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THERE ARE MULTIPLE investigations into a number of pharmacies which have been accused of effectively defrauding the State out of significant amounts of money in the last 10 years by making fraudulent pharmacy claims, TheJournal.ie has learned.
The HSE is carrying out at least ten Clause 16 investigations against several pharmacies in Ireland. A Clause 16 inquiry is the name given to serious internal investigations carried out by senior members of the health service.
Investigations are now ongoing into pharmacies based in north Dublin, Wicklow, Louth and Limerick. TheJournal.ie understands that this is not the entire number of pharmacies being investigated and it is believed more are being looked at.
The majority of these investigations centre around the practice known as phased dispensing.
Phased dispensing is used to prevent excessive or incorrect dosing by the patient. Instead of giving patients a month’s supply of their medication, they are given one week’s supply at a time.
This means pharmacies can claim dispensing fees for each time that the patient returns.
The HSE is investigating prescription claims made by the pharmacy as far back as 2013. The pharmacy can initially claim for €5 for the first dispensing fee. It can then claim over €3 for each additional phased claim.
Last week, TheJournal.ie revealed that a pharmacist, who has already been suspended from practicing due to other legal matters, was also being investigated for fraud.
Separately, the HSE is currently in the process of clawing back €10 million in dispensing fees it believes a number of pharmacies overclaimed. The HSE is carrying out a much wider investigation into a number of pharmacies which it suspects may have overclaimed for prescription charges.
TheJournal.ie understands that the total money being queried by the HSE runs into the hundreds of thousands of euro. A number of pharmacies have been sued by the HSE in recent months in relation to similar incidents.
A spokeswoman for the HSE said: “Due to the sensitive nature of Clause 16 investigations, the HSE is not in a position to comment in respect of this enquiry.”
Speaking in relation to phased dispensing, a spokesperson for the Irish Pharmacy Union said: “This is a vitally important facility for certain patients who cannot safely and effectively manage their medication regimen. Phased dispensing allows a patient’s pharmacist, family members and carers to support and ensure the safe and proper use of the medicine by the patient.
“If an allegation has been made, the pharmacist concerned is entitled to a proper investigation before any conclusion is reached.”
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Another thing that gets up my goat is that when you are given a month’s prescription you get 28-days!! One month of the year is 28 days so why not 30 days! It means you’re always short one month on the year and two 6-month scripts don’t get you through the year, means another script visit to the GP (€65) and another script fee!
@Lydia McLoughlin: l always ask for 31 days to be put on prescription as l agree you have to make a third visit instead of two per year. This is another racked that should be stopped.
@Orla Cosgrave: It is not a racket. It is because most packs manufactured by pharmaceutical companies come in 28s. Some come in 30s. When your prescription is dispensed most pharmacists will just hand out the full pack. Also, when packs with 28 are given out, most of the time the prescription will have 28, so the pharmacist is just following the instruction from the doc. If you want a 30 day supply, just ask your doc to write 30 on the prescription and/or ask your pharmacist to give you 30.
@Lydia McLoughlin: well as u know a lunar month is 28 days and lots of people forget there 13 months in a year but as people are superstitious about 13 it’s compounded down to 12 months ,not all months have 28 days so naturally the pharmaceutical companies take advantage,it means more money for them
@Lydia McLoughlin: very valid point.
Hopefully there made pay the money back, forgot where I was, not a chance.
@Michael Mulcahy: pharmacists are not part of the HSE/Public Servant nomenklatura. ‘Suspended’ does not mean ‘suspended on full pay’, overpayments will be clawed back.
I’m not a pharmacist, & have no time for pharmaceutical ‘overreach’, some of which is encouraged by the same nomenklatura. You’ll never hear of investigations of their subsistence, mileage claims, for one glaring example.
So is this that thing where if you e spent some time in hospital and you get a script, head to the pharmacy and they say they can only give you a week’s supply until you get your GP to do up the script “properly”. Then they’ll give you the remainder of the month with the GPs script!? Coz every pharmacy in the country is at that.
If this is the same thing, then shouldn’t GPs be looked at too for being complicit in the practice? Maybe I’m talking out me hole, but it sounds right to me.
@Engine No. 9: not the same thing this is more far reaching your doctor gives you a prescription for a months supply of let’s say your heart tablets but when you bring it to t u é chemist they give it to you at a weekly basis using excuse they are dangerous medication so for your safety they’ll break up prescription but in reality the can claim dispensing charge to hse of €14instead of €5 for same prescription
@Engine No. 9: The hospital emergency scheme is a legal issue, that’s how the system works and it’s not up to GPs/Pharmacists – they’d get in trouble if they didn’t follow the 7 day procedure.
@nelliekel: they provide a great service. They question medication on scripts if there is a change , especially if you are on long term meds. They give you a weeks supply of meds if you were not able to get to doctor. Hospitals dont give medical card scripts so you have to go to your own doc then for one. I have no doubt there could be abuse going on but it is with any system/ scheme if it can be chanced for gain, then it will be.
@Engine No. 9: the week of medication from a hospital script only refers to medical card patients, you receive a week of your medication on hospital emergency scheme you then need a regular medical card prescription from your doctor to collect the rest of he months medication
@Engine No. 9: how are GPs complicit? The rule for medical card prescriptions is that they must be filled out by a GP. That rule is in the department of health. If someone gets a prescription from the hospital after 6pm on a friday are they supposed to go until monday when the GPs surgery reopens before they start taking their prescription drugs.
I don’t see the issue with pharmacists charging a dispensing fee each time they’re dispensing a prescription. Why shouldn’t they be paid each time they make up, check and dispense a prescription. I’m not a pharmacist.
@Sirius: There is no problem with the dispensing fee per say. If you have a script for 1 month supply of tablets, you’d expect to receive the full supply when purchasing €4/€5 per purchase I believe. The problem arises when the pharmacist decides to dispense the tablets on a weekly basis at the same price thus allowing the pharmacist to make €12/€15 extra per sale.
@Marie Prendergast: the pharmacist doesn’t decided to dispense the medication weekly, it must be written on the prescription by the doctor that they want it dispensed weekly or fortnightly or whatever the case may be
@Marie Prendergast: the investigation only applies to full medical card patients pay a nominal charge hence why the hse are up in arms. In ottherwords the pharmacists are allegedly fraudulently claiming multiple dispensing fees when they should be only charging one. Another example of the tax payer being ripped off
@Marie Prendergast: the pharmacist follows the prescription, whatever the prescribing doctor writes on it is what they do. I still don’t see the issue with the pharmacist charging a dispensing fee for each dispensing.
Multiple investigations into multiple prescription scam…
Can doctors do this also? As I used to always get a months supply of tablets then it changed to i had to get them every week?
This won’t be posted if I name the group but a pharmacy group were fined 12 million euro for bad practice by the HSE in regard to claims for payment . Now were they the only group or pharmacy acting on loop holes for extra cash from the state body ? If the unnamed group were “at it” then it was pretty widespread . ..
That should cost a penny or two???
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