Department of Health: Family doctors have been overpaid by approximately €8.4 million for so called "ghost" medical card holders and the Department of Health has not recouped any of it, according to the Comptroller and Auditor General's report.
The number of GPs involved, it said, is approximately 1,780 and they were overpaid by amounts ranging from €31 to €42,000.
The overpayments originally came to light when the Department of Health began implementing a Government decision to extend medical card eligibility to all aged over 70, regardless of means.
When the decision began to cost millions more than anticipated, medical card lists were examined and it emerged that many on the lists were dead or had moved, but GPs were still being paid to treat them.
The Comptroller and Auditor General's 2003 annual report, published yesterday, stated that a removal exercise by health boards and the GMS (Payments) Board has now taken 104,236 names off the GMS register of medical card holders. Almost 30,000 of these were over 70.
While the Department of Health told the Oireachtas Public Accounts Committee a year ago that it intended to fully recoup the overpayments, to date no money has been recovered, the report added.
It said negotiations about this with the GPs representative body, the Irish Medical Organisation, were ongoing .
"The IMO resisted the recoupment of overpayments and maintained that GPs have been underpaid for certain other categories of medical card clients under 65, namely unregistered newborn babies and teenagers who become eligible for a card in their own right on reaching the age of 16," it said.
It added that given "the strong probability of a legal challenge" by the IMO to any efforts to get GPs to hand back the money, the Department of Health agreed to have the alleged underpayments examined.
"The IMO have only recently responded to draft terms of reference for an examination of alleged underpayments and have also raised a number of other concerns," the report said.
The IMO will meet the GMS Payments Board today to discuss the issue further.
The Comptroller and Auditor General, Mr John Purcell, added in his report that he had been told by the Department of Health that there was no provision in existing contracts with GPs that would allow for the automatic deduction of overpayments.
But he said the Department wanted to engage with the IMO on a wide-ranging review of general practice, including a full review of their current contract.
The IMO had refused "until certain industrial relations issues are addressed".
The IMO wanted, among other things, to be paid money due to GPs under the two most recent national pay agreements before it will talk about a review of GP contracts.
Meanwhile, the report stated that €6.4 million had been repaid to patients overcharged under the Drugs Payment Scheme.
Some 36,278 refund cheques were issued by the end of July, it said, with average refunds amounting to €177. With only a small number of refunds outstanding, the cost of administering the refunds has come to €55,000.
The overcharging happened when the threshold above which people could make claims under the scheme was raised in July 1999. However, the new changes were not signed into law by the then health minister, Mr Brian Cowen.
The new regulations did not, therefore, come in until February 2001, which meant people who had been claiming refunds in the intervening period were being assessed on the new threshold instead of the lower one.
Some 175,000 people were originally believed to have been overcharged between July 1st, 1999, and February 28th, 2001.