Michael Healy-Rae (Kerry South, Independent)
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171. To ask the Minister for Health the circumstances that exist that allow a general practitioner to bill a private health insurer for a minor surgical procedure when the person involved has a medical card; and if he will make a statement on the matter. [19731/14]

Alex White (Dublin South, Labour)
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Under the terms of the GMS contract ‘the medical practitioner shall provide for eligible persons, on behalf of the Health Service Executive, all proper and necessary treatment of a kind usually undertaken by a general practitioner and not requiring special skill or experience of a degree or kind which general practitioners cannot reasonably be expected to possess’.  The medical practitioner shall not demand or accept any payment or consideration from a GMS patient other than payments from the HSE as outlined under the terms of the contract, which include fees for procedures such as excisions/cryotherapy/diathermy of skin lesions; suturing of cuts and lacerations; and recognised vein treatment.

If a general practitioner provides a service to a GMS patient that is covered by the GMS contract, the GP is precluded from accepting payment either from the patient directly or from other sources such as the patient’s private health insurer.  Claiming against a health insurance policy is a matter between the insured and the insurer. It is the insurer's responsibility to satisfy itself that a claim is valid under the terms of the policy.