Case descriptions
Referral to a Committee
Dr Andreas Henco
Medical practitioner
Cairns Queensland
Medicare Australia was concerned that Dr Henco may have practised inappropriately in relation to:
- rendered services
- volume of daily servicing constituting a prescribed pattern of servicing (80/20 deeming provision)
- initiation of pathology and diagnostic imaging
- prescribing of antibiotics
- use of Regulation 24.48
Dr Henco rendered 80 or more professional attendances per day on 24 occasions.
The Director reviewed Dr Henco’s medical records and had no major concerns about MBS items 53, 698,49 5020 or his prescribing of amoxicillin/clavulanic acid tablets. For MBS item 54 services, however, the Director found that the conditions treated were straightforward and would not have taken the time needed to meet the MBS item descriptor. Dr Henco’s prescribing of cefaclor was considered inappropriate, as the conditions being treated were minor viral respiratory tract infections. The Director concluded that Dr Henco may have ‘up coded’ many of his consultations, provided services not medically necessary, failed to keep adequate and contemporaneous records, and failed to provide an appropriate level of clinical input to his services and prescribing.
A Professional Services Review Committee was established. The Committee found that Dr Henco had practiced inappropriately in 83 per cent of MBS item 54 services. The Committee examined 15 occasions where Dr Henco prescribed cefaclor and found that he practised inappropriately on eight of those occasions. The Committee found 80 per cent of Dr Henco’s use of CT scanning of the lumbar spine inappropriate and his claimed use of an operating microscope to perform ‘ear toilet’ inappropriate in all instances.
Dr Henco returned to Germany at the time Medicare Australia referred him to PSR. This did not inhibit the investigation as medical records were sourced from the practice at which he had worked. As provided for in the Act, the Committee met and considered the evidence in Dr Henco’s absence.
The Determining Authority made a Determination that Dr Henco be reprimanded and counselled by the Director, repay $84,338 in Medicare benefits, be suspended for six months and be disqualified from providing services to which an item in Group A2 of the General Medical Services Table relates for six months.
Although Dr Henco did not return from Germany he promptly repaid Medicare benefits as required by the Determining Authority.
- 48 Regulation 24 allows a pharmacist to dispense repeat prescriptions with the original supply
- 49 MBS item 698 is a professional attendance at consulting rooms between 11 pm and 7 am