Refund of Illegally Charged Prescription Levies. Where in HSE and how to reclaim levy

[PatMacG]

My local HSE replaced my long-term illness book (LTI) with a medical card when I was assessed as qualifying for a medical card once diagnosed as having illnesses not covered by my LTI. This was HSE policy at the time. A qualifying person could not hold and use both a medical card and a LTI concurrently.

When the prescription levy was introduced, I was charged the prescription levy on my LTI medications, which were now prescribed and dispensed on my GMS medical card. This amounts to 17.50 per month currently.

After the ombudsman's report linked to below, the HSE policy changed and in the case of the person who took the case to the Ombudsman, the charges she incurred were refunded.

[broken link removed]

Extract from the omdudsman's report :-

"Following the intervention of the Ombudsman the HSE agreed to:

• Award Ms Kelly’s son a LTI card,
• Refund Ms Kelly the cost of medications for her son in the period from when she first made an application under the LTI scheme to the time when her application was granted (approximately €3,000),
• Uniformly administer the LTI scheme nationally, thereby including ADHD as constituting a mental illness which, in the case of persons under 16 years, gives entitlement to a LTI card. ..."

The matter of refunds for costs incurred unnecessarily is resolved as far as I am concerned following the ombudsman's intervention - the HSE owes me for monies collected illegally.

This is extract from an email I received directly from the offices of Minister James Reilly last night :

"... You should apply again for the LTI book and seek reimbursement from the HSE. ..."

Extract from my response:

"... My application for a return of my LTI book, completed, signed and stamped by xxxx xxxxxxx, my GP, was handed into xxxxxxx HSE Offices this afternoon. Hopefully the very helpful staff there can issue the book before I have to pay out more money unnecessarily.

Is there a specific part of the HSE I can write to to look for a refund? The organisation is so vast that from the outside, it is impossible to know who to contact.

I appreciate your help, Have a good St Patrick’s week-end."

Would anyone here know who to apply to for a refund of the prescription levies I paid unnecessarily?

Thanks.

 

[mathepac]

This would seem to be your first port of call:

HSE National Advocacy Unit
Quality & Patient Safety Directorate
Oak House
Millennium Park
Naas
Co Kildare.

I believe they will then address the query / complaint / issue directly to the relevant local HSE unit.

Enclose PPS Number, GMS Medical Card Number, LTI book number (if available).

 

[mathepac]

Further developments in this matter.

You will note that to get any meaningful communication established, I had to go the political route. This goes against the grain for me but I felt I was left with no other options.

"Dear mathepac

Thank you for your email of <date A>, to the Ministers office, received into our office on <date B> in relation to the Long Term Illness Scheme.

May I firstly apologise on behalf of the Primary Care Reimbursement Service (PCRS) for the delay in responding to your correspondence. There is a considerable volume of work on hand at present and this is causing some delay in responding to correspondence. Our goal is to deal as efficiently and courteously as possible with all our clients.

The HSE is in the process of identifying any person who paid prescription charges in these circumstances and is making arrangements so that the relevant charges can be refunded in full. This work is on-going and will identify the people involved, the respective time period and how much they have paid in prescription charges. It is planned that this work will be completed before the end of Q2 and the medical card holder who paid these prescription charges does not need to take any action.

If you require further assistance, please do not hesitate to contact us.

Kind regards,

Named HSE Employee

Customer Relations Unit,
HSE: Primary Care Reimbursement Service, Unit 1-9 First Floor,
J5 North Park Business Park,
Exit 5, M50,
Finglas,
Dublin 11.

Tel: 01-8647100
Fax: 01-8647181"

Of note to me sadly, is the fact that communications from me to this exact section of the HSE, phone calls, letters, DIY claim forms, etc, get no mention at all. These all predated the political intervention and generated only a single returned phone call.; others were promised but never materialised.

It seems that in 21st century Ireland, it's not enough to be a client; to get results you must be a client with clout.