Assumptions on UDA clawback must not be made

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Published: Thursday, 11 April 2013 08:31
Written by News Editor
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Assumptions on UDA clawback must not be made
The British Dental Association (BDA) has welcomed a ruling by the NHS Litigation Authority that a primary care trust (PCT) must prove the level of inappropriate claims it is alleging a practice has made, rather than making assumptions based on a snapshot of a limited period of time or number of patients. Dr John Milne described the ruling as ‘a victory for common sense.’

The ruling, which has been made against Somerset PCT, says that it was not acceptable for the PCT to calculate possible over-claiming for a period of several years by looking at a small, selected amount of cases, but that it was instead required to provide evidence of the over-payments it alleges have been made.

Dr John Milne, Chair of the BDA’s General Dental Practice Committee, said:  “The BDA has long argued that it is inappropriate for PCTs to press for clawback on the basis of guesswork and assumption.
“This ruling is a victory for common sense. In cases where overpayments are being alleged, the onus should be on the party making the allegation to prove them, not on the accused party to disprove them. Ideally such situations are resolved by a constructive dialogue between a practice and PCT, but where that isn’t possible it is only right and proper that the alleged wrongdoing is proved by the production of evidence.”
Details of the ruling against Somerset PCT are available on the NHS Litigation Authority website.

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