PSR Annual Report 2005-2006

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Glossary

AASB
Australian Accounting Standards Board
AEIFRS
Australian Equivalents to International Financial Reporting Standards
AGAAP
Australian Generally Accepted Accounting Principles
Act
Health Insurance Act 1973, as amended by the Health Legislation (Professional Services Review) Amendment Act 1994 and subsequent amendments
adjudicative referral
A case prepared by the Director, instituting a referral to a PSR committee, after an investigation of the concerns contained in an investigative referral. (From 1 January 2003 the Director makes a referral to a PSR committee to investigate concerns.)
AMA
Australian Medical Association
committee
A Professional Services Review committee established by the Director in accordance with section 93 of the Act to examine a case of apparent 'inappropriate practice' referred by Medicare Australia
COX-2
a selective inhibitor-the newest of the nonsteroidal anti-inflammatory drugs
Determining Authority
A three-person panel responsible for determining the sanction following an adverse PSR committee finding
Determining Officer
An officer appointed by the Minister to determine an appropriate sanction to apply where a PSR committee finds a person under review has engaged in inappropriate practice, as defined in the Act
Director
The Director of Professional Services Review is an independent statutory officer appointed by the Minister-the occupant must be a medical practitioner and the AMA must agree to the appointment
disqualification
Exclusion (partial or complete) from eligibility for the practitioner's services to attract Medicare benefits
FMO
Finance Minister's Orders
inappropriate practice
Professional conduct in relation to Medicare which a committee of peers would reasonably consider would be unacceptable to the general body of the peer group (section 82)
investigative referral
A case prepared by Medicare Australia and referred to the Director, containing Medicare Australia's concerns and the reasons it considers a practitioner or other person may have engaged in inappropriate practice in the terms of section 82 of the Act. (From 1 January 2003, the Commission asks the Director to review the provision of services by a practitioner.)
MBS
Medicare Benefits Schedule
Minister
Minister for Health and Ageing
MPRC
Medicare Participation Review Committee
OH&S
occupational health and safety
Panel
PSR Panel consisting of medical practitioners, dentists, optometrists, osteopaths, chiropractors, physiotherapists and podiatrists nominated by the relevant professional organisations and who have been appointed by the Minister
PBS
Pharmaceutical Benefits Scheme
PSR
Professional Services Review
referral
A case prepared by the Director and referred to a PSR committee for investigation, detailing the concerns and the reasons a practitioner or other person may have engaged in 'inappropriate practice' in the terms of section 82 of the Act
request for review
A case prepared by Medicare Australia asking the Director to review the provision of services and containing Medicare Australia's concerns and the reasons it considers a practitioner or other person may have engaged in inappropriate practice in the terms of section 82 of the Act (applies from 1 January 2003)
80/20 rule
A prescribed pattern of services applying to practitioners providing 80 or more professional attendances on 20 or more days in a 12-month period

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