1. Agency overview
Our relationships
PSR has working relationships with the Health Insurance Commission, the Department of Health and Ageing, the Professional Services Review Tribunals and health registration boards nationwide.
Health Insurance Commission
Professional Services Review’s workload is dependent on requests sent by the Commission. The Commission, which administers the Medicare and Pharmaceutical Benefits Schemes, can request the Director to review provision of services by a practitioner for suspected inappropriate practice.
Cases of possible fraud identified during the PSR process are referred back to the Commission for action.
Department of Health and Ageing
The Department of Health and Ageing has policy responsibility for providing advice to the Minister on development and maintenance of the PSR scheme. The Department liaises with stakeholders in the scheme and performs the broader tasks of policy review and development of legislation.
The Minister has appointed a senior officer of the Department, the First Assistant Secretary, Medical and Pharmaceutical Services Division, to the position of Determining Officer for cases referred to PSR prior to 1 August 1999. There are no referrals made before that date outstanding for completion by the Determining Officer. The role of Determining Officer will cease to exist once the last case currently before the Federal Court has been finalised. (The Determining Authority has an expanded role to that of the Determining Officer for cases referred after 1 August 1999.)
Professional Services Review Tribunals
The Health Insurance Amendment (Professional Services Review) Act 1999 preserves the right of practitioners to seek a review of determinations made by the Determining Officer in relation to matters referred by the Commission before that legislation came into effect in August 1999. Once the last case currently before the Federal Court is finalised, the Tribunals will cease to function. The Tribunals are not, however, empowered to review decisions of the Determining Authority, which took over the role of the Determining Officer for cases referred after August 1999.
Health registration boards
The Act allows PSR to refer a person under review to appropriate bodies when a significant threat to the life or health of a patient is identified or where the person under review has failed to comply with professional standards.