Dental Protection successful in challenging ‘irrational and unfair’ Practitioner Services decision on Payments
Judicial Review finds PSD misapplied regulations on recovery of overpayments
Dental Protection (DPL) has successfully challenged the actions of Practitioner Services (PSD) of NHS National Services Scotland in a Judicial Review over the recovery of alleged overpayments.
Following a review of a small number of clinical records, PSD alleged that, due to insufficient detail within the records, the claims a DPL member had submitted could not be supported. PSD therefore sought the recovery of the claims made.
Before seeking recovery, PSD permitted the dentist to review her own records and provide comments on the findings. After reviewing more than 5,000 claims, the dentist concluded that the detail in relation to some claims did not satisfy PSD’s requirements. The dentist voluntarily offered to repay more than £10,000 but PSD chose to disregard the dentist’s own review and informed her that they intended to recover more than £71,000. They then withheld payments by instalment from her monthly schedule.
DPL instructed solicitors to act for its member and a petition for Judicial Review of the actions of PSD was raised. The petition was granted in February and the actions of PSD were found to be “patently irrational and unfair” and the decision to act as it did was a “material error of law”.
The court criticised the actions of PSD for disregarding without explanation the dentist’s own extensive review and to instead proceed on the basis of an extrapolation exercise based on a very small number of records. The sum of £48,000 was recovered before the matter came to the attention of the Court.
Helen Kaney, head of dental services Scotland at Dental Protection, said: “In this case, Practitioner Services were found to have misapplied the regulations and acted unfairly and irrationally. It is important that payment verification processes are now reviewed to ensure they are fair and that, in future, Practitioners Services acts in accordance with the law when attempting to recover overpayments.
“Dental Protection would urge all dentists to ensure their records are sufficiently detailed in order to justify any claims made to Practitioner Services Division.”