Sunday, February 11, 2007

Hospital fraud?

Last Wednesday’s Irish Times reported Health Minister Mary Harney as saying in a Dail debate that if a private patient arrived in a public hospital, the consultant received a fee, irrespective of what bed the patient was in.

This seems to indicate that anyone with private health insurance is charged for their stay in a public hospital, regardless of how they got there or what treatment they received.

If you arrive in a public ward bed in hospital via their A&E Department or via a public waiting list, surely your PRSI payments have covered you for this service? Why should your health insurer be asked to pay on the double?

What are the implications if hospitals are charging VHI, BUPA & Vivas for routine admissions to public beds and associated procedures?
1. People who pay both PRSI & Health Insurance are deprived of their entitlements under PRSI.
2. Costs for Health Insurers are inflated with the knock-on effect on annual premiums for members.
3. The hospital is incentivised to extend your stay as a revenue generating measure, when there is clearly a shortage of beds.

Are we in a situation that, in those circumstances, you should refuse to provide information about having health insurance, unless you are being provided with a bed in a private or semi-private ward?

If this is how the system operates, could this be a fraud perpetrated against the health insurers by the hospitals?

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