FutureCare, the health insurance programme for senior citizens has been overpaying on claims due to a “system configuration error”.The error was corrected in April which means dozens of seniors will soon be getting bills in the hundreds of dollars that they were not expecting, and that thousands of dollars of taxpayer dollars, which provide the lion’s share of the funding for the scheme, has gone down the drain.The saga has already caused confusion among FutureCare clients and even some doctors.Since its inception in 2009, FutureCare has been reimbursing surgeons 100 percent for procedures performed at the local hospital.As of April 1, 2011, the scheme began to reimburse only 75 percent without proper explanation or prior notice to doctors or clients.“FutureCare has not changed its benefits policy. The Health Insurance Department (HID) discovered a system implementation error, which resulted in medical providers being paid more than they should have been,” said Health Minister Zane DeSilva in response to our queries.“HID made the system configuration changes and implemented this as of April 1, 2011. The configuration issue was discovered internally and acted upon immediately when found.”He said: “FutureCare pays 75 percent of defined professional services for outside (private) physicians who performs procedures in the hospital. Examples include: Surgery, Internal Medicine and Management by a Specialist.”The Minister went on to say that policyholders are not typically informed when the automated system is “tweaked”.The news comes after Opposition MP Louise Jackson raised the alarm over what she said were serious lapses in the programme’s information campaign over the benefits available to seniors for overseas care a claim robustly denied by Minister DeSilva.One FutureCare client said that prior to getting surgery done here in May, she contacted the Health Insurance Department to evaluate her options. She said she was told that FutureCare would cover overseas treatment as long as the cost did not exceed what it would cost in Bermuda.The client, who did not want to be named, said she opted to have the procedure done locally.“My understanding was that the cost to have it done here would be fully covered,” she said. “They never, ever indicated that was not the case.”But she was later informed by her surgeon that FutureCare was only paying 75 percent of the cost of the surgery.FutureCare has been informing surgeons that the change came into being as of April this year. But the client says that she was in contact with the FutureCare administrators in the latter part of April.“Why would they not say that when I was clearly asking them for guidance?”Dr Council Miller said he was always of the view shared by other doctors that the policy was to reimburse 100 percent of the cost of procedures done at the hospital.He said that he noticed a reduction in reimbursements a few weeks ago and asked the Minister and his Permanent Secretary about it at a recent meeting.“They both acted as if they did not know of any reduction,” he said. He said he then contacted the Health Insurance Department who told him that, since the early part of the year, the policy was to reimburse only 75 percent.One administrator at a doctor’s office said despite her queries she is yet to get any straight answers from the Health Insurance Department.“I kept asking them ‘is it a mistake?’ and they keep saying ‘no’.”She said FutureCare has not put anything in writing and they have not informed the patients directly.“Rather than send these 70 and 80 year old people bills for hundreds of dollars I’m trying to get them [FutureCare] to pay,” said the administrator. “But that is the bottom line. Technically, they are left with these bills.”She said: “As far as we know the policy is they pay 100 percent for local surgery. That’s what they have been doing all this time and that’s what everyone else [other health insurance providers] continues to do.”Minister DeSilva denied that clients had not been informed of their benefits under the programme.“FutureCare clients have been informed of limitations of benefits since 2009. There has been constant dialogue on this subject. For example, flyers were handed out when the 20 percent co-pay was implemented for prescription drugs,” he said.“We do not inform policyholders every time we tweak the automated system as this is routine configuration and maintenance.”In June 2008, India-based company Apollo Health Street was contracted by Government to complete data entry and claims auditing to verify that claims were processed correctly.That followed an early decision to automate the FutureCare system. Implementation of the system began in early 2009 and was completed in September 2010.It was not possible to determine yesterday who, if any one, would be made accountable for the error, or whether HID would seek reimbursement of the overpayments, as the Minister did not respond to our further queries by press time.FutureCare paid out $5 million in claims in its first six months of operations. Besides policyholders’ premiums, it is funded through a Government subsidy and a cross subsidy by the working population through transfers from the Mutual Reinsurance Fund.