PSR Director's Update for January and February 2019

20 February 2019

 

Due to the nature of negotiated agreements and secrecy limitations imposed by the legislative scheme, no practitioners who have entered into s 92 agreements with the Director are named. The Director has the power to disclose the names and addresses of practitioners who are found by a Committee to have engaged in inappropriate practice and who are subject to a final determination.
Read the Director’s policy on the naming of practitioners in PSR's Policy on the Publication of Case Outcomes
For media enquiries, please contact PSR at 02 6120 9100 or feedback@psr.gov.au.
 

In January 2019, one final determination became effective and in February 2019, nine s 92 agreements entered into between the Director and persons under review came into effect.

A. Director’s Section 92 agreements effective in February 2019

The following agreements entered into by the Director and persons under review (in accordance with s 92 of the Act) came into effect:

  • An agreement with a general practitioner. The Director reviewed this practitioner’s rendering of Medicare Benefits Schedule (MBS) items 23, 721, 723, 2713 and 66833, and Pharmaceutical Benefits Scheme (PBS) items 3119E, 9048F and 9479X. The practitioner acknowledged they engaged in inappropriate practice in connection with providing these items, except for MBS items 23 and 66833, and PBS items 3119E in relation to which the Director had no concerns. The practitioner agreed to repay $100,000, to be disqualified from providing MBS items 721, 723 for 12 months, and will be reprimanded by the Director.
     
  • An agreement with a medical practitioner. The Director reviewed this practitioner’s rendering of MBS items 65, 598 and 600, and PBS items 3119E and 3138E. The practitioner acknowledged they engaged in inappropriate practice in connection with providing these items, except for PBS items 3119E and 3138E in relation to which the Director had no concerns. The practitioner agreed to repay $300,000, to be disqualified from providing MBS items 65, 585, 588, 591, 594 for 12 months, and will be reprimanded by the Director.
     
  • An agreement with a medical practitioner. The Director reviewed this practitioner’s rendering of MBS items 598 and 600. The practitioner acknowledged they engaged in inappropriate practice in connection with providing these items. The practitioner agreed to repay $210,000, and will be reprimanded by the Director.
     
  • An agreement with a medical practitioner. The Director reviewed this practitioner’s rendering of MBS items 597, 599 and 2725. The practitioner acknowledged they engaged in inappropriate practice in connection with providing these items. The practitioner agreed to repay $350,000, to be disqualified from providing MBS items 2725 for 12 months, and will be reprimanded by the Director.
     
  • An agreement with a general practitioner. The Director reviewed this practitioner’s rendering of MBS items 23, 36, 721, 723, 732 and 2713. The practitioner acknowledged they engaged in inappropriate practice in connection with providing these items. The practitioner agreed to repay $500,000, to be disqualified from providing MBS items 721, 723 and 732 for 12 months, disqualified from providing MBS items 36 and 2713 for six months and will be reprimanded by the Director.
     
  • An agreement with a general practitioner. The Director reviewed this practitioner’s rendering of MBS items 23 and 36. The practitioner acknowledged they engaged in inappropriate practice in connection with providing these items. The practitioner agreed to repay $220,000, to be disqualified from providing MBS items 36 for 6 months, and will be reprimanded by the Director.
     
  • An agreement with a medical practitioner. The Director reviewed this practitioner’s rendering of MBS items 597 and 599, and PBS items 3119E and 5470X. The practitioner acknowledged they engaged in inappropriate practice in connection with providing these items. The practitioner agreed to repay $550,000, to be disqualified from providing MBS items 585, 588, 591, 594 for 12 months, and will be reprimanded by the Director.
     
  • An agreement with a general practitioner. The Director reviewed this practitioner’s rendering of MBS items 23, 721, 723, 732, 5020, 66596, 66716 and 66838. The practitioner acknowledged they engaged in inappropriate practice in connection with providing these items. The practitioner agreed to repay $220,000, to be disqualified from providing MBS items 721, 723, 732 for 6 months, and will be reprimanded by the Director.
     
  • An agreement with a general practitioner. The Director reviewed this practitioner’s rendering of MBS items 23, 721, 723 and 732. The practitioner acknowledged they engaged in inappropriate practice in connection with providing these items. The practitioner agreed to repay $390,000, to be disqualified from providing MBS items 721, 723, 732 for 12 months, and will be reprimanded by the Director.

B. PSR Committees’ final determination effective in January 2019

One final determination became effective in January 2019.

PSR Committee No. 1035:

This general practitioner was directed to be reprimanded and counselled by the Director and to repay $1,297.20 to the Commonwealth. These directions followed from a final report of a PSR Committee which concluded the practitioner engaged in inappropriate practice for services that he rendered as MBS items 2713 and 2717.

The Committee’s findings relating to MBS item 2713 – Professional attendance by a general practitioner in relation to a mental disorder and of at least 20 minutes in duration:

The Committee found that in some instances:

  • The general practitioner’s clinical input was inadequate and/or
  • The general practitioner did not make an adequate clinical record of the service, including providing sufficient clinical content to justify a consultation lasting at least 20 minutes. 

The Committee’s findings relating to MBS item 2717 – Professional attendance by a general practitioner of at least 40 minutes for the preparation of a GP mental health treatment plan:

The Committee found that in some instances:

  • The regulatory requirements of the item number were not met, in relation to a date of review, emergency care plan and/or crisis intervention for the patient and/or
  • The general practitioner did not make an adequate clinical record of the service, including on a number of occasions providing insufficient clinical content to justify a consultation lasting at least 40 minutes.

C. Federal Court

No decisions from the Federal Court were handed down in January or February 2019.

D. Referrals to the major non-compliance (fraud) division

No matters were referred to the major non-compliance (fraud) division in January or February 2019.

E. Referrals to AHPRA

Two matters were referred to AHPRA in January 2019.