proactively engaged” with the health insurance providers regarding reimbursement of the charges.

“It is extremely regrettable that the health insurance providers have thus far refused to provide cover, reimburse patients, or in some cases have not yet confirmed their position in this regard; and this has resulted in an added expense and uncertainty for our patients.”

Individual basis

The group stressed its hospitals incurred “no profit”, adding “these fees are charged on an individual basis, and not an attendance basis; therefore, no patient will be charged more than once for these procedures during a cycle of care”.

The largest health insurers, VHI, Laya and Irish Life Health, all indicated this week that they were in talks with private hospitals over the charges.

The private Beacon Hospital in Dublin has said that Laya Healthcare subscribers would be covered for a €250 Covid-19 test required for some patients being treated in its facilities. The hospital said talks were under way with other insurers.

Minister for Health Stephen Donnelly said on Monday the Government would “take a very dim view” of private hospitals profiting from Covid-19 testing.