Mary Hanafin (Dún Laoghaire, Fianna Fail)

Changes to the treatment benefit scheme were announced in the 2010 budget. From 1 January 2010, treatments available under the scheme are limited to a free optical and dental examination together with the treatments previously available under the medical appliance scheme, namely hearing aids and contact lenses required for medical reasons. People who at 31 December 2009 were undergoing a course of treatment or who had applied for approval to commence treatment will have their applications for dental benefit processed under the rules that operated prior to 1 January 2010.

In the period immediately after the changes were announced in the budget, there was a sharp increase in the number of inquiries from customers and from dentists on behalf of customers seeking approval for dental treatment. From the level of correspondence received from some dentists, it was clear they were submitting bulk applications on behalf of their patients. Claims involving many hundred customers were received from eight dental practices. These applications were supplied in alphabetical order as if downloaded from a database.

On checking with a number of customers, it became evident that many of them had not approached the dentist to seek treatment nor had they authorised the dental practice to submit an application on their behalf. The dentists concerned were contacted and agreed to withdraw the inquiries and resubmit them in the proper manner.

In order to avoid any repetition of the problem, a letter was issued to all dentists clarifying the procedures to be followed in submitting eligibility and approval inquiries. These procedures include the need to ensure that the patient had given approval for the inquiry to be made and the need to provide a confirmed appointment date and contact number for each customer. This was difficult in some cases because the customers had passed away. It has been noted that since the letter issued, the majority of inquiries have been submitted in the correct manner. Inquiry applications received without all the relevant information are being returned. A number of dentists have been in contact with the Department since the issuing of the letter to advise that they submitted inquiries in error, to ask for them to be withdrawn and to advise that they will submit a revised list of inquiries in the correct manner. It is estimated that over 150,000 eligibility inquiries for dental treatment were received in the period between budget day and 31 December last. The inquiries in question are being processed. It strikes me that dentists were very busy in the ten working days between budget day and the end of the year. Priority is being given to confirming patient eligibility. Officials will perform spot checks on inquiries to ensure that they were submitted properly and with the consent of patients. Any breaches of the guidelines will be reported to the Office of the Data Protection Commissioner for appropriate follow-up action.

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