Cyprus Mail

HIO official says difficult to spot doctors abusing the system

A senior official with the Health Insurance Organisation (HIO) conceded on Tuesday that they may have taken a sledgehammer to the problem of excessive patient visits to specialist doctors enrolled with the national health system.

Speaking on CyBC radio, HIO deputy director Andreas Papaconstantinou was being asked to comment on reactions by certain groups of doctors to the recent announcement that caps would be placed on the number of patient visits.

Earlier, the HIO had said that from now on gynaecologists, neurologists and dermatologists would be permitted up to 20 patients per day and urologists 15. Orthopaedic surgeons will be permitted on average 25 patients per day.

This was being done to limit abuses of the system.

Reacting, dermatologists said they would take ‘dynamic steps’ and gave the HIO a one-month deadline to withdraw the new rules. Effectively they have threatened to leave the national health system (Gesy), citing breach of contract on the part of the HIO.

The HIO is the organisation with which physicians enter into a contract to operate within Gesy.

Addressing doctors’ reactions, Papaconstantinou said the HIO is open to revising the newly-announced restrictions, hinting they were not set in stone.

He acknowledged the visits system may be flawed, but added that the HIO is willing to talk with specialist doctors and hear them out.

The official conceded that to date the HIO hasn’t penalised a single doctor for such abuses – billing for excessive patient visits.

In theory, the HIO has the authority to expunge a wayward doctor from Gesy, that being the ultimate sanction.

But Papaconstantinou suggested it’s hard to track individual wayward doctors.

He cited the fact that annually some 12 million requests are filed for doctor examinations under Gesy. It was therefore impossible to sift through all this data – which was why the HIO had to resort to applying horizontal measures.

“’We have sent letters of warning to various doctors for strange behaviours. But to date, we have not found an abuse that would justify the ultimate sanction [expulsion from Gesy],” he said.

Among the new guidelines announced by the HIO, are benchmarks for cardiologists limiting stress tests to 15 per cent per monthly visits, and routine ECG tests to 70 per cent for instance.

Gesy-registered patients also have a cap of four visits per year to neurologists and gynecologists. There may be exceptions for instance during pregnancy, the announcement specified.

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