Agency Overview
The object of the Professional Services Review (PSR) scheme is to protect the integrity of the Medicare Benefits Scheme and the Pharmaceutical Benefits Scheme (PBS) by:
- protecting patients and the community in general from the risks associated with inappropriate practice
- protecting the Commonwealth from having to meet the cost of services provided as a result of inappropriate practice.
The role and function of PSR is to administer Part VAA of the Health Insurance Act 1973 (the Act). The current scheme, effective 1 January 2003, is an avenue for review and investigation of cases of suspected inappropriate practice by practitioners who render or initiate services attracting a Medicare benefit or who prescribe under the PBS (see Appendix 3). After undertaking a review, the Director must decide to either take no further action, or provide the practitioner with a written report and invite submissions on any further action.
After time for submissions, the Director must:
- decide to take no further action
- enter into an agreement, or
- establish and make a referral to a peer review committee.