NHS Somerset is reminding local people to carefully check whether they are entitled to claim an exemption from prescription charges for items such as medicines, dental treatment, sight tests and glasses.
The warning comes as the NHS in Somerset and the local NHS Counter Fraud Service have crack down on fraudulent claims for prescription charges, which cost the local NHS thousands of pounds in lost revenue.
Sample checks of prescriptions routinely made at pharmacies across Somerset and patients who are found to have claimed for assistance when they were not entitled to may face prosecution or receive a hefty penalty charge.
Andy Knight, NHS Counter Fraud Specialist said, "The majority of patients who claim exemption from NHS prescription charges are honest but fraud exists and it is costing us thousands of pounds that we could use to help patients.
"During the past year we have increased the number of random checks on prescriptions at every pharmacy in Somerset1 as a result 1,400 penalty notices were issued to patients; recovering £22,712 in charges and penalties from patients who were found to have wrongly claimed for help with health costs. There are a wide range of exemptions in place in England for those who are genuinely eligible for help and around 90 per cent of prescriptions are already dispensed free of charge to patients4. We take strong action against patients who are not eligible for assistance but fraudulently claim."
Incurring a penalty change is not a small matter. Patients will be asked to pay back the original NHS fee plus five times the original fee as a fine (maximum £100 fine) and further charges are incurred if payment is not made within 28 days. This means that a prescription that would have cost £7.403 could cost £37.00 if the patient is found to have wrongly claimed for help with health costs.
Andy Knight continued, "Figures over the past year2 show the number of fraudulent claims have fallen for sight tests and glasses (37%) and dental work (9%) which is good, but we will continue to take tough measures to fight NHS prescription fraud in Somerset. If you need advice about prescription charge exemptions you should ask your doctor or pharmacist or ring the NHS BSA on 0845 850 1166."
The price of the 12 month prescription pre-payment certificate (PPC) has been frozen for the second year running and this allows people to save money and get all the prescriptions they need for an average cost of £2.00 per week.
1. In April 2010 fraud measurement work by NHS Somerset and the local NHS Counter Fraud Service established that 59% of ophthalmic patients in Somerset wrongly claimed to be exempt from paying NHS charges for their sight and glasses. In addition 21% of patients wrongly claimed to be exempt from NHS dental charges and 11% of patients wrongly claimed to be exempt from paying NHS prescription charges.
2. Figures for May 2011 indicate that there has been a 37 per cent reduction in patients wrongly claiming to be exempt from paying NHS charges for their sight tests and glasses. However, 22 per cent of claims sampled were still found to be false and as a result 291 penalty charge notices were issued to patients. There was also a 9 per cent reduction in patients wrongly claiming to be exempt from paying NHS dental charges.
Prescription prepayment certificates (PPC) are available in England and they can save you money.
Prescription costs as of April 1 2011:
The current prescription charge is £7.40. From 1 April 2010 a three monthly PPC is £29.10. This saves you money if you need four or more items in three months.
A 12 month certificate is £104.00 and saves money if 15 or more items are needed in 12 months.
PPCs are available by 10 monthly direct debit instalment payments. The prescription prepayment certificates allow anyone to obtain all the prescriptions they need for £2 per week.
You can get free NHS prescriptions if, at the time the prescription is dispensed, you:
- are 60 or over
- are under 16
- are 16-18 and in full-time education
- are pregnant or have had a baby in the previous 12 months and have a valid maternity exemption certificate (MatEx)
- have a specified medical condition and have a valid medical exemption certificate (MedEx)
- have a continuing physical disability that prevents you from going out without help from another person and have a valid MedEx
- hold a valid war pension exemption certificate and the prescription is for your accepted disability
- are an NHS inpatient
- Income Support
- Income-based Jobseeker's Allowance
- Income-related Employment and Support Allowance, or
- Pension Credit Guarantee Credit
BBC News article