Written answer
Health Services
GMS and GP visit card holders cannot be charged for clinically necessary routine blood tests; suspected improper charges should be reported to the HSE for investigation and refunds.
622. Deputy Brian Stanley asked the Minister for Health to outline and clarify charges regarding GMS patients for routine blood tests; and the steps her Department are taking to make sure people are not being improperly charged for routine tests. [66895/26]
Comment on this
GPs are private practitioners, most of whom hold a GMS contract with the HSE for the provision of GP services without charge to medical card and GP visit card holders.
Under the terms of the GMS contract, GPs are required to provide eligible patients with ''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". Persons who hold a medical card or a GP visit card are not subject to any co-payments or other charges in respect of such services.
The issue of GPs charging GMS patients for phlebotomy services is complex given the numerous reasons and circumstances under which blood tests are taken. Clinical determinations as to whether a blood test should be taken to either assist in the diagnosis of illness or the treatment of a condition are made by the GP concerned. There is no provision under the GMS GP contract for persons who hold a medical card or a GP visit card to be charged for clinically necessary blood tests.
Blood tests undertaken in the context of the GP Chronic Disease Management programme are covered by the fees paid to GPs by the HSE for this care.
Where a patient who holds a medical card or GP visit card believes they have been incorrectly charged for routine phlebotomy services (i.e. a blood test to either assist in the diagnosis of illness or the treatment of a condition) by their GP, or has been charged for a blood test provided under the Chronic Disease Management programme, then that patient should report the matter to their HSE Local Health Office. The local management, upon being notified of potential inappropriate charging of a GMS patient, shall contact the GP concerned and carry out an investigation into the complaint and will, where appropriate, arrange for a refund of charges incorrectly applied by that GP.
Fees charged by GPs outside the terms of the GMS contracts (and other HSE GP held contracts) are a matter of private contract between clinician and patient.