The National Health Service (Ophthalmic Services) (Wales) Regulations 2023

Overpayments

35.—(1) Where—

(a) a Local Health Board has made a payment to a patient under regulation 7(6) in respect of a sight test, and

(b) the amount paid exceeds the fee payable to the contractor for general ophthalmic services set out in the Statement,

the Local Health Board must deduct the excess from remuneration otherwise payable to the contractor.

(2) Paragraphs (3) to (5) apply where a Local Health Board considers that it has made an overpayment for primary ophthalmic services to a contractor (whether in error or otherwise).

(3) The Local Health Board must, except to the extent that the Welsh Ministers on the application of the Local Health Board direct otherwise, inform the contractor of that fact.

(4) If the contractor admits the overpayment, the Local Health Board may recover the amount overpaid by a deduction from the contractor’s remuneration or in some other manner.

(5) If the contractor does not admit the overpayment—

(a) the Local Health Board may refer the matter under regulation 5(1) of the National Health Service (Service Committees and Tribunal) Regulations 1992(1) for investigation, and

(b) if the Local Health Board, or the Welsh Ministers on appeal, decide that there has been an overpayment, the amount overpaid will be recoverable by a deduction from the contractor’s remuneration or in some other manner.

(6) Recovery of an overpayment under this regulation is without prejudice to the investigation of an alleged breach of the terms of service.

(1)

S.I. 1992/664, amended by S.I. 2002/2469; there are other amending instruments but none is relevant to these Regulations.