2002 Amendments - Clarifying the objectives of the PSR Scheme

Consistent with the recommendations of the 1999 Review, the PSR Scheme was modified further in 2002, to clarify the intended operation of the Scheme and to address certain issues identified by the Federal Court in the Pradhan decision. The legislative amendments were made by the Health Insurance Amendment (Professional Services Review and Other Matters) Act 2002. All key stakeholders supported the amendments to the Act, which came into effect on 1 January 2003. The main amendments included:

  • the inclusion of a new objects clause, emphasising the public protective aim of the Scheme
  • the replacement of the investigative referral process with a request from Medicare Australia that the Director examine Medicare services rendered or initiated by a practitioner for whom a Medicare benefit had been claimed during a period (s.86). This amendment meant that the Director or a PSR Committee was able to examine patient records relating to any or all specified services rendered or initiated by the practitioner during a specified period, and was not restricted by Medicare Australia’s reasons for the request
  • the validation of previous referrals potentially affected by the Pradhan decision and
  • enhanced procedural fairness opportunities at various stages of the Scheme’s review process.

Related Legislation