The National Appeals Service operates as part of the Quality Assurance and Verification team and is independent of acute and community services within the HSE.
Purpose of the National Appeals Service:
The purpose of the National Appeals Service is to provide an internal and impartial review of decisions relating to applications for specified services and entitlements, where applicants are dissatisfied with the outcome of their application/review and to determine whether the original decision may be upheld or revoked, either fully or partially in accordance with legislation and guidelines.
An appeal option is provided for decisions which are made in accordance with relevant legislation, regulations and guidelines. In some instances the option for a reassessment/review process may be provided in advance of the appeal process, however, certain timeframes will apply.
A statutory appeal service is provided for the Nursing Homes Support Scheme (NHSS) wherein appeals officers appointed from a panel, approved by the Minister for Health, make decisions as prescribed in Section 32 of the NHSS Act 2009, (as amended).
A non-statutory appeals service is provided for other eligible schemes. Appeal decisions are made in line with the relevant legislation, regulations and guidelines for these schemes.
Aim of the National Appeals Service:
It is our aim to:
- provide prompt, accurate, courteous, efficient and impartial service to all of our service users.
- provide a high standard service and treat all of our service users fairly and equally.
We would ask that Service Users be equally courteous and respectful when communicating with National Appeals Service staff.
Schemes for which appeals can be made to National Appeals Service in the Health Service Executive:
- Nursing Homes Support Scheme (Also known as Fair Deal Scheme) - Appeals process is operated in line with Section 32 of the NHSS Act 2009, as amended, which provides the option of an appeal in relation to a decision made under the scheme (as specified).
- Medical Cards & GP Visit Cards (GPV) including General Medical /GPV cards, Over 70s Medical/GPV cards and Cards relating to persons 16-25 years of age - This is operated in line with the provisions of the Health Act 1970, as amended, and relevant regulations and guidelines.
- Residential Support Services Maintenance and Accommodation Contributions (RSSMAC) – (Also known as Long Stay Contribution) - This is operated in line with Sections 67A, 67B, 67C and 67D of the Health Act 1970, (as amended) and national guidelines issued by the Department of Health.
- Nursing Home Subvention Scheme - This is operated in line with the Nursing Homes Act 1990 and Nursing Homes (Subvention) Regulations.
- Health Amendment Card for persons suffering with Hepatitis C - This is operated in line with the Health Amendment Act 1996 (as amended).
- Supplementary Blind Welfare Allowance - As provided under Blind Persons Act 1920 (as amended) and in line with National guidelines issued by the Department of Health
- Mobility Allowance - As provided under Section 61 of the Health Act 1970( as amended) and in line with National Guidelines issued by the Department of Health.
- Acute (In-Patient) Hospital Charges - As provided in the Health Act 1970 as amended) and in line with regulations issued by the Department of Health.