Agency overview
The PSR Scheme
The object of the PSR Scheme is to protect the integrity of the Medicare benefits and pharmaceutical benefits programs by:
- protecting patients and the community in general from the risks associated with inappropriate practice
- protecting the Commonwealth from having to meet the cost of services provided as a result of inappropriate practice.
The PSR Scheme was developed to provide an effective peer review mechanism to deal quickly and fairly with concerns about possible inappropriate practice.
A practitioner engages in inappropriate practice if his or her conduct, in connection with rendering or initiating services, is such that the conduct would be unacceptable to the general body of the group (that is, medical practitioner, dentist, optometrist, chiropractor, physiotherapist, osteopath or podiatrist) in which the practitioner was practising.
A person who is an officer of a body corporate engages in inappropriate practice if the person causes or permits an employee to engage in inappropriate practice.
Key players in the PSR Scheme are:
- The Director of PSR, who is a medical practitioner appointed by the Minister for Health and Ageing with the agreement of the Australian Medical Association (AMA). Dr Anthony Webber was appointed Director of PSR on 14 February 2005 for a three-year period. Dr Webber’s appointment was extended for a further three-year term from 14 May 2008.
- The PSR Panel, comprising medical and other health care practitioners, who are appointed by the minister. At 30 June 2008, 165 members of the panel were available to serve on Committees. Of these, 21 were also appointed as Deputy Directors of PSR to serve as chairpersons of Committees.
- PSR Committees, comprising members of the PSR Panel, established by the Director on a case-by-case basis to consider the conduct of practitioners.
- The Determining Authority, comprising a medical practitioner as Chair, a layperson and a member of the relevant profession who are appointed by the minister. The Determining Authority’s role is to decide on sanctions for practitioners found by Committees to have engaged in inappropriate practice and to consider whether to ratify agreements entered into by the Director and the person under review.
- Medicare Australia that makes requests to the Director of PSR to review the provision of services by practitioners.
- The Australian Government Department of Health and Ageing that has responsibility for legislation and policy relating to the PSR Scheme.