These are the main conclusions given in Document no. 3:3 (2005–2006) The Office of the Auditor General’s investigation of services from laboratory and X-ray agencies that was submitted to the Storting on 21 October 2005.
The objective of the investigation was to assess whether the administration of approval schemes and agreements with private laboratories and X-ray institutes constitutes good utilisation of resources. The management and monitoring of reimbursement claims from private laboratory and X-ray agencies were also investigated to discover whether they are satisfactory.
The investigation shows that the regional health enterprises do not have sufficient information about the need for laboratory and X-ray services and the cost of producing these services within their own organisation. They therefore have little opportunity to assess whether purchasing services from private laboratories and X-ray institutes represents sound economy.
To be entitled to reimbursement from the National Insurance Service, private laboratories and X-ray institutes are required to have an agreement with one or more regional health enterprises. The investigation shows that the regional health enterprises have entered agreements without following the regulations for public procurements. The agreements do not adequately specify the services the private laboratories and X-ray institutes are to perform. In some cases the health enterprises have also purchased such services without making an agreement.
The National Insurance Administration does not adequately monitor the reimbursement claims from private laboratories and X-ray institutes and cannot document how these payments were monitored. Standard agreements that are intended to regulate the various aspects of payment between the National Insurance Service and private laboratories and X-ray institutes have not been put to use. In addition, no appropriate specialist support network has been established in the National Insurance Service that can clarify issues concerning the correct application of rates when processing reimbursement claims. No written risk assessments exist and there are no written procedures specifying how the payment monitoring should be carried out.
In its response to the Office of the Auditor General, the Ministry of Health and Care Services states that the financing scheme for private laboratories and X-ray institutes was recently changed. The changes came into effect on 1 September 2005 and will facilitate better monitoring of this area.
The provision concerning delayed public access to documents that are compiled by or sent to the Office of the Auditor General in connection with the Document no. 3:3 series (2005–2006) has been repealed, cf. Section 28, paragraph 2 of the Auditor General Act.