# "Health Repayment Scheme":  Scheme Administrator KPMG is not very efficient.



## pjq (25 Jun 2007)

My Uncle died in 2003 having spent years an institution , we decided to reclaim the costs taken from his pension under the famous Mary Harney scheme.
We filled in the forms in Aug 2006 , since then "The Scheme Administrator" has; 
1. returned the Grant of Admin. 
2. one month later , we were informed that we must send them the Grant of Admin - within 2 weeks!! ( had they lost it ?? ) 
3. and now after 10 months , they noted that the Peace Comissioner had not entered his address on the form.
Maybe I'm just unlucky , but I have the feeling that "The (nameless) Scheme Administrator" is not a very efficient administrator . Are others having similar issues ? 
PJQ
ps  I searched "health repayment" and found nothing


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## steph1 (26 Jun 2007)

*Re: Health Repayment Scheme*

Log onto www.repay.ie.

I have had similar problems with forms being sent back to me looking for additional information which had already been forwarded to them.  I am also claiming back the costs that they took from my late father's pension plus my owns costs as I had to pay a monthly fee to the nursing home.


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## pjq (26 Jul 2007)

*Re: Health Repayment Scheme*

An UPDATE

I just got the "Decision of Scheme Administrator" , there is an amount for 2002 and one for 2003 plus an inflation adjustment . However in the 6 page letter there is no explanation of how the amounts are calculated or more importantly , why is there no refund for the 8 years before 2002 when he was over 66 and thus pensionable .

The repayments for 2002 and 2003 are roughly 80% of the Non Cont. Pension , which would be as forseen in the Act. 

NEXT STEPS
I think that I will call both the Administrator and Citizens Information  to find answers . Anybody in a similar situation ? any suggestions?
PJQ


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## steph1 (27 Jul 2007)

*Re: Health Repayment Scheme*

'why is there no refund for the 8 years before 2002 when he was over 66 and thus pensionable'.

See www.repay.ie 

How to Make a Claim
1. Who should apply for repayment?
The scheme allows for the repayment of charges to the following people:

Living people who were wrongly charged at any time since 1976 

The estates of people who were wrongly charged and died on or after 9 December 1998 (the cut off point for claims relating to deceased people) 
People falling into the above categories should apply for repayment.

There will not be a refund for 8 years before your uncle died that would mean a refund from 1993 onwards.  But you should check as to why there is no refund from 1998 to 2001


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## pjq (3 Aug 2007)

*Re: Health Repayment Scheme*

Another Update

I called Citizen Info. - they could not tell me if others having the same problem .

I called Scheme Admin. ( this is not part of our civil service , its outsourced to KPMG ) - they gave me another no. to call
I called 2nd no. - the no. was the Appeals Info line and the civil servant there told me , they have no access to the calculations , they have asked them (KPMG) not to direct queries on the detail to the Appeals section .
I wrote to KPMG - " let me have calculations within 14 days so that I can decide whether to appeal the calculations"     
They phoned immediately - " to get the calculations you need to tick the appeals form and sign it" ( I asked for clarification )   this is a Less-Than-Straightforward way of saying go the appeals procedure we wont give you any explanation.

Conclusion , dealing with the Systems Administrator is less-than-straightforward. They have peed me off , mind you they have had a year in which to do it . We will appeal !


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## pnh (7 Aug 2007)

*Re: Health Repayment Scheme*

How about an email to ministers_office@health.irlgov.ie. Can't do any harm can it.Your post caused me to dig out my file for a claim made on behalf of my mother.I made the claim getting on for a year ago now and apart from a letter in Jan last asking for a piece of of info which I believe I included in the original claim-I have not heard a word since.
Time to start chasing this up I think.


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## dubdoc (5 Sep 2007)

*Re: Health Repayment Scheme*

I have had all of the same problems, I wrote to them on behalf of my grandfather who had sent in his claim form(remember people that were still alive would be prioritised) over a year ago, I asked them for confirmation firstly they had recieved all the forms he had sent and secondly for some clarification of when they would start to make these refunds.  After a huge amount of time wasted speaking to people who did'nt actually seem to know themselves what was going on, they then informed me they had lost ALL his forms, and would send him duplicates to complete yet again!!  Did this and still have not even had a letter of confirmation from them, he has now taken to telephoning himself every day, sometimes twice, and even knows some of the call centre staff on first name terms! It has really given him something to get up for every morning, that is the only one good thing I can say about the whole system.


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## steph1 (6 Sep 2007)

*Re: Health Repayment Scheme*



pnh said:


> How about an email to ministers_office@health.irlgov.ie. Can't do any harm can it.Your post caused me to dig out my file for a claim made on behalf of my mother.I made the claim getting on for a year ago now and apart from a letter in Jan last asking for a piece of of info which I believe I included in the original claim-I have not heard a word since.
> Time to start chasing this up I think.




I have been on to this office twice lately, once by phone where I was informed that my application had been processed through to calculation stage and that basically all was in order.  That was about 6 weeks ago.  I think the file is literally sitting in somebody's in-tray waiting to be approved.  I emailed them the other day and got a reply stating that my application was being processed.

It seems to be taking an awful long time to process something that should be relatively straightforward.  I will keep on top of this now.  Maybe if enough applicants keep phoning or emailing it might make them speed up the process.


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## steph1 (21 Sep 2007)

*Re: Health Repayment Scheme*

See another new website set up for this scheme if you wish to appeal.  Might need this when the scheme administrator finally gets around to making a decision on the application in the first place.

[broken link removed]


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## steph1 (25 Sep 2007)

*Re: Health Repayment Scheme*

Has anybody here received any payments yet from this scheme?


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## pjq (25 Sep 2007)

*Re: Health Repayment Scheme:  Scheme Administrator is not very efficient.*

Another UPDATE
So I went ahead and filled out the "Appeal" form ,,, and a week later I got another form to fill out ( reasons for appealing) ., how very typically efficient!

 I posted the reply to the Appeals Office ( part of Civil Service ) and in exactly 1 week  , I had a copy of the calculation and an explanation as to why the claim only covered 2 out of 20 years spent in care AND the name of the person who supplied the info at the care institution , WOW!

Now I need to find out how the man spent 18 years in care without being in "long-stay care" and thus didn't incurring "long-stay charges" when he became pensionable . But Social Welfare might be able to help here .

pjq


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## steph1 (7 Oct 2007)

*Re: Health Repayment Scheme:  Scheme Administrator is not very efficient.*

I have just taken out a copy of my claim form and it is exactly a year to the day that I submitted the claim on behalf of my late father.

This is a ridiculous length of time to be waiting for this to be settled.  I have not even received a notification from the Scheme Administrator giving me any idea of how much the claim will be.  

Think as a previous poster has suggested an email to the minister's office might be in order.


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## pnh (16 Oct 2007)

*Re: Health Repayment Scheme:  Scheme Administrator is not very efficient.*



steph1 said:


> I have just taken out a copy of my claim form and it is exactly a year to the day that I submitted the claim on behalf of my late father.
> 
> This is a ridiculous length of time to be waiting for this to be settled.  I have not even received a notification from the Scheme Administrator giving me any idea of how much the claim will be.
> 
> Think as a previous poster has suggested an email to the minister's office might be in order.


Just wonder if anyone has made progress with this.Had a response to a letter I wrote in August-basically telling me little I did not already assume.This sentence for instance:
"Unfortunately,due process in respect of gathering essential information neccessary to accurately and efficiently process claim applications is unavoidable".
Just how long does it take to gather essential info.?Months-certainly.Years?? They already have accurate info from me and just need to verify it.
Looking more and more like serious measures need to be taken..anyone have Joe Duffys number


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## steph1 (26 Oct 2007)

*Re: Health Repayment Scheme:  Scheme Administrator is not very efficient.*



pnh said:


> Just wonder if anyone has made progress with this.Had a response to a letter I wrote in August-basically telling me little I did not already assume.This sentence for instance:
> "Unfortunately,due process in respect of gathering essential information neccessary to accurately and efficiently process claim applications is unavoidable".
> Just how long does it take to gather essential info.?Months-certainly.Years?? They already have accurate info from me and just need to verify it.
> Looking more and more like serious measures need to be taken..anyone have Joe Duffys number



I love that expression - 'due process'.  To me it looks like they are saying we will get around to it eventually.

Any letters or emails that I have received from the scheme administrator look like normal run of the mill standard letters that issue when somebody writes in or sends an email - makes it look like the application is being dealt with.

I am seriously beginning to wonder if there is now a problem with this scheme and the repayment of monies owed to those of us who had no alternative but to have our loved ones cared for.  Bearing in mind the current situation in the HSE and the cutbacks that are going on.

I have sent three emails to the contact email address for this scheme over the last two weeks and I have not received a reply to any of them.

As per the above quote and gathering essential information, I went to the trouble of contacting the hospital where my late father was and they forwarded me copies of receipts and I also had to get onto my bank who I have to say were most helpful in getting me copies of all the cheques that I had written.  

Is anyone else on here following up applications at the moment?


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## steph1 (1 Mar 2008)

*Re: Health Repayment Scheme:  Scheme Administrator is not very efficient.*

Have any of the other posters on this thread any updates on their applications under this repay scheme?

I decided to send a further email last week as it is last September (07) since I've had anything in writing from this body and despite ringing in mid December and been told that my application was ok and has been forwarded on for processing thats all the communication I've had.

This is the reply that I received from the so called Scheme Adminstrator

'Thank you for your mail. 


The claim is being assessed at present. The Deadline for the Scheme was

December 31st 2007. We are not accepting any new claims and are 
concentrating on making payments on all existing claims. Unfortunately
 there 
is no definate timeframe that we can give you. 

We will be in touch with further information as soon as possible. 

Regards, 

Scheme Administrator 


Now I know well what the deadline for the scheme was which was one of the reasons why I made sure that my claim was forwarded as soon as I could process it.  A cousin of mine has had her claim processed and paid out and she received this a few months ago and I was just curious as I had my own claim in a good few months ahead of hers.


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## csirl (3 Mar 2008)

*Re: Health Repayment Scheme:  Scheme Administrator is not very efficient.*



> I posted the reply to the Appeals Office ( part of Civil Service ) and in exactly 1 week , I had a copy of the calculation and an explanation as to why the claim only covered 2 out of 20 years spent in care AND the name of the person who supplied the info at the care institution , WOW!


 
So are you saying that the civil service adminstrators are more efficient than the KPMG private sector ones?


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## Black Sheep (4 Mar 2008)

*Re: Health Repayment Scheme:  Scheme Administrator is not very efficient.*

Does anyone remember the Ombudsman's report of 2003 or 2004 in which he (Michael Mills) stated that claims which were not processed within one year would be entitled to extra payment to compensate for "Lack of spending power". 
Seems to me some of you may have a claim.

I have no involvement in either claiming or processing claims


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## Complainer (4 Mar 2008)

*Re: Health Repayment Scheme:  Scheme Administrator is not very efficient.*



csirl said:


> So are you saying that the civil service adminstrators are more efficient than the KPMG private sector ones?



Sssshhhh - Don't tell Purple. His head would explode.


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## pjq (2 May 2008)

*Re: Health Repayment Scheme:  Scheme Administrator is not very efficient.*

OPs Update

I called the institution where my Uncle spent 18 yrs ,  they could see from the last few years records that he had not been charged for all the periods of care when he could have been charged , there were other periods when he lived in a community within the institution when his contributions don't fall within the scheme . They even offered to check older years . I decided not to put them to the trouble as I do believe them when they say that they did not always charge when they could have , what a chaos!  
I informed them in Oct 07 , that I was in agreement with their calculation , got more papers to sign in March 08 ,,,   finally got the payment within a month of signing .
pjq


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## steph1 (2 May 2008)

*Re: Health Repayment Scheme:  Scheme Administrator is not very efficient.*

Just to update on my case I finally got my cheque two days ago and to be fair thanks to a local TD who I asked to intervene on my behalf.  Now I am not normally in the habit of running to a TD in cases like this but to be honest I was sick of the same old emails and same phone calls and going nowhere fast.

I had paid for my father's care from my own resources.  Now in the application form there was a 'Section F' which was to be completed if you paid for any of the care in the nursing home from your own resources.  And following a letter from the TD the HSE sent me a letter saying that if I would agree to withdraw Section F they could process the claim quicker.  Cannot figure out for the life of me why this Section was on the form for if it was not to be filled in.

Anyway its all sorted out now and I was happy with the claim offered.  Anyone else on this forum that has a claim keep in touch with the Scheme Administrator and if nothing is happening an email or a phone call to your local TD may help.


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## becky (2 May 2008)

*Re: Health Repayment Scheme:  Scheme Administrator is not very efficient.*



Complainer said:


> Sssshhhh - Don't tell Purple. His head would explode.


 

Thats exactly what I thought.


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## pytelium (6 May 2008)

*Re: Health Repayment Scheme:  Scheme Administrator is not very efficient.*

This is my first post and I am fuming over this set up. I have entered claims  for both my late mother and father over a year and have been constantly on the phone to the helpline since last October.It has been excuse after excuse after excuse.We have been told that the files are in calculation since last November. About 6 weeks ago we were told that they were issuing 300 to 400 letters a week and that the everyone would be paid out by August 2008. When I ask them the total number of claims unpaid, a primary school child could work out that it would take up to 2 more years,not a few months to pay out. Lately they have changed their story,now ALL the letters will be sent out in bulk. Meanwhile I read in the papers that the majority will be paid out by June 2008,witha SMALL few to pay after that...

Should I believe this after all that has gone on..

I wrote to my local TD last November..I did not speak to him..but his secretary rang me and said she enquired and got the same answers I did. This guy is also a Minister of State..and he has not done anything for me either..

There must be many people in the same boat as I am..


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## pjq (6 May 2008)

*Re: Health Repayment Scheme:  Scheme Administrator is not very efficient.*

Maybe try an opposition TD , they might be more agressive . FFers don't want to hear about problems in the health area , they won't make a fuss because it highlights their failure to manage the health "services".
It would be interesting to know how much KPMG got paid for their assistance , I can immagine that its a pretty penny , especially when you think that most of the work ( finding old files that show from whom deductions were made ) is work carried out by local hospital admin. staff . In addition , appeals go to HSE staff.  
pjq
PS I have nothing against KPMG , they have a super worldwide reputation ......  and here in Ireland Mary Harney and the HSE have an unequalled reputation .


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## SiobhanLAW (8 May 2008)

*Re: Health Repayment Scheme:  Scheme Administrator is not very efficient.*

Hi All

I applied for repayment for money taken from my late aunt mostly because of the harassment she received from the Health Board for payment of this each month and the phone calls I used to get at work from members of the Western Health Board looking for the payment.

Although I have receipts for all the money and letters from the health board about the fees my claim was rejected on the grounds that she was in a private nursing home. She was in a Western Health Board hospital and had a medical card (which I still have). I sent off an appeal and photocopied the receipts, letters etc.

Today I received a letter telling me that my appeal has been rejected on the grounds that she was in a private nursing home which she wasn't.
It appears to me that this final rejection letter was sent out as standard without the file even being looked at. I phoned up but cannot speak to the Appeals Officer - was just told to write in but as I pointed out what is the point in writing in when clearly my original appeal wasn't even read as I felt I had a cast iron case since I have her medical card and receipts and letters.
What steps can I take now. Does anyone else feel the appeals is a con.


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## aircobra19 (8 May 2008)

*Re: Health Repayment Scheme:  Scheme Administrator is not very efficient.*

This seems to be a common experience. Not related to this scheme but to get payment for a relative of monies owed from the Health Board for something else we made endless phone calls and letters, for about 3 yrs and got nowhere. They simply did nothing except play phone and letter bingo with us. Like others who posted earlier we reverted to getting our local TDs involved, and only then were the payments made.


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## Welfarite (8 May 2008)

*Re: Health Repayment Scheme:  Scheme Administrator is not very efficient.*



SiobhanLAW said:


> Hi All
> 
> I applied for repayment for money taken from my late aunt mostly because of the harassment she received from the Health Board for payment of this each month and the phone calls I used to get at work from members of the Western Health Board looking for the payment.
> 
> ...


 
The basic point of appeal appears to be that the hospital was a public hospital and not a private one. Have you given them evidence of this to support your contention?


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## SiobhanLAW (8 May 2008)

*Re: Health Repayment Scheme:  Scheme Administrator is not very efficient.*

Hi

Yes, when I sent off the appeal form I submitted photocopies of both receipts and letters from the Western Health Board which were on headed paper from the Health Board. 

It just looks to me as if the Appeals Officer didn't even read the file or he would have seen these photocopies and copies of letters that I had sent on behalf of my late aunt (while she was alive) to the then Minister for Health and the Taoiseach. 

Maybe because I'm currently living in the UK they think that I'm just chancing my arm cashing in on a dead relative but this isn't the case. I only moved here after she (RIP) passed away and was very close to her as she was like a mother to me so I know how upset she was having to give up her pension and because of that also having to ask me to pay some of her bills  - didn't mind doing that at all as she had done a lot for me when I was young but she did find it humiliating that she was left with no money of her own. I'm on a cruasade with this as I believe the stress of it contributed to her death. 
A month after she passed away the Health Board wrote to me asking me to pay for her last month as they hadn't collected it!!!


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## pytelium (9 May 2008)

*Re: Health Repayment Scheme:  Scheme Administrator is not very efficient.*

You were entitled to an oral hearing when you lodged an appeal..the law itself will be challenged in the high Court(4 years time) and it could take 7 years for the law to be overturned if there is Supreme court appeal..


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## steph1 (9 May 2008)

*Re: Health Repayment Scheme:  Scheme Administrator is not very efficient.*

But in all fairness isn't it a disgrace when people had no choice but to have their loved one's looked after and had to pay for this out of their own resources and then have to go down the road of sending letters, emails and resorting to contacting TD's etc in order to have their monies refunded to them.  Its a disgrace in this day and age that these schemes take so long to administer.  Too much red tape as usual.

I am very thankful that I have been sorted out and am extremely grateful to my own local TD for intervening on my behalf.  His vote is safe come the next election


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## aircobra19 (9 May 2008)

*Re: Health Repayment Scheme:  Scheme Administrator is not very efficient.*

Theres something deeply wrong in the HSE.


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## steph1 (9 May 2008)

*Re: Health Repayment Scheme:  Scheme Administrator is not very efficient.*

Agreed.  Too many chiefs, managers managing managers etc. etc.  Its not the doctor's or nurses fault but the stupid systems they have to abide by.


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## pjq (9 May 2008)

*Re: Health Repayment Scheme:  Scheme Administrator is not very efficient.*



steph1 said:


> I am very thankful that I have been sorted out and am extremely grateful to my own local TD for intervening on my behalf.  His vote is safe come the next election



A TD voting for a 1st World, well managed, Health Service is like a turkey voting for Christmas . Well managed = don't need a little fixer = not grateful enough to vote for "little fixer TD" 

I don't blame anyone for going to a TD to deal with the mess that is our public service, I have used them myself , but I don't owe them anything ! They are paid very well by the taxpayer for what little they (are able to) do. 
pjq


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## ajapale (9 May 2008)

*Re: Health Repayment Scheme:  Scheme Administrator is not very efficient.*

This thread is about the administration of the health repayment scheme. This role has been subcontracted to the private sector KPMG.

There are scores of other threads here which deal with the HSE and its poor management and service delivery.

Try to keep this thread to deal with the issues surrounding the "health repayments scheme" and its (mal)administration.

If generalised rants continue then this thead will be consigned to the Letting Off Steam section.


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## pytelium (18 May 2008)

Having dealt witha government TD,I emailed a lengthy letter,detailing my case to an opposition TD. I also emailed the Ministers office with the same letter. Neither have replied ..I provided them with email addresses plus landline and mobile numbers. These two courses of action were suggested above.. I suppose I will have to resort to snail mail and phone calls now to these two avenues..


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## aircobra19 (19 May 2008)

Email really doesn't cut it for dealing with these kind of issues.


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## pytelium (27 May 2008)

I sent a copy of my email to an opposition TD..he rang me and told me he would have a PQ in the dail..but he did not have much hope of me getting paid quickly as he felt they were deliberately delaying payout because of the cash shortage now.


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## pytelium (23 Jun 2008)

Still no offer letter and 4 working days left in June...after consulting 2 TD'S..


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## pytelium (26 Jun 2008)

Now they tell me that all offer letters will be sent out by the end of August,last week they told me all offer letters will be sent out by the end of June..


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## poor 1 (9 Sep 2008)

Has any had satisfaction where the patient was forced to go to a private nursing home ? 
I have been told that it is outside the "Scheme".  My mother spent 3 years in a private nursing home because there was nothing else available.

Does anyone know of payments made to patients that were forced to go to a private nursing home ?

I have heard that there have been a couple of High Court cases to contest some aspects of the scheme, but I have'nt got any details of what the cases were or their sucess.
         I would be grateful if you have any knowledge of any of the above situations that would help the appeal case. 
Thank You.


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## pytelium (15 Sep 2008)

sorry poor one..cant help...

I am now being told I will get an offer letter in the next 3 weeks..that means sometime in October..

The scheme was supposed to end at the end of August..

I even met a Minister whom I found less than polite and he tried to defend the indefensible..


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## pytelium (4 Jan 2009)

it will be february 2009 before I get paid


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## james1 (27 May 2009)

Hello Poor 1.
Our family was in a similar position. We were also told that we were not covered by the scheme. We have appealed same and are still waiting for an oral hearing.
I was also wondering if anyone has been successful in this type of situation or does anyone know of any court cases contesting this aspect of the scheme.
Thanks.


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## james1 (22 Jul 2009)

Hello again,

I was wondering if anyone had any success with the Health Repayment Scheme recently and what would be the best way to approach the oral appeal? Thanks


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## CMBK (2 Nov 2009)

I'm new to the site.  Interesting to see how many people are having the same problems as me.  Still trying to get satisfaction.  Also have the feeling that the file is not being read and, although I've had an oral hearing (early this year but that person is no longer an appeals officer!), I feel I now have to try to explain the whole thing to somebody else, if I manage to get another hearing.


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## ajapale (31 Dec 2010)

Would anyone else like to share their experiencies about this rare  example of a private sector agency carrying out public service? 

Does  anyone have anything good to say about the administration of the scheme?

Has KPMG improved any in the provision of this public service?


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