Alex White (Dublin South, Labour) | Oireachtas source

The amendment to section 48A(1) includes a requirement for a person with full eligibility to provide information on income and assets if so requested by the HSE. It does not make sense, however, to only apply this requirement to existing medical card holders. Therefore, we propose to delete the reference to "prior to the coming into the operation of this section".

Fair points were raised about the reviews, to which I will refer, but the amendment provides for a net change, which is that the power to review will be provided for in legislation in respect of all future medical cards issued. The current provision only provides for this power in respect of existing medical card holders. If this is agreed to by the committee, the same power will be extended to cover all medical cards issued in the future.

There are a number of ways to review eligibility. The first relates to the defined eligibility period - usually three years. The second is risk-based reviews, on which Deputy Billy Kelleher touched, based on specific criteria such as inactive medical cards or where information from other statutory bodies such as Revenue indicates the medical card should be reviewed. The third type is the so-called random review, while the fourth is use of the death event notification system which identifies the deceased and enables the cessation of capitation payments in cases where the GP or family have not notified the HSE.

The policy on random reviews arises from a recommendation of the Comptroller and Auditor General in his most recent report:

The HSE should conduct reviews of random samples of cardholders on an annual basis. This would allow the HSE to develop an estimate of the level of excess payment in the system as a whole. Tracking changes in this estimate of excess payment would allow the HSE to evaluate the effectiveness of its overall control strategy.

The total number of random reviews that have taken place is 2,628.

Those are the total number of reviews that have taken place on, as it were, a random basis. The other reviews I have mentioned, namely risk-based reviews and reviews based on the expiration of the eligibility period and so forth, are taking place.