Medical card GPs receive €1.8m in overpayments

General practitioners operating the medical card scheme received a net overpayment of around €1.8 million, a long-running investigation carried out by the Department of Health and the Health Service Executive (HSE) has found.

The HSE review, assessed by external consultants, found GPs had been overpaid by €6.5 million in some areas of the scheme and underpaid by around €4.7 million in others.

However, it is unclear as to whether individual GPs who benefited from the net overpayments will have to pay the money back to the Exchequer.

The controversy over the payments to GPs for treating "ghost" patients, who in reality were either dead or ineligible, has been ongoing for about five years.

The overpayments originally came to light as part of an assessment of medical card lists following the Government's decision to extend the scheme to everyone over 70.

In his report in 2003, the Comptroller and Auditor General maintained that GPs in the medical card scheme had been overpaid by about €8.4 million for treating "ghost" patients. The Comptroller estimated that nearly 1,800 GPs had benefited from the overpayments with amounts ranging from €31 to €42,000.

The Dáil Public Accounts Committee later recommended that efforts should be made by the Department of Health "to achieve a satisfactory and fair outcome in the matter of recovering overpayments made to GPs on foot of invalid medical cards".

The Department of Health had indicated at the time that GPs would have to repay the money provided in error. However, GP leaders had claimed that family doctors had been significantly underpaid in other areas of the scheme, particularly in relation to delays in the registration of newborn infants.

In a report to the Public Accounts Committee last week, the Department of Finance said its Minister, Brian Cowen, had been informed that the HSE review had uncovered a net overpayment to GPs of approximately €1.8 million.

"The Minister has been informed that decisions regarding next steps will need to be informed by an analysis of the degree of under/overpayment by individual GPs, as well as other considerations such as the contractual review negotiations, the potential administrative workload in dealing with the recovery repayments to individual GPs and the benefits which should accrue from the requirement [under the Labour Relations Commission's agreement of 2005] that GPs now play their part in the joint management of the client register. The matter will be kept under review to ensure that outstanding overpayments are eliminated where this is appropriate."

The Department of Finance said that Mr Cowen agreed with the committee that it was important that payment systems in place "must be based on accurate and timely information to ensure correctness" .