RTÉ News has learned that for the past two years, GPs have had the same powers to renew or reinstate medical cards, which were announced in the Government's ten-point plan yesterday.
The provision was made under an agreement between the Health Service Executive and the Irish Medical Organisation reached in 2012.
Under the agreement, which has been in place ever since, in "sensitive circumstances" a GP can reinstate a patients' eligibility for up to a year and in other circumstances the reinstatement of eligibility is for four months.
It remains unclear the extent to which all GPs have been aware of these powers, or have chosen to exercise these powers, during the recent controversy over the withdrawal of cards.
So far this year, 712 clients of GPs have had their cards reinstated under this system.
A "sensitive renewal" is permitted where a patient's eligibility was due for review and the GP was aware of circumstances that would result in the patient losing the card, because the patient had not or could not complete the standard review process.
A GP can also reinstate a patient's eligibility, if a patient attends for services and for some reason the patient's eligibility has been suspended but the GP is satisfied that patient is still entitled to receive services free of charge.
This reinstatement can be for four months.
Both of these options have been open to GPs since 2012 regardless of whether the patient's eligibility was awarded in line with national guidelines, or if it was granted on a discretionary basis.
The IMO's annual report for 2012 makes reference to the new system on page 21.
It said that following meetings, joint IMO/HSE (Primary Care Reimbursement Scheme) documents were agreed.
The IMO said the system went live in March 2012 and was used to add newborns, reinstate patients, including sensitive patients, as well as remove patients.
A spokesperson for Minister for Health Leo Varadkar said the minister had been clear yesterday in announcing that the power of GPs to issue cards in difficult circumstances would be "strengthened".
The Chairman of the Irish Medical Organisation's GP Committee has rejected the idea that GPs have had the ability, up to now, to re-instate or extend discretionary medical cards.
Dr Ray Walley said while they had called for this in 2010, no criteria were ever agreed as to when this could be done.
He said that GPs only had the ability to register newborns in exceptional circumstances to allow for their immunisations and other care.
Dr Walley said that if it was the case that GPs could reinstate cards up to now, "why would the Minister for Health have announced it yesterday?"
He said that GPs saw yesterday's announcement as a positive, important step towards creating an ethical patient-centred, humanistic-approach to registering some of the most vulnerable with a discretionary medical card.
Dr Walley said they welcomed that the minister plans to improve the system, but criteria have yet to be agreed for these to be fully implemented.
He added that the registration of the vast majority of medical and discretionary cards remained the responsibility of the HSE registration's system.
The National Association of GPs said it was unaware of reported powers that GPs had already been given by the HSE to reinstate cards.
Chief executive of the recently-established organisation Chris Goodey said that if GPs had been aware, they would have exercised the power.
