The HSE is investigating Lloyds pharmacy over concerns about potential claims of multiple payments for dispensing single prescriptions to medical card holders.
The Irish Times reports that managers of individual branches in the Lloyds Pharmacy Ireland - the largest pharmacy group in the country - were advised in a memo that they could boost fee income by 66% by using a system developed within the company to change how they bill for prescriptions dispensed to medical cards holders.
The pharmacy have told Newstalk.com they "strongly refute allegations relating to our phased dispensing service and have communicated this to the HSE.
Lloyds Pharmacies "fully adhere to the HSE's own phased dispensing guidelines, agreements and processes," the pharmacy said in a statement.
"That the HSE is now interpreting these differently runs contrary to the clear understanding of the pharmacy community.
"We will continue to invest in and provide this vital service to our patients as it makes it easier and safer, particularly for those on multiple medications, to manage their health.
"We are engaging with the HSE and the Pharmaceutical Society of Ireland on this matter.
"In parallel, our staff incentive structures are currently under review," the statement added.
The allegations came after a whistleblower went to the HSE and the HSE did an inspection of some Lloyds pharmacies.
The pharmacy has said they did nothing different to any other pharmacy, and deny there was fraud in claiming four fees in a single month for dispensing a single prescription.
Lawyers for Lloyds have criticised the HSE for alleging fraud in a letter sent to the company’s Managing Director, Goretti Brady, this month. The lawyers have called on the HSE to withdraw the “entirely unfounded” allegations.
A graphic, seen by RTE, shows that employees are encouraged to promote the MyMed system. The MyMed system – a system for patients on a high number of different prescription medications – sees patients given weekly packs of medications, separated into daily doses. But a pharmacy will earn significantly more if the dispensing of the medication is billed as if phased out over one month, rather than dispensed in one visit.
The system of phasing payments means the pharmacy receives the first €5 dispensation fee, plus three more payments, of €3.27 each. The HSE says the pharmacy is only entitled to one €5 payment per prescription item.
A graphic circulated to pharmacy mangers advises of “the difference in fees between a MyMed and normal dispensing”.
The graphic says: “MyMed increases our dispensing fees by 66%!”and lays out how by using phased fees the total income from 5 items would rise from €25 to €74.05 per month. Per year this amounts to €588.60 in total fees to the pharmacy per patient.
The HSE has told Newstalk.com that the body "is in the process of carrying out investigations in relation to certain claims submitted for payment by a pharmacy chain. The HSE will not confirm the identity of the pharmacy chain involved at this time. Both current and historic claims are the subject of the investigations.
"The HSE is not confining itself to a particular time period, the investigations are open-ended. The scope of our investigations involves a number of matters including Phased Dispensing," the statement said.
In response to the HSE lawyers for Lloyds said the MyMed system “dramatically increases the time” spent dispensing medication, and the process “clearly involves the assembly of four separate weeks’ supply of medication, each of which require to be checked individually and amounts to the dispensing of medication on a phased basis, notwithstanding that all four trays may be supplied to the patient at the one time.”
This was, lawyers said, why Lloyds charged for phased dispensing.