Agency overview
The object of the PSR Scheme is to protect the integrity of the Medicare benefits and pharmaceutical benefits programs 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 PSR Scheme was developed with the aim of providing an effective peer review mechanism to deal quickly and fairly with concerns about possible inappropriate practice.
A practitioner engages in inappropriate practice if the practitioner’s conduct, in connection with rendering or initiating services, is such that the conduct would be unacceptable to the general body of the group (that is, medical practitioner, dentist, optometrist, chiropractor, physiotherapist, osteopath or podiatrist) in which the practitioner was practicing.
A person who is an officer of a body corporate engages in inappropriate practice if the person causes or permits a practitioner employed by the person or body corporate to engage in inappropriate practice.
The essential features of the PSR Scheme are:
- Director of PSR, who is a medical practitioner appointed ministerially and able to engage staff and consultants, to investigate requests to review from Medicare Australia. The Minister for Health and Ageing appointed Dr Anthony David Webber Director of Professional Services Review from 14 February 2005 for a three-year period
- PSR Panel, comprising medical and other health related practitioners, who are appointed ministerially. At 30 June 2007, 133 members were appointed by the Minister as Panel members to serve on Committees. Of these, 21 were also appointed as Deputy Directors of PSR to serve as chairpersons
- Committees, comprising practitioners from the PSR Panel, established by the Director on a case-by-case basis to consider the conduct of practitioners
- Determining Authority comprising a medical practitioner as Chair, a layperson and a member of the relevant profession who are appointed ministerially. The Determining Authority’s role is to decide on sanctions for practitioners found by Committees to have engaged in inappropriate practice and to consider whether to ratify agreements entered into by the Director and the person under review.
At every major point in the process the practitioner is given the opportunity to make submissions that could influence the outcomes.