PSR Annual Report 2006-07
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Glossary
- AAT
- Administrative Appeals Tribunal
- ACSI 33
- Australian Government Information and Communications Technology Security Manual
- Act
- Health Insurance Act 1973, as amended by the Health Legislation (Professional Services Review) Amendment Act 1994 and subsequent amendments
- 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 non-steroidal anti‑inflammatory drugs
- Determining Authority
- A three-person panel responsible for determining the sanction following an adverse PSR Committee finding
- 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
- EPBC Act
- Environmental Protection and Biodiversity Conservation Act 1999
- ESD
- ecologically sustainable development
- FOI
- freedom of information
- inappropriate practice
- Conduct in connection with rendering or initiating services for which a Medicare benefit was payable, and which a Committee of peers could reasonably consider would be unacceptable to the general body of the peer group (section 82 of the Act)
- MBS
- Medicare Benefits Schedule
- Minister
- Minister for Health and Ageing
- OH&S
- occupational health and safety
- Panel
- PSR Panel consisting of medical practitioners, dentists, optometrists, chiropractors, physiotherapists, osteopaths and podiatrists appointed by the Minister following consultation with the relevant professional organisations
- Prescribed pattern of services
- A prescribed pattern of services is also known as the 80/20 rule, whereby a practitioner is deemed to have practiced inappropriately if he or she renders 80 or more services on 20 or more days in a 12-month period
- 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.
- 80/20 rule
- see prescribed pattern of services