Filenews 11 October 2024 - by Marilena Panayi
The Health Insurance Organisation (HIO) imposed fines totalling €49,100 last month on 51 health service providers, namely doctors, personal and specialists, and pharmacists. The largest fine, amounting to €30,000, was imposed on a specialist doctor specializing in dermatology, while a total fine of €16,500 was imposed on 47 personal doctors for an increased number of referrals for physiotherapy and prescription of quantities of drugs greater than those needed by patients to meet the needs of a month.
In detail and according to the relevant announcement of the HIO, the dermatologist, who was fined €30,000, as found after a relevant investigation, entered in the GHS software claims for compensation that were either incorrect or not justified by what the doctor recorded when submitting his request.
As we are informed, the doctor in question, while performing specific medical procedures, entered in the software different codes relating to services that had not been offered.
In addition to the dermatologist, two other specialist doctors were fined €800 and €300. A urologist and a doctor specializing in orthopaedics. In the first case, the doctor performed medical procedures in a place that did not meet the specifications, while the orthopaedist had exceeded the limit set by the HIO for issuing referrals to physiotherapy.
For the 47 adult personal doctors, fines ranging between €300 and €500 concerned either referring patients to physiotherapy without properly following clinical guidelines to justify issuing these referrals, or prescribing quantities of drugs "excessive and not medically necessary".
'On the basis of the information before the Agency, it was established that the personal doctors in question issued prescriptions for medicinal products with an excessive and non-medically necessary quantity exceeding the monthly medical needs of the beneficiaries.' Following an investigation, it was also found that 'prescriptions were issued while other prescriptions were in force for the same medicinal products'.
Similarly, a pharmacist was fined €1,500 for administering to patients quantities of drugs greater than those recommended by the doctor through his prescription.
'On the basis of the evidence before the Agency, it was established that the pharmacist in question made claims for reimbursement for the supply of a quantity of medicinal products which was unnecessary and/or excessive for monthly use and contrary to the instructions of the doctor who issued the prescription.' The quantities of medicines apparently administered by the pharmacist "exceeded the needs of the beneficiaries and should not have been administered".
The publication of the fines imposed during September was made in the context of the HIO's decision to inform citizens about the controls carried out within the GHS and the actions taken by the Organization in order to combat abuses.
As noted in the announcement posted on the GHS website on Wednesday morning, "the policy of the Organization, in addition to imposing any fine, is to recover any amounts that have been unduly paid to healthcare providers."
