LCQ8: Elderly Health Care Voucher Scheme
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Question:
The Elderly Health Care Voucher Scheme (ECV Scheme) aims to supplement the existing public healthcare services by providing financial incentive to enable the elderly to choose private healthcare services, including preventive care, that best suit their needs. At present, each eligible elderly person is allotted ECVs of a total value of $2,000 each year, with the cumulative total value of ECVs being capped at $4,000. It has been reported that the number of complaints about ECVs received by the Department of Health (DH) increased substantially year on year in each of the past three years, and quite a number of which involved abusive use of ECVs. In this connection, will the Government inform this Council:
(1) of (i) the number of complaints about ECVs received and (ii) the number of such complaints into which investigations were conducted, by DH in each of the past three years (with a tabulated breakdown by nature of the complaints);
(2) whether it has examined the implementation of specific measures to further prevent the abusive use of ECVs, and whether it will step up its monitoring of the service providers for the ECV Scheme; and
(3) whether it will consider afresh raising the cap on the cumulative total value of ECVs, so as to prevent service providers from persuading elderly people into using their ECVs indiscriminately by taking advantage of their mentality that those ECVs above the cap will anyway be nullified?
Reply:
President,
The Government launched the Elderly Health Care Voucher (EHCV) Scheme in 2009 to subsidise Hong Kong elders aged 70 or above to use primary care services provided by the private sector. Since July 1, 2017, the eligibility age for the EHCV Scheme has been lowered from 70 to 65. The number of elders who can benefit from the EHCV Scheme has increased to about 1.2 million. As at end December 2017, more than 950 000 elders had made use of vouchers. To ensure prudent use of public money, the Department of Health (DH) has put in place measures and procedures for checking and auditing voucher claims, and conduct investigations into the complaints received. The DH will review and enhance its monitoring mechanism from time to time to guard against abuse of vouchers.
My reply to various parts of the question is as follows:
(1) The DH received 24, 42 and 72 complaints about the EHCV Scheme in 2015, 2016 and 2017 respectively. The complaints involved the coverage of the scheme, operational procedures, administrative and supporting services, suspected fraud, improper voucher claims and issues related to service charges of participating service providers, some of which involved more than one area of concern. For each complaint received, the Health Care Voucher Unit of the DH would contact the person concerned/complainant for further details and take appropriate follow-up actions.
(2) and (3) There is currently no restriction on the number of years that an elderly person may carry forward the unspent vouchers, but the cumulative amount of vouchers in a voucher account cannot exceed $4,000. As proposed in the 2018-19 Budget, the Government will raise the accumulation limit of vouchers from $4,000 to $5,000 from 2018 onwards to allow greater flexibility in using vouchers, and provide, on a one-off basis, an additional $1,000 worth of vouchers for each eligible elderly person in 2018. The above proposals will be implemented upon the passage of the Appropriation Bill.
To protect the interests of the elderly, it is stipulated in the terms and conditions of the EHCV Scheme Agreement that participating service providers shall ensure that the voucher amount used by an elderly person does not exceed the fee for the healthcare service received on a particular occasion. They shall not charge the elderly any fees for creating a voucher account or using vouchers. The DH issues regularly to participating service providers a set of Proper Practices under the EHCV Scheme to remind them of the proper practices in making voucher claims, which include not imposing different levels of fees based on whether vouchers are used or not, enhancing the transparency of service charges as far as possible, explaining the charges to patients at their request before providing service, and allowing patients to choose from different healthcare treatment/management options which may have different service charges after considering the explanation provided by healthcare staff. Besides, registered healthcare professionals have to abide by their codes of professional conduct and ethics and to fulfil their professional obligations.
To ensure proper reimbursement of voucher claims to participating service providers and prudent use of public money, the DH has put in place measures and procedures for checking and auditing voucher claims. These include conducting routine inspections of service providers, monitoring and surveillance to detect aberrant patterns of transactions so as to take timely follow-up actions and necessary investigation, and conducting investigations into complaints received. Generally speaking, if any participating service provider is found to have failed to comply with the terms and conditions of the EHCV Scheme Agreement, the voucher claims will not be reimbursed by the Government. In case the reimbursement has been made, the Government will recover the amount from the service provider concerned. The DH will also issue an advisory/warning letter to the service provider concerned as appropriate. In addition, if any service provider is suspected of fraud, the DH will refer the case to the Police and/or relevant law enforcement agencies for follow-up. The DH may also disqualify the service provider concerned from participating in the EHCV Scheme. If any service provider is suspected of professional misconduct, the DH will refer the case to the relevant professional regulatory board/council for follow-up.
Apart from the above monitoring mechanism, the DH has also stepped up public education on the EHCV Scheme. For examples, since July 2017, elderly persons have been reminded of the points to note when using vouchers (including asking service providers about the details of service charges before giving consent to use vouchers, and checking the information on the consent form before signing) through talks held for them and their caregivers at District Elderly Community Centres, Neighbourhood Elderly Centres, residential care homes for the elderly and DH's Elderly Health Centres, as well as publications targeted at the elderly and relevant stakeholders. In addition, the DH has produced a new Announcement in the Public Interest for broadcasting on television and radio starting from March 1 this year as another way to remind elderly persons of the above points to note. To enhance transparency, the DH is collating some voucher claim statistics for uploading onto the EHCV Scheme's website for public reference.
Ends/Wednesday, March 21, 2018
Issued at HKT 18:14
Issued at HKT 18:14
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