Fraud trial of doctor hears HSE pays GPs on 'trust basis'

The Health Service Executive pays general practitioners "completely on a trust basis", the former principal medical officer at the Primary Care Reimbursement Service (PCRS) has said at the fraud trial of a doctor in Carlow Circuit Court.

Dr Muhammad Waqas Rabbani, of Tullow Family Medical Centre, The Square in Tullow, pleaded not guilty to 20 counts of fraud that related to offences allegedly committed on different dates between 3 and 29 September 2018.

The prosecution, led by barristers Mark Lynam and Brian O'Shea, allege that Dr Rabbani dishonestly induced the HSE, through the PCRS, to make payments to him for services that he claimed he provided to medical card patients, but did not actually do so.

The 45-year-old was charged under section 6 of the Criminal Justice (Theft and Fraud Offences) Act 2001, such that he made gain or caused loss by deception.

Dr Joyce Cooney, the principal medical officer at PCRS in October 2018, explained to the jury that a person who holds a medical card is entitled to attend their GP for free.

The PCRS reimburses the cost of providing the free service to the doctor through a monthly payment and other subsidies.

Additionally, Dr Cooney said doctors are entitled to claim extra payments each month for any specialised treatments, such as sutures or nebulisers, or urgent consultations outside the normal opening hours of the practice.

Dr Cooney said the doctors undertake to only submit truthful claims in their contract with the HSE, but that payments are made "completely on a trust basis".

An investigation into the veracity of Dr Rabbani’s claims began in October 2018 after the probity division of the PCRS raised a query about them, said Dr Cooney.

Dr Rabbani attended a meeting in the PCRS offices in April 2019 and denied making invalid claims, according to notes taken at the meeting that were also read to the jury.

Dr Rabbani said he had a busy practice, with 14,000 patients, and that he saw up to 75 patients a day.

After the investigation by PCRS concluded, the Medical Council and An Garda Síochána were notified.

Detective Garda Kieran Shields searched Dr Rabbani’s practice on Friday evening, 25 February 2022.

Detective Garda Philip O’Sullivan subsequently began taking statements from medical card patients of Dr Rabbani.

Over the past week, 45 patients of Dr Rabbani in October 2018 gave evidence that they did not receive specialised treatments that Dr Rabbani claimed they did and some stated the signature on the claim forms were not their own.

Several noted that it often takes weeks to get an appointment with the doctor.

There were four claims Dr Rabbani made for alleged consultations with patients at a nursing home that its director of nursing could not cross-reference to notes of doctors' appointments on their internal system.

Dr Rabbani is being represented by barristers Lorcan Staines and Rebecca Smith and solicitors Michael J Staines and Co.

Mr Staines noted that the defendant is a married Pakistani national who came to Ireland in 2017.

He has two young children and no previous convictions.

The trial continues tomorrow.