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

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