‘Ghost’ medical card bill costs us €210m

Medical cards for people who are dead, have left the country or are no longer entitled to them are costing the taxpayer as much as €210m a year.

A major review of payments to GPs who treat medical card patients has found large numbers of “redundant cards” are still being paid for by the exchequer — despite there being no need for their existence.

The review of the Primary Care Reimbursement Scheme, drawn up by PricewaterhouseCoopers (PwC) on behalf of the HSE, said “ghost” cards are costing the State between €65m and €210m every year.

A HSE spokesperson said the figures in the report, obtained by the Irish Medical Times, are an estimate only “and cannot be relied on for any purpose other than providing a broad understanding of the potential scale of excess expenditure”.

This is because a full audit of all people who have medical cards did not take place — meaning it is not known exactly how many people still have cards despite having died, left the country or being no longer eligible.

Despite this disclaimer, the 52-page document — commissioned in February as part of a review of the controversial centralisation of the medical card scheme — said there is a real risk taxpayers are paying out far more than they should to provide medical cards.

“Concerns have been documented in the past regarding the number of ineligible or invalid medical/GP cards in existence. These related to cardholders who are no longer eligible, cardholders who are deceased or who have left the country.

“Estimates of excess payments under the scheme could be in the range of approximately €65m to €210m per annum. Significant savings in annual expenditure could therefore arise as a result of the identification and removal of these ineligible cardholders.”

Responding to the report, which said there is an urgent need to “enforce” the removal of cards if people do not respond to queries, the Irish Medical Organisation, which represents GPs paid to treat medical card patients, said the accuracy of the medical card list is not its responsibility.

A spokesperson said the Primary Care Reimbursement Scheme has accepted responsibility for the GMS list.

Limerick-based GP Dr Mary Gray said there are also cases of doctors effectively being shortchanged because they are treating patients who should be entitled to medical cards, but who are not on the list.

“Studies which GPs have done have identified an error margin of 10%. This involved underpayments to GPs,” she said.

A HSE spokesperson said the PwC review was commissioned to highlight where excess expenditure through the scheme is taking place.