New measures aim to make it easier for public hospitals to be paid for procedures, writes MARTIN WALL
THE STATE’S largest health insurer, the VHI, has warned the Government that proposed moves to introduce measures aimed at making it easier for public hospitals to get paid for procedures would expose the company and its subscribers to significantly increased costs.
VHI has also said it considered “unlikely” the premise that tardiness on the part of hospital consultants in signing insurance company forms was responsible for the delay in public hospitals submitting claims.
The HSE has argued that over €160 million is owed to it in outstanding claims in respect of private patients treated in public facilities.
Minister for Health James Reilly has said he is to introduce measures which would allow the HSE to collect bills from insurance companies without having to wait on consultants to sign claims forms – a process known as “decoupling”.
The Irish Timesreported last year that a HSE report suggested that one consultant was responsible for outstanding claims of about €770,000 due to delays in signing insurance forms.
However, in correspondence to the Department of Health, the VHI has expressed concern at the proposals to allow for decoupling.
In a letter to the Minister, the chairman of the VHI, Bernard Collins, said decoupling would not deal with the root cause of the HSE’s cash-flow problems.
He warned that decoupling would also expose the VHI and by extension its customers “to significantly increased costs due to the additional resources that would be required to manage multiple separate claims submissions and to collate invoices in advance of consideration of same”.
In a separate internal report drawn up by medical director Dr Bernadette Carr, and submitted to the Minister, VHI said both HSE-run and voluntary public hospitals currently submitted claims considerably later following patient discharge than those in the private sector.
“The lead days for public hospitals currently stands at least double that for private hospitals.
“The HSE are currently saying that this delay is attributable to some consultants’ tardiness in signing claims forms. The HSE is, therefore, requesting that the requirement for them to collate all invoices associated with an episode of patient care be removed so the public hospitals can submit their invoices in advance of any others.
“VHI does not believe this will address the problem of delayed submission of claims by public hospitals and delayed payment.”
Dr Carr’s report said VHI regarded the HSE’s premise as “unlikely”.
She said the same requirements for submission of claims existed for both public and private hospitals and in many cases the same consultants practised in both sectors. “The consultant cohort in both hospitals is almost entirely the same, making it very unlikely that the considerably longer lead times . . . are attributable to them.”