Filenews 3 December 2022 - by Marilena Panayi
The HIO proceeded to 26 terminations or suspensions of contracts of GHS service providers, which, according to information from "F", is preparing in the near future to show the exit door to other doctors, health professionals or laboratories that are found to be abusing the System. Of the 26 cases, some were already taken to the Police or took the path of Justice, while there are also some providers who, while expelled from the GHS, then complied with the instructions of the Organization and returned to the System.
An important role in the HIO's effort to identify providers who abuse the System seems to be played by the citizens themselves. Indicative was the case of a doctor to whom the exit door from the GHS is essentially shown by the citizens themselves who simply monitor their e-mail and carefully read the emails sent to them by the Organization.
The case of the doctor in question is currently in the final stage of investigation and as we are informed the decision will be damning. The investigation began when 9 different citizens contacted the HIO and informed that they had received in their e-mail a message from the GHS that the doctor had submitted a request to be compensated for services that they themselves had not received.
In another case, an important role was played by health professionals themselves. This case concerned a dentist whose contract with the HIO has already been terminated. It was revealed when GHS beneficiaries went to their family dentist for the annual cleaning to which they are entitled through the GHS and their dentist could not serve them because their name was already registered in the software and they themselves appeared to have already received this service. The Health Insurance Organization monitored the registrations of the specific dentist in the GHS software and after it was found beyond any doubt that the entries were false, proceeded to terminate his contract.
In total, the HIO terminated contracts in 15 cases. Of these, three involved doctors (2 specialist doctors and one personal doctor). Another 9 doctors (8 specialists and one personal doctor) the validity of their contract with the HIO was suspended and they were placed under investigation. Three cases were taken to the Police and are under investigation or pending before the Courts.
The list of 26 cases includes nine clinical laboratories. In 8 cases their contract with the HIO was terminated and in 3 of them, the contract entered into force again, when the providers complied with the instructions of the Organization. In one case the contract was suspended, after its investigation it came back into force and the HIO imposed a fine.
The HIO also terminated the contract in the case of two pharmacies. The first case concerned a pharmacy that did not meet the operating criteria, as defined by the relevant legislation, but the second case concerned serious abuses of the GHS and the case was reported to the Police.
Finally, the Organization terminated the contract of a clinical psychologist who was found to have abused the System.
Until recently, HIO audits were mainly carried out through the registrations of healthcare providers in the GHS software. Now, as the director of the HIO Maria Kythreotou mentioned while speaking to "F", on-the-spot checks are also carried out at the premises of the GHS providers. To date, visits for testing have been carried out in laboratories "and it is expected that the tests will soon begin in GHS hospitals as well". The audit concerns the records of the providers, their registrations or in the cases of hospitals, the registers of surgeries, etc.
"Our goal is to strengthen the HIO's controls so that we have as much information as possible at our disposal before the final decision is made," said Ms. Kythreotou.
The HIO, the Director of the Agency said, "does its own checks through the software, etc. However, in order to be able to really intervene, it needs the cooperation of the citizens, the beneficiaries of the System. We all receive e-mails in our e-mail from the GHS. It would be good to keep an eye on them."
