The Previous Schemes/History
Detailed information on the PSR scheme is published in the document Your Guide to the PSR Process
The 1994 Scheme
The Professional Services Review Scheme was
established within the Health Insurance Act 1973 ("the Act") in
1994. It was subsequently significantly amended in 1997, 1999 and
2002. In each amendment the
operation of the earlier legislation was mostly preserved in relation
to matters referred by the (then) Health Insurance Commission ("the
HIC") before the
amendment commenced.
To introduce the Professional Services Review
Scheme the Act was amended by the Health Legislation (Professional Services Review)
Amendment Act 1994 (No.22 of 1994) which commenced on 1 July 1994.
Section 12 of that amendment preserved the operation of the
previous Medical Services Committees of Inquiry and Optometrical
Services Committees of Inquiry in relation to matters already being
considered under those schemes.
Regulations relevant to the original PSR legislation were:
Health Insurance Regulations (Amendment) - 1994 No.138
which commenced on 1 July 1994 and the Explanatory Statement.
Health Insurance Commission Regulations (Amendment) -
1994 No.257 which commenced on 28 July 1994.
Note also the Report of the Senate Standing
Committee on Community Affairs on the Health Legislation (Professional
Services Review)
Amendment Bill 1993 (SJ No.43) tabled in the Senate on
23 November 1993.
The 1997 Scheme
Amendments to the scheme by the Health Insurance Amendment Act (No.1) 1997
(No.146, 1997) commenced on 6 November 1997. Section 4 of that
amendment preserved the operation of certain sections for matters
referred by the HIC under s.86 before that date.
The 1999 Scheme
Following the Report of the Review Committee of
the Professional
Services Review Scheme, further amendments to the scheme were made
by the Health Insurance Amendment (Professional Services
Review) Act 1999 (No.95, 1999) which commenced as follows:
- Clauses 1, 2 and 3 commenced on Assent (16 July
1999);
- clauses 2 and 27 (regarding medical records)
commenced on 1 November 1999;
- the remaining provisions commenced on 1 August
1999.
Part 2 of the amendments generally
preserved the operation of the previous legislation for matters
referred by the HIC before 1 August 1999. See also the Explanatory Memorandum.
Additional minor amendments to the scheme were
made by Schedule 4 of the Health Legislation Amendment Act (No.3) 1999
(No.159, 1999).
Regulations
The current consolidated regulations relevant to
the PSR scheme are the Health
Insurance (Professional Services Review)
Regulations 1999 (No.258 1999) as amended see Regulations
A history of amendments is as follows:
Guidelines
Previously guidelines have been made by the
Minister in relation to referrals to the Director of Professional
Services Review.
Referral Guidelines for the 1994 Scheme were
- Guidelines as to Form and Content of Referrals
to the
Director of Professional Services Review made by the Minister under
the then s.87(3) of the Health Insurance Act 1973 on 9 May 1994.
which only applied to referrals made before 1
August 1999 by virtue of
- Professional Services Review Scheme - Guidelines as
to Form and Content of Referrals to the Director of Professional
Services Review Amendment Guidelines 1999 (No.1) made by the
Minister under the then s.87(3) of the Health Insurance Act 1973 on 13
December
1999.
Referral Guidelines for the 1999 Scheme were
- Health Insurance (Professional Services Review -
Content of Investigative Referrals) Guidelines 1999 made by the
Minister under the then s.87(3) of the Health Insurance Act 1973 on 9
December
1999.
- Health Insurance (Professional Services Review -
Content and Form of Adjudicative Referrals) Guidelines 1999 made by
the Minister under s.93(4) of the Health Insurance Act 1973 on 13
December 1999.
No guidelines have been made under s.93(4) for the
current (2003)
PSR Scheme.
Sampling
The first operational sampling scheme was set out
in
- Professional Services Review Scheme -
Directions as to
Sampling (No.2) made by the Minister under the then s.106K of the
Health
Insurance Act 1973 on 31 January 1995. (The earlier Directions as
to Sampling (No.1) were replaced by
Directions (No.2) before any cases were referred by HIC to PSR.)
That sampling scheme did not apply to referrals
made after the 1997 repeal of the then s.106K.
Following the 1999 amendments, the Minister made
the following Determination under the new s.106K(3) of the Act
specifying the content and form of a sampling methodology that may be
used by a Committee for the purposes of the new s.106K(1):
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