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Written Answers - Medical Cards

Tuesday, 7 February 2012

Dáil Éireann Debate
Vol. 754 No. 3

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 536.  Deputy Michael Healy-Rae Information on Michael Healy-Rae Zoom on Michael Healy-Rae  asked the Minister for Health Information on James Reilly Zoom on James Reilly  if he will expedite an application for a medical card in respect of a person (details supplied) in County Kerry. [6800/12]

[545]Minister of State at the Department of Health (Deputy Róisín Shortall): Information on Róisín Shortall Zoom on Róisín Shortall As this is a service matter it has been referred to the Health Service Executive for direct reply to the Deputy.

 537.  Deputy Kevin Humphreys Information on Kevin Humphreys Zoom on Kevin Humphreys  asked the Minister for Health Information on James Reilly Zoom on James Reilly  if there has been a general review of medical cards for all those over the age of 70 years taking into account the change in eligibility introduced on 1 January 2009; and if he will make a statement on the matter. [6783/12]

 538.  Deputy Kevin Humphreys Information on Kevin Humphreys Zoom on Kevin Humphreys  asked the Minister for Health Information on James Reilly Zoom on James Reilly  the options available to a person over the age of 70 years who voluntarily gave up their medical card when the eligibility criteria were changed on 1 January 2009; if it will be possible to have their medical card from before 1 January 2009 reinstated; and if he will make a statement on the matter. [6784/12]

Minister of State at the Department of Health (Deputy Róisín Shortall): Information on Róisín Shortall Zoom on Róisín Shortall I propose to take Questions Nos. 537 and 538 together.

Eligibility for medical cards specifically for those over the age of 70 years is based on means. Under the Health Act 2008, the income thresholds for entitlement to a medical card for persons aged 70 and over is €700 (gross) per week (€36,500 per year) for a single person and €1,400 (gross) per week (€73,000 per year) for a couple. Income thresholds are reviewed annually. The last annual review was conducted in September 2011 and a decision was taken not to amend the income thresholds. There are no plans to change the eligibility criteria at this time.

A new streamlined user-friendly medical card review process for the over 70’s was recently introduced by the Health Service Executive which ensures that where a person’s circumstances have not changed since their last review/application, they simply certify this and return a single sheet review form to Primary Care Reimbursement Service central office. Where their circumstances have changed to the extent that they may no longer be eligible for a medical card, their case is reviewed in the normal way. The validity period for medical cards issued to people aged 66 and over is now 4 years. Notwithstanding, there continues to be an obligation on all card holders to notify the Health Service Executive of any change in their circumstances which would disentitle them from holding a medical card.

 539.  Deputy Michael Healy-Rae Information on Michael Healy-Rae Zoom on Michael Healy-Rae  asked the Minister for Health Information on James Reilly Zoom on James Reilly  his views on the medical card application process and the associated long delays; and if he will make a statement on the matter. [6793/12]

Minister of State at the Department of Health (Deputy Róisín Shortall): Information on Róisín Shortall Zoom on Róisín Shortall The final part of the centralisation project took place on the 1 of July 2011 with the centralisation of Medical Card processing and associated tasks for the entire country in the Primary Care Reimbursement Service (PCRS) office in Finglas, Dublin.

For the first time in the State’s history a single uniform system of application processing has been put in place. This system replaces the different systems previously operated through more than 100 Offices across the country. Some of the changes that have been introduced include the medicalcard.ie website and the standardisation of medical card assessments.

However, I am aware that there have been difficulties. These issues are a matter of serious concern and I have held several meetings with the HSE to raise the concerns. As a result of these discussions a number of changes are being introduced to the medical card application system. These changes will assist in speeding up the turn around for applications by easing the level of pressure on the medical card system, particularly with respect to the review process [546]which, due to the timing of the re-issuing, and hence review, of a large cohort of medical cards has placed a large demand on the resources of the centralised office.

In 2010 the Central Office introduced a self assessment review process for people aged 70 years and over, as that cohort was managed entirely by the central office. Following on from this development the HSE has eased the review process for all pensioners. The change will mean that reviews for medical card holders who are 66yrs or over will operate on a self-assessment basis, as currently happens with over-seventies. The self-assessment review model will also be extended to medical card holders under 66, who were granted their medical card on the basis of a means assessment, where the HSE is satisfied is living in this jurisdiction.

The HSE is also standardising eligibility periods from two years to three years for people aged under 66yrs, with a new four year eligibility period for medical card holders aged 66 or over. Notwithstanding, there continues to be an obligation on all card holders to notify the HSE of any change in their circumstances which would disentitle them from holding a medical card. The HSE is in the process of arranging access to data in the possession of the Revenue Commissioners and the Department of Social Protection to allow them conduct reviews without troubling medical card holders for further documentation. It is also intended to increase the fine applying to false claims in a forthcoming Bill.

Discretionary cards, emergency cards and cards held by people in a small number of other categories will continue to be reviewed in the normal way, but the HSE are confident that the extension of the self assessment model to the great majority of medical card holders will simplify the process substantially, will improve the service to the client and will improve turnaround times for reviews. It is hoped that ultimately about 80% of renewals will be dealt with in this way. This new process also focuses attention on active users of the Medical Card to ensure that those most in need are involved in the streamlined process.

In addition, from this month, the HSE will implement a new system that gives GPs the additional ability to identify and assist the most vulnerable Medical Card holders in our society. GP’s will be able to maintain the eligibility of these patients where they are going through the renewal system. GP’s will also be able to add new babies onto the medical card system on-line.

I wish to emphasise that in no circumstances should a medical card holder who genuinely engages with the review of their medical card have their entitlement withdrawn before that review is complete. Some such cases were brought to my attention in recent weeks and this is unacceptable. The HSE is taking steps to ensure that this rule is properly implemented.

In addition the PCRS’s central office is working to deal with some of the processing issues that have been arising. This has included reviewing and refining their systems for the receipt and logging of applications and documents being sent in as a result of requests for additional information. In addition, the PCRS has received further staff resources this month as a result of a transfer from the Central Statistics Office and this should make an impact on processing times. I am continuing to engage with the HSE with regard to other possible improvements.

I will continue to monitor the situation and have arranged to meet the HSE on a regular basis to discuss any issues which may arise with respect to medical cards.


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