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HSE is carrying out multiple investigations into pharmacy prescription fraud claims

The majority of these investigations centre around the practice known as phased dispensing.

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THERE ARE MULTIPLE investigations into a number of pharmacies which have been accused of effectively defrauding the State out of significant amounts of money in the last 10 years by making fraudulent pharmacy claims, TheJournal.ie has learned. 

The HSE is carrying out at least ten Clause 16 investigations against several pharmacies in Ireland. A Clause 16 inquiry is the name given to serious internal investigations carried out by senior members of the health service. 

Investigations are now ongoing into pharmacies based in north Dublin, Wicklow, Louth and Limerick. TheJournal.ie understands that this is not the entire number of pharmacies being investigated and it is believed more are being looked at. 

The majority of these investigations centre around the practice known as phased dispensing. 

Phased dispensing is used to prevent excessive or incorrect dosing by the patient. Instead of giving patients a month’s supply of their medication, they are given one week’s supply at a time. 

This means pharmacies can claim dispensing fees for each time that the patient returns.

The HSE is investigating prescription claims made by the pharmacy as far back as 2013. The pharmacy can initially claim for €5 for the first dispensing fee. It can then claim over €3 for each additional phased claim. 

Last week, TheJournal.ie revealed that a pharmacist, who has already been suspended from practicing due to other legal matters, was also being investigated for fraud.

Separately, the HSE is currently in the process of clawing back €10 million in dispensing fees it believes a number of pharmacies overclaimed. The HSE is carrying out a much wider investigation into a number of pharmacies which it suspects may have overclaimed for prescription charges.

TheJournal.ie understands that the total money being queried by the HSE runs into the hundreds of thousands of euro. A number of pharmacies have been sued by the HSE in recent months in relation to similar incidents. 

A spokeswoman for the HSE said: “Due to the sensitive nature of Clause 16 investigations, the HSE is not in a position to comment in respect of this enquiry.”

Speaking in relation to phased dispensing, a spokesperson for the Irish Pharmacy Union said: “This is a vitally important facility for certain patients who cannot safely and effectively manage their medication regimen. Phased dispensing allows a patient’s pharmacist, family members and carers to support and ensure the safe and proper use of the medicine by the patient.

“If an allegation has been made, the pharmacist concerned is entitled to a proper investigation before any conclusion is reached.”

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