Insights

Federal Court of Australia confirms Professional Services Review (PSR) has the power to order part repayments

Professional Services Review (PSR) is a Commonwealth Agency whose objective is to protect the integrity of the Commonwealth Medicare benefits, dental benefits and pharmaceutical benefits programs and, in doing so, protect patients and the community from the risks associated with ‘inappropriate practice’, and protect the Commonwealth from having to meet the cost of medical and […]

Professional Services Review (PSR) launches telehealth review

Professional Services Review (PSR) is a Commonwealth Agency whose objective is to protect the integrity of the Commonwealth Medicare benefits, dental benefits and pharmaceutical benefits programs and, in doing so, protect patients and the community from the risks associated with ‘inappropriate practice’, and protect the Commonwealth from having to meet the cost of medical and […]

Medicare Shared Debt Recovery Scheme to significantly affect recovery of incorrect Medicare billings from next month

From 1 July 2019, the Shared Debt Recovery Scheme will allow the Commonwealth Government to hold a practitioner (primary debtor) as well as another party such as medical and other health practices (secondary debtor) responsible for repayment of debts resulting from incorrectly claiming Medicare benefits. According to the recently enacted Health Insurance (Medicare Compliance Shared […]

Federal Court confirms strict interpretation of the 80/20 rule under the Health Insurance Act 1973

In a recent decision, the Federal Court of Australia confirmed that health care practitioners alleged to have engaged in ‘inappropriate practice’ in providing 80 or more professional services on each of 20 or more days during a relevant period are burdened with the evidentiary onus of establishing that there was an absence of alternative medical […]

Shared Debt Recovery Scheme to hold both medical practitioners and employing and contracting organisations responsible for incorrect Medicare billing

The Shared Debt Recovery Scheme will take effect on 1 July 2019. The recent enactment of the Health Legislation Amendment (Improved Medicare Compliance and Other Measures) Bill 2008, will mean that from 1 July 2019 the Commonwealth Government will be able to pursue both individual medical practitioners and employing and contracting medical organisations for repayment […]

Medical Board reforms for older medical practitioners and those the subject of multiple complaints

The Medical Board of Australia has announced the implementation of a new Professional Performance Framework that will apply to registered medical practitioners in Australia. The Board proposes to introduce performance processes for practitioners with a record of multiple substantiated complaints against their registration, as well as for practitioners over 70 years of age. Australia does […]