Learn from the mistakes of others

Legal hiccup hits Medicare abuse investigations.
ABC News Online.

First Posted: Monday, May 8, 2006. 4:45pm
Last Update: Monday, May 8, 2006. 4:45pm (AEST)

The Federal Court has ruled that the process used by the Professional Services Review to investigate a doctor accused of misusing Medicare was technically unlawful, because of the way in which the doctor's Medicare claims were examined.

Federal Health Minister Tony Abbott says he is considering legal advice to see if the system needs to be changed as a result of the ruling.

The Federal Opposition says it is concerned about the methods the Government uses to investigate doctors.

Opposition health spokeswoman Julia Gillard says the Government must address the issue.

"Obviously we need a rigorous system to make sure that no-one is abusing Medicare. If there's any hole in the system of prosecutions then it has got to be fixed," she said.

Ah, oops!

"What do you mean, no one bothered to check first?"


This is just plain stupid. Again. Still.


Just what exactly is "Professional Services Review"? A tribunal? board? panel? It's an 'organisation', or a 'scheme' ...

The Professional Services Review
Protecting the integrity of our public health schemes

The Professional Services Review (PSR) exists to protect the integrity of Medicare [Australia] and the Pharmaceutical Benefits Scheme (PBS). In doing so it also protects patients and the community in general from the risks associated with inappropriate practice, and protects the Commonwealth from having to meet the cost of services provided as a result of inappropriate practice.

Health practitioners covered by the PSR Scheme include any practioner[sic] that provides Medicare or PBS services. This includes; medical and dental practitioners, podiatrists, chiropractors, physiotherapists and optometrists.

The PSR Scheme is the process used for reviewing and investigating the provision of services by a person to determine whether the person has engaged in inappropriate practice.

On this web site you can find out more about PSR as an organisation; how the PSR Scheme works; and how a PSR Committee undertakes a hearing and reaches a decision on the Health Practioner (also known as the Person Under Review or PUR). You can also find out more about the important role the PSR Director plays in this process, and where the Determining Authority fits into the scheme.

A comprehensive legal section provides a broad and comprehensive set of legal materials and information on the legislative and regulatory frameworks in which the PSR Scheme operates.