GPs in County Galway who charge Medical Card holders an additional fee for blood pressure monitoring and blood tests are in breach of their contracts for doing this, the Regional Health Forum was told this week.
Cllr Daithi O Cualain said that there is an ongoing issue of Medical Card holders being charged an additional fee for certain services by some GPs within county Galway.
“For example 24 hour blood pressure monitoring, routine bloods and other services. Is it intended to refund medical card holders who have been charged incorrectly for services which are covered by their medical cards,” he asked.
In response to his question, the National Contracts Office, Health Service Executive, Primary Care Strategy and Planning confirmed that routine blood tests are included under the General Medical Services (GMS ) contract and therefore should be provided free of charge to GMS patients.
“Paragraph 11 of the GMS contract, states that ‘the medical practitioner shall provide for eligible persons, on behalf of the Health Service Executive, all proper and necessary treatment of a kind usually undertaken by a general practitioner and not requiring special skill or experience of a degree or kind which general practitioners cannot reasonably be expected to possess.’
“It is also outlined in paragraph 27 of the GMS contract that a medical practitioner shall not demand or accept any payments of consideration whatsoever in reward for services provided by him/her, or for travelling or for other expenses incurred by him/her or for the use of any premises, equipment or instruments in making the services available.
Since May 2016, the HSE has been providing funding to GMS General Practitioners (GPs ) for the provision of 24 Hour Ambulatory Blood Pressure Monitoring for diagnosis and treatment of hypertension on behalf of GMS patients.
It said that where evidence is provided to the HSE by GMS patients of charges being sought from GPs for phlebotomy the matter is dealt with on a case by case basis.
“Where appropriate, the HSE will arrange a refund of costs incorrectly applied by the GPs and re-coup the value from payments to GPs.”
Specifically in relation to County Galway the Primary Care Unit has confirmed that it has received 15 communications in the past year from GMS patients relation to phlebotomy charges and none in respect of charges for 24 hour BP monitoring.
