Ireland: HSE Takes Case Against Hickey Pharmacy Group

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HSE says it is owed more than €5 million by Hickey over alleged dispensing rules issue

A legal row between the HSE and a leading pharmacy group over dispensing fees is to be heard in the Commercial Court.

The HSE estimates the overall amount allegedly due to it from the Hickey Group between June 2011 and August 2016 as a result of alleged non-compliance with phased dispensing rules is more than €5 million.

The case by the HSE against DGM Pharmacies Ltd, which operates the Hickey Group of pharmacies, is regarded as a test case for 29 other cases brought in relation to the system of phased despensing fees.

Mr Justice Brian McGovern, who admitted the case to the big business division of the High Court on Monday, was told by Eileen Barrington SC for the HSE, that proceedings in twenty nine other cases have been issued.

Phased dispensing is used to prevent excessive or incorrect dosing by the patient.

Instead of giving patients a month’s supply of their tablets, they are given one week’s supply at a time. When the patient or a family member visits the pharmacy weekly, the pharmacist can check on their adherence to their medication.

In a grounding affidavit, Anne Marie Hoey, HSE assistant national director of the primary care reimbursement service, said in a payment mechansim was established in mid-1996.

Under that, enhanced dispensing fees became payable to community pharmacist contractors for general medical services patients where an item on a single prescription fee is dispensed across multiple supply occasions.

She said it has emerged from inspections of pharmacies within various groups, including the Hickey Group, that claims were allegedly made to the HSE for phased dispensing claims where supply allegedly occurred on a single occasion.

The Hickey Group’s standard operating procedure for monitored dosage systems stated a month’s supply would usually be provided to the patient by way of a blister pack and yet fees were charged by the Hickey Group for phased dispensing, she said.

The HSE alleges there has been non-compliance with the phased dispensing rules, resulting in the payment of pharmacists for services they did not provide in circumstances where the HSE believed phased dispensing had taken place.

Ms Hoey said every phased dispensing claim will be reviewed but it is estimated the overall amount due from the Hickey Group from June 2011 and August 2016 in more than €5m.

She said it would appear the Hickey group has taken remedial action so as to no longer routinely claim for phased dispensing when it provides blister packs with a month’s medication to a patient.

The Hickey group has commenced separate proceedings against the HSE over allegedly wrongfully withholding payment for phased dispensing as of October 2016.