Disappointed at Lack of Action on Consultant Insurance Claim Arrears

STATEMENT BY KEVIN HUMPHREYS Labour Party TD, Dublin South East.

Wednesday 10th October 2012 

Ten months ago I raised in the Dáil the issue of hospital consultants who have not signed off on health insurance claims resulting in a loss of over €70 million in revenue for the health service. Yesterday this issue was raised at the Public Accounts Committee and €74 million is still outstanding. I am disappointed that little or no action has apparently been taken by the HSE or Minister Reilly to recoup that money.

I would call on the Minister and the HSE to clarify immediately what steps have been taken to collect this money by ensuring that consultants sign off on claim forms.  The public need to know what contract or disciplinary measures are being put in place to prevent a recurrence of this outrageous oversight which is affecting funding for patient care.

In a response to a parliamentary question on 12th January 2012 the Minister for Health indicated that he would have health service management engage with the consultant representative bodies, and that the timely completion of private patient claim forms was an issue he wanted to see addressed.

‘At this point, it is unclear if any action has been taken to collect the outstanding money, or if consultants have been told to ensure that they complete claim forms in a timely manner.’

‘Neither is it clear if consultants can be disciplined for not completing claim forms.’

It is unacceptable that this money remains outstanding, while patients suffer cutbacks in frontline services across the country in critical areas like home help.

ENDS

QUESTION NO:  228

DÁIL QUESTION addressed to the Minister for Health (Dr. James Reilly)

by Deputy Kevin Humphreys

for WRITTEN ANSWER on 12/01/2012

 

*  To ask the Minister for Health the disciplinary procedures that are being taken against hospital consultants who did not sign off on health insurance claim forms in a timely manner, resulting in the loss of €76 million to the State; if he will consider pursuing the individual consultants for these losses where negligence occurred; and if he will make a statement on the matter.

Kevin Humphreys T.D.

 

REPLY.

There is no explicit contractual requirement that medical consultants sign off on health insurance claim forms within an agreed timeframe. However, Consultant Contract 1997 provides that a consultant will co-operate with the employing authority in the collection of maintenance fees, while Consultant Contract 2008 provides that consultants are to work within the framework of the hospital/agency’s service plan and to ensure that functions are undertaken in a manner that minimises possible disruptions in service. Where there is a delay in finalisation of claim forms the charges due to public hospitals are not lost. Receipt, however, is delayed.  This impacts negatively on the hospital’s cash flow and financial position.

 

While the HSE and voluntary hospitals recoup considerable sums from private health insurance companies in respect of private and semi-private treatment services provided to their members, lengthy delays often occur between the discharge of patients and the receipt of payment from the companies. This has led to an unacceptably high level of debtor days with a significant amount in fees outstanding. Some hospitals are much more efficient at collecting this income than others.  It is intended that more hospitals will achieve the income collection standard of the better performing hospitals, and, as a result,  a target of €50 million in accelerated income has been set for 2012.

 

I have already indicated my intention to have health service management engage with the consultant representative bodies to achieve efficiencies, productivity increases and reform under the Public Service Agreement. The timely completion of private patient claim forms is among the issues which I wish to see addressed in this context.