Case descriptions
Agreement entered into between Director and person under review
Dr X
General practitioner
Victoria
Medicare Australia had previously referred Dr X to PSR in 2003. Dr X had a niche practice, in which he treated patients with drug and alcohol addiction. The previous Director of PSR subsequently dismissed that matter.
Medicare Australia referred Dr X to PSR again in 2007 due to concerns over his rendered services, daily services, rendering of skin excision items, and prescribing under the PBS – in particular total PBS items and drugs of dependence. Medicare Australia’s statistics showed that Dr X was in the 99th percentile for rendered services and total benefits. His patient numbers were in the 92nd percentile, and his total PBS statistics were in the 97th percentile.
In addition, Dr X was at or above the 96th percentile for prescribing drugs of dependence.
The Director reviewed a sample of Dr X’s medical records. During the course of his review the Director meet with Dr X to discuss concerns about his prescribing of lactulose, diclofenace, diazepam, fentanyl and buprenorphine during the review period. Discussion also centred on his lack of recording of clinical detail in a minority of medical records in relation to MBS item 36, and skin excision item services.
Dr X acknowledged that during the review period he had failed to have due regard to the restrictions applying to prescribing lactulose and diclofenace under the PBS. Through his discussions with Dr X and a subsequent written submission the Director’s concerns were largely addressed.
Dr X impressed as a competent practitioner dealing with a difficult and demanding patient base. The Director considered it appropriate to enter into an agreement to resolve this matter.
Dr X agreed to be reprimanded by the Director and to repay $3500 in Medicare benefits that related to those consultations in which he had inappropriately prescribed lactulose and diclofenace outside PBS restrictions.