MORE THAN 30,000 claims for dental treatment have been refused by the Health Service Executive (HSE) so far this year because they did not reach the criteria for a valid claim, the HSE said yesterday.
It was responding to a report in T he Irish Timeswhich said that fraudulent and inappropriate claims by dentists participating in the publicly funded Dental Treatment Services Scheme (DTSS) could cost at least € 8 million this year.
The HSE said that there are “significant levels” of controls and checks in place which would be strengthened by a new inspectorate function.
The Irish Timesarticle was based on a series of unpublished reports commissioned by the Department of Health and the HSE.
The HSE said that there was “no specific evidence of inappropriate claiming by dentists in the report” but that it suggested weaknesses in probity arrangements which could result in misclaiming.
In 2008, some 31,000 treatments of 1.2 million were not reimbursed and in 2009 over 31,000 claims of almost one million treatments were not reimbursed because they did not reach the necessary criteria for a valid claim.
The HSE controls include randomly writing to individual patients to ask if they have received the treatments which have been claimed on their behalf.
Some €43,000 of duplicate claims (under the social welfare scheme and the DTSS) have also been recouped by the Department of Social and Family Affairs in a routine cross-check with the HSE.
Before the end of the year, the HSE is to complete a review of dental services which will include looking at probity arrangements.