MORE than 50 GPs have been accused of massively overcharging the HSE for treating medical card holders outside of normal surgery hours.
One GP who submitted a bill for €186,000 in back money has been told he is only due around €15,000 because of the failure to properly validate the claims.
The fees are due for "out-of-hours" service to medical card holders in the evening, night and weekends when they required urgent care which could not wait until normal surgery hours.
A HSE spokeswoman said it carried out a review of these claims by GPs in 2009 and found "claiming patterns" were a concern.
"As part of its routine probity and audit measures, the HSE was unable to verify the reasonableness and accuracy of some claims," she added.
It meant that the bill sent by the doctor could not be verified and this led to a build-up of so-called legacy claims by 264 GPs.
She said: "From February 2011 to July 2013 there were 440,748 out-of-hours claims submitted to the HSE by 264 doctors. Of these, payment was withheld in respect of 62,966 claims.
"Under a mediation agreement the HSE has agreed to pay 211 GPs the full amount of their unpaid claims totalling €537,169.
"A partial payment has been offered to the remaining 53 GPs totalling €377,204 in respect of 28,543 claims."
Under the mediation agreement, worked out with the Irish Medical Organisation (IMO), it was agreed that the GPs had until the end of October to accept the settlement offer from the HSE.
If they still dispute the amount they are being paid they can appeal to the independent mediator, senior counsel Tom Mallon.
As part of the ongoing engagement with the IMO, the HSE issued guidelines to all medical card doctors on what constitutes "an eligible claim" and claiming patterns for some doctors "have altered significantly", she added.
The latest financial headache for the HSE comes as its new performance report shows that only two-thirds of the projected pay savings under the Haddington Road Agreement will be made this year.
The knock-on effect will be more health cuts and another end-of-year bailout as it goes over budget.
The report for July said it had projected savings of €150m under Haddington Road, but this will not be possible because of delays in implementing the agreement.
It means the HSE is facing a deficit of around €107m by the end of the year. The deficit may extend to around €200m.
Under the schemes covering medical cards and drugs payments- as well as fees to GPs, the HSE expects to have a deficit of between €65m to €100m.
It is also in the red because of the failure to impose the new charges on health insurers for treating private patients in public hospitals.