PSR Director's Update for November 2018

12 December 2018

 

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 November 2018, eight s 92 agreements entered into between the Director and persons under review came into effect.

A. Director’s Section 92 agreements effective in November 2018

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

  • An agreement with a general practitioner. The Director reviewed this practitioner’s rendering of Medicare Benefits Schedule (MBS) items 23, 36, 44, 721, 723, 732, 2525, 2713, 2717 and 5063 and prescribing of Pharmaceutical Benefits Scheme (PBS) items 1215Y, 2622B, 3162K, 8611F, 8785J, 8935G, 8936H, 10509D, 10624E, 10628J, 10642D, 10657X and 10659B. The practitioner acknowledged they engaged in inappropriate practice in connection with providing these items, except for PBS items 10509D, 10624E, 10628J, 10642D, 10657X and 10659B, in relation to which the Director had no persisting concerns. The practitioner agreed to repay $400,000, to be disqualified from providing MBS items 732, 2713, 2717 and 5063 for 12 months, and to be reprimanded by the Director.
     
  • An agreement with a general practitioner. The Director reviewed this practitioner’s rendering of MBS items 23, 36, 193, 197, 721, 723, 5020 and 5040.  The practitioner acknowledged they engaged in inappropriate practice in connection with providing these items. The practitioner agreed to repay $530,000, to be disqualified from providing MBS items 36, 197, 721 and 723 for 12 months, and to be reprimanded by the Director.
     
  • An agreement with a medical practitioner. The Director reviewed this practitioner’s rendering of MBS items 597, 598, 599 and 600. The practitioner acknowledged they engaged in inappropriate practice in connection with providing these items. The practitioner agreed to repay $300,000 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, 44, 5020, 5040 and 5060 and their prescribing of PBS item 8254K. The practitioner acknowledged they engaged in inappropriate practice in connection with providing these items. The practitioner agreed to repay $450,000, to be disqualified from providing MBS item 36, 44, 5040 and 5060 services for 18 months, and to be reprimanded by the Director.
     
  • An agreement with a general practitioner. The Director reviewed this practitioner’s rendering of MBS items 23, 35, 36, 721, 723, 2715, 5020, 5028 and 30192 and prescribing of PBS items 2089Y, 2622B, 3133X, 3162K and 8254K. The practitioner acknowledged they engaged in inappropriate practice in connection with providing these items. The practitioner agreed to repay $400,000, to be disqualified from providing MBS items 36, 721, 723 and 2715 for 12 months and to be reprimanded by the Director.
     
  • An agreement with a medical practitioner. The Director reviewed this practitioner’s rendering of MBS items 597 and 599. The practitioner acknowledged they engaged in inappropriate practice in connection with providing these items. The practitioner agreed to repay $610,000, to be disqualified from providing MBS items 585, 588, 591, 594 and 599 for 12 months and to be reprimanded by the Director.
     
  • An agreement with a general practitioner. The Director reviewed this practitioner’s provision of MBS items 23, 721, 723, 732, 2517, 2715, 2717, 65070, 66512, 66770, 69496 and 10997 and prescribing of PBS item 8814X. The practitioner acknowledged they engaged in inappropriate practice in connection with MBS items 723, 732 and 2715. The Director had no concerns about the other reviewed items. The practitioner agreed to repay $40,000 and will be reprimanded by the Director.
     
  • An agreement with a general practitioner. The Director reviewed this practitioner’s rendering of MBS items 597 and 599. The practitioner acknowledged they engaged in inappropriate practice in connection with providing these items. The practitioner agreed to repay $280,000 and will be reprimanded by the Director.

B. PSR Committees’ final determinations effective in November 2018

There were no final determinations that became effective in November 2018.

C. Federal Court

The decision in the judicial review application first mentioned in September 2017 remains reserved.

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

No matters were referred to the major non-compliance (fraud) division in November 2018.

E. Referrals to AHPRA

One matter was referred to AHPRA in November 2018.