Prescription penalty charges backdated?

Fragamuffin

Hi, I have been out of work for a year with some heart issues and receiving ESA until I returned basic pay part time work this month.
I received a fine from the NHS today telling me i had claimed a prescription in December fraudulently. Even though I was on ESA, I was told you still have to pay for prescriptions if it is contribution based ESA (E.g. you have been working previously and paid NI).
It is not very clear, but however i can't argue and paid the fine which wipes out much of my pay for this week. Had i have known i would have setup a yearly prepayment as I am doing now that i am back in work.
My real worry is now though that they are going to check back on all previous prescriptions & items and come back to me with a fine for each prescription and item I had over the last year? Will they do this or is it just a spot check? If they fine me for each on then i am going to owe thousands and i wont be able to afford that Just wish i had known at the start and could have bought a Prepaid Cert for £112.00

TELLIT01

They could check all previous prescriptions. It is up to the claimant to ensure they tick the correct box and the forms do list the benefits which qualify for free prescriptions.

aninvasion

My husband has had exactly the same thing recently even though he was told he was eligible. They must be doing spot checks right now.

Luckily the bill was only for £50!

We are looking at a pre-paid certificate instead.

If they've already calculated and sent you a fine I'd just pay it and consider a slap on the wrist and check you tick the right box next time

Fragamuffin

Thanks aninvasion, I paid the fine as soon as I realised that "income" and "contribution" ESA where different things. I just ticked the ESA box.
Just worrying now they may work their way back through the year or prescriptions in my name and fine me for any other occasions all separately. If they are going to do that I rather they hit me in one go and one fine rather than worry now for the next 6 months.
Good call on the pre-paid certificate. We got one as soon as i started working beginning of this month also.
Would have got one last year had we have understood losing your job to illness means you have to pay for Prescription.

Sncjw

What about applying for the low income scheme you can get form from dentist doctor and opticians. You fill it out and see if they help to all costs or partial. Just for the future

Fragamuffin

Thanks Sncjw, i'll look into it. Never heard of that before.

Wizardy18

Can't see how you could of accidentally claimed free prescriptions given there is no box to tick for ESA - so something in your story isn't adding up.

BorisThomson

Wizardy18 wrote: »

Can't see how you could of accidentally claimed free prescriptions given there is no box to tick for ESA - so something in your story isn't adding up.

Of course there is. The issue is that they ticked income based ESA, not understanding the difference between that and contributions based ESA.

pmduk

Just to confirm, there certainly is a box for income-based ESA. It's box H on the reverse of your prescription.

Fragamuffin

Hi all, thanks very much for the constructive comments.
I followed up on this today and openly and honestly discussed this with the NHS Penalties & Pre-Paid Certificate issuing department.
It turns out this is one of the more common mistakes they see of the ESA benefit types being incorrectly ticked and claimed. However they sympathetically said the law is as it stands you must still pay the fine regardless (which I have done) or you can make an appeal and explain your circumstances online and see if they will waive part of the fine but it is not a given that they will.
They also explained to me how the fine system works which I will post in a separate reply below for others benefit & piece of mind.

Fragamuffin

NHS Prescription Fines & How they work (Rx = Prescription):
1. Each Month the Pharmacy will send all Rx to the NHS and a large proportion of those will be spot checked to see if the claimant is on a benefit that relates to the box they have ticked.
2. If you are found to of incorrectly claimed then they will charge you a fine of 5 x times per item at the current prescription charge up to a maximum of £100 in any one month.
E.g. 1 item on 1 prescription incorrectly claimed equals
5(Fine) x £8.60 (Current Rx charge per item) = £43
+
The Standard Rx item charge of £8.60 = £51.60
Judging by this if you claimed two or more items on your prescription your maximum fine liability will not exceed £100 for that month.
3. Regardless of if you have made multiple Rx incorrect claims in that month you will only be fined once in that month up to £100 only.
4. The fine I received was for 14th December 2017 and this estimates the processing time at about 10 weeks for it to be picked up and fine issued. I was informed that spot checks do not go backwards from that date but any future dates from there it is possible that I could receive fines each month I made an incorrect claim up to a maximum of £100 per month if it is spot checked.
5. Fines are not backdated from the point you were fined. E.g. If you are fined in December they do not take your details and start to work back through all your previous Rxs to check and issue fines. Only dates forward from that again maybe spot checked & fined.
6. What can you do if you find yourself in this Predicament:
a) Pay the fine & accept your mistake, plus any future fines for following months that they (may) pick up on. Once you have been fined you will normally know within 3 months and so can limit the potential future fines by making sure your paying or ticking the correct box. This also means you should only end up in a position of facing three months of fines maximum if there speed at spotting this remains the same.
b) Pre-Payment Certificate. Make sure to get one of these if you think your yearly prescription charges will exceed its cost of roughly £112 a year (Giving you a set yearly cost cover for all Rx). Also you can backdate this by 1 calendar month and contact the Pharmacy to alter the box you ticked incorrectly as long as they have not submitted them by then for that month.
c) Make an Online query about the fine and ask for leniency at there discretion.