The 2014-2015 annual report of the Professional Services Review (Australian Government) is now available online.
The scheme seeks to protect patients and the community in general from the risks associated with inappropriate healthcare practice’ and protecting ‘the Commonwealth from having to meet the cost of services provided as a result of inappropriate practice, under the Medicare scheme.
38 cases were completed in the year, 12 of which saw no action taken. 18 matters saw ‘negotiated agreements’ with repayment orders, reprimands and in some cases partial Medicare disqualification. The repayment orders totalled about $1.5 million which seems to average a little under $100,000 per matter.
Various final (not negotiated) determinations were made, one of which appears to have given rise to a substantial repayment order of almost $2 million.
PSR reported in 2013–14 that many referrals to PSR from Medicare were in respect of GPs’ use of MBS Chronic Disease Management items and MBS Health Assessment items. This trend was reported as having accelerated in 2014–15.
The report on page 11 made mention of the potential responsibility of large practice owners, saying:
Most large practices engage GPs on a revenue-sharing basis rather than as salaried employees. Contracted GPs receive a percentage of income generated. An emerging issue is the extent to which the practice owner is responsible for ensuring that contracted practitioners do not engage in inappropriate practice.