Case descriptions
Referral to a Committee
Dr George Maragoudakis
Medical practitioner
Frankston Victoria
Dr Maragoudakis participates in the MedicarePlus Program entitling him to claim VRGP consultation items.
Medicare Australia was concerned that Dr Maragoudakis may have practiced inappropriately as he rendered 80 or more attendances on 31 days during the review period. The Medicare benefits for the attendances that fell under the 80/20 rule amounted to $50,850.40. Dr Maragoudakis was brought to PSR’s attention in December 2001.
Dr Maragoudakis was invited to make submissions to the Director. In his submission Dr Maragoudakis claimed that his rendering of services was due to exceptional circumstances and should be dismissed by the Director. He stated his practice was in a low socioeconomic area and treated many unemployed and disabled patients. He explained that these patients needed more frequent and urgent care than most in the general population.
Dr Maragoudakis also stated that there was a shortage of practitioners in the area, and it was difficult to get locums. His practice was one of three bulk billing practices in the area, and he worked 80 hours a week to meet patient demand.
A Professional Services Review Committee was established. The Committee unanimously found that Dr Maragoudakis had engaged in inappropriate practice. It concluded that Dr Maragoudakis’ conduct in providing services amounted to a prescribed pattern of services and that exceptional circumstances did not affect his provision of services during the referral period.
The Determining Authority, having considered the age of the referral and the changes Dr Maragoudakis has made to his practice since the review period, made a final determination that Dr Maragoudakis be reprimanded and counselled by the Director, and that he be disqualified from provision of general practitioner attendance services for three months.