PSR Director's update for April and May 2026

A. Section 92 agreements effective in April and May 2026

Eleven agreements entered into by the Director or an Associate Director and persons under review (under section 92 of the Act) came into effect in April 2026. No agreements came into effect in May 2026:

Respiratory and sleep medicine physician

During the review period, the practitioner rendered more total services than 99% of their peers, and rendered the highest volume nationally of services billed as the following Medicare Benefits Schedule (MBS) items:

• 11503 (complex measurement of properties of the respiratory system, including the lungs and respiratory muscles)
• 12203 (overnight diagnostic assessment of sleep – laboratory sleep study)
• 12204 (overnight assessment of positive airway pressure)
• 12250 (overnight diagnostic assessment of sleep – home sleep study)

The Director reviewed the practitioner’s rendering of MBS item 110 (initial attendance by a consultant physician), 11503, 12203, 12204 and 12250 services. The Director had the following persisting concerns:

• In relation to MBS item 110 services:
  • the MBS requirements were not always met, including where the service was not for an initial attendance in a single course of treatment
  • the practitioner’s clinical input was sometimes inadequate
  • the medical records did not always contain sufficient information to explain the service.
• MBS item 11503 services rendered by the practitioner were not always clinically indicated. The MBS requirements were also not always met, including where the service was performed in association with other items prohibited by the MBS item descriptor, or where the results of the procedure were not formally reported
• For MBS item 12203 and 12204 services, the MBS requirements were not always met, including that the patients were not always seen by a qualified sleep medicine practitioner and there was not always an assessment of clinical necessity. There was also not always adequate clinical input provided, with the possibility patients were prescribed an inadequate CPAP level due to the deficiency in recording pressure determination studies.
• The requirements for MBS item 12205 services were not always met, including where the practitioner did not appropriately assess whether a patient was eligible for this study.

The practitioner acknowledged having engaged in inappropriate practice in connection with providing MBS item 110, 11503, 12203, 12204 and 12250 services. The practitioner agreed to be counselled by the Director and to repay $2,000,000 to the Commonwealth.

General practitioner

During the review period, the practitioner rendered services billed as 22 individual MBS items in excess of 99% of their peers. 

An Associate Director reviewed this practitioner’s rendering of the following MBS item services:

• 23 (attendance lasting at least 6 minutes and less than 20 minutes)
• 36 (attendance lasting at least 20 minutes)
• 707 (attendance for health assessment lasting at least 60 minutes)
• 721 (preparation of a general practitioner management plan (GPMP))
• 723 (coordination of team care arrangements (TCAs))
• 732 (review of a GPMP or TCAs)
• 2713 (attendance in relation to mental disorder lasting at least 20 minutes)
• 5020 (after-hours attendance lasting between 6 and 20 minutes)
• 31363 (excision of malignant skin lesion with a diameter of 14mm or more)
• 91891 (telehealth attendance lasting at least 6 minutes)

The Associate Director had no concerns in relation to MBS item 23 and 36 services. In relation to the remaining items, the Associate Director had persisting concerns that:

• the MBS requirements were not always met, including minimum time requirements where relevant
• the practitioner’s record keeping was inadequate, including where the clinical records did not contain sufficient clinical information
• some services rendered by the practitioner were not clinically indicated
• the documentation for chronic disease management (CDM) services (item 721, 723 and 732 services) provided by the practitioner was not sufficiently comprehensive and did not include all necessary details
• the practitioner co-billed MBS items 31363 and 23 where the record did not support that a separate consultation occurred to the excision or was clinically indicated.

The practitioner acknowledged having engaged in inappropriate practice in connection with providing MBS item 707, 721, 723, 732, 2713, 5020, 31363 and 91891 services. The practitioner agreed to:

• be reprimanded by the Associate Director
• be counselled by the Associate Director
• repay $300,000 to the Commonwealth
• be disqualified from providing MBS item 965, 967, 92029, 92030 (current equivalents, including video equivalents, for CDM services) and 707 services for 12 months. 

General practitioner

During the review period, the practitioner rendered a prescribed pattern of services (rendering 30 or more relevant phone services on 20 or more days in a 12-month period), and rendered services billed as the following MBS items in excess of 99% of their peers:

• 707
• 731 (contribution to multi-disciplinary care plan for patient in residential aged care facility (RACF))
• 90035 (attendance at RACF lasting at least 6 minutes and less than 20 minutes)
• 90043 (attendance at RACF lasting at least 20 minutes) 
• 90051 (attendance at RACF lasting at least 40 minutes)

An Associate Director reviewed this practitioner’s rendering of a prescribed pattern of services, and their rendering of MBS item 707, 731, 90035, 90043 and 91891 services. The Associate Director had persisting concerns that:

• the practitioner rendered 30 or more relevant phone services on each of 36 days during the review period, and exceptional circumstances did not exist that affected the rendering of services on those days
• the MBS requirements were not always met, including where the practitioner did not personally attend on the patient on the date of service, or where minimum time requirements were not met where relevant
• the practitioner’s record keeping was inadequate, including where:
  • the practitioner relied on templates that were not sufficiently personalised to the patient or lacked relevant clinical details
  • the practitioner’s records did not contain sufficient detail to explain the service
  • the clinical records were not created contemporaneously, or
  • the practitioner did not create their own records and instead relied solely on RACF records for the patient.

The practitioner acknowledged having engaged in inappropriate practice in connection with providing MBS items 707, 731, 90035, 90043 and 91891 and in providing services that constituted a prescribed pattern of services. The practitioner agreed to:

• be reprimanded by the Associate Director
• be counselled by the Associate Director
• repay $360,000 to the Commonwealth 
• be disqualified from providing MBS item 707 and 731 services for 12 months.

General practitioner 

During the review period, the practitioner rendered a prescribed pattern of services (rendering 80 or more relevant services on 20 or more days in a 12-month period) and provided the following MBS services and Pharmaceutical Benefits Scheme (PBS) items in excess of 99% of their peers:

• MBS item 90035
• MBS item 90043
• PBS item 1215Y (paracetamol 500 mg + codeine phosphate hemihydrate 30 mg tablet)
• PBS item 8455B (tramadol hydrochloride 50 mg capsule, 20)
• PBS item 10094G (tapentadol 200 mg modified release tablet, 28)
• PBS item 8523N (tramadol hydrochloride 100 mg modified release tablet, 20)
• PBS item 3162K (diazepam 5 mg tablet, 50)
• PBS item 8254K (amoxicillin 875 mg + clavulanic acid 125 mg tablet, 10)

An Associate Director reviewed this practitioner’s rendering of a prescribed pattern of services, their rendering of MBS item 23, 90035, 90043 and 91891 services, and their prescribing of PBS items 1215Y, 3162K, 8254K, 8455B, 8523N and 10094G. 

The Associate Director had persisting concerns that:

• the practitioner rendered 80 or more relevant services on each of 24 days during the review period, and exceptional circumstances did not exist that affected the rendering of services on those days
• the practitioner did not always provide adequate clinical input when providing MBS item 23, 90035 and 91891 services, including not attending the patient when rendering item 90035 services and failing to assess the patient’s compliance with regularly prescribed medications or counsel a patient when briefed about their potential overuse by the pharmacist
• the practitioner’s record keeping was not always adequate, including where their records were not sufficiently individualised to the patient or did not contain sufficient detail to explain the service
• the practitioner prescribed the above PBS items where the PBS restrictions were not met, and in circumstances where they did not properly assess the clinical indication or potential risks of these medications.

The practitioner acknowledged having engaged in inappropriate practice in connection with providing MBS item 23, 90035, 90043 and 91891 services and PBS items 1215Y, 3162K, 8254K, 8455B,8523N and 10094G, and in providing services that constituted a prescribed pattern of services. The practitioner agreed to:

• be reprimanded by the Associate Director
• be counselled by the Associate Director
• repay $325,000 to the Commonwealth
• be disqualified from providing MBS item 90043 services for 12 months
• be disqualified from providing MBS item 91891 services for 6 months. 

Medical practitioner 

During the review period, the practitioner rendered services billed as MBS items 91805 (video attendance by a medical practitioner, lasting between 45 and 60 minutes) and 92211 (video attendance by a medical practitioner, in the unsociable hours, for an urgent assessment) in excess of 99% of their peers. 

An Associate Director reviewed this practitioner’s rendering of MBS item 91805 and 92211 services, and had persisting concerns that:

• the practitioner did not keep adequate and contemporaneous records that supported the services billed by them
• for MBS item 91805 services, the requirements that the practitioner be the patient’s usual medical practitioner and that the consultation last at least 45 minutes were not always met 
• for MBS item 92211 services, the record did not always reflect that the patient’s condition required an ‘urgent assessment’, or that the consultation was conducted by video.

The practitioner acknowledged having engaged in inappropriate practice in connection with rendering MBS item 91805 and 92211 services. The practitioner agreed to: 

• be reprimanded by the Associate Director
• be counselled by the Associate Director
• repay $615,000 to the Commonwealth
• be disqualified from providing MBS item 91805 services for 12 months.

General practitioner 

During the review period, the practitioner provided the following MBS item services in excess of 99% of their peers: 

• 732
• 92024 (telehealth attendance for the preparation of a GPMP)
• 92025 (telehealth attendance to coordinate development of a TCA)
• 92028 (telehealth attendance to review of coordinate a GPMP or TCA)
• 66833 (quantification of 25-hydroxyvitamin D in serum) 
• 66716 (TSH quantitation) 
• 66838 (serum vitamin B12 test).

The Associate Director reviewed this practitioner’s rendering of MBS item 36, 721, 723, 732, 10997, 91891, 92024, 92025 and 92028 services, and their initiation of MBS item 66716, 66833 and 66838 services. The Associate Director had no concerns in relation to MBS item 10997 services, but had persisting concerns in relation to the remaining items that:

• the MBS requirements for each item were not always met, including that:
  • the minimum time requirements for professional attendance services were not always met
  • the practitioner often did not undertake clinically relevant actions
  • where relevant, the practitioner did not always attend the patient via telehealth
  • the practitioner sometimes initiated pathology services that were not clinically relevant, or when the patient was not eligible for them
• the practitioner’s rendering of CDM services did not always meet the MBS requirements, including that:
  • for MBS item 721 and 92024 services, a comprehensive GPMP was not always prepared
  • when producing or reviewing a TCA, it was not always evident that 2 other healthcare providers were consulted 
  • the practitioner did not adequately assess and review GPMPs or TCAs for MBS item 732 and 92028 services 
• the practitioner’s record keeping was inadequate because they failed to record sufficient clinical information to explain what occurred during the service and sometimes did not write records in English. 

The practitioner acknowledged having engaged in inappropriate practice in connection with providing MBS item 36, 721, 723, 732, 66716, 66833, 66838, 91891, 92024, 92025 and 92028 services. The practitioner agreed to: 

• be reprimanded by the Associate Director
• be counselled by the Associate Director
• repay $125,000 to the Commonwealth
• be disqualified from providing MBS item 965, 967, 92029, 92030 services for 12 months.

General practitioner

During the review period, the practitioner rendered the second highest volume nationally of MBS item 721 and 723 services, and rendered MBS item 23, 721, 723, 5020 and 91891 services in excess of 99% of their peers.

The Associate Director reviewed this practitioner’s rendering of MBS item 23, 721, 723, 732, 5020 and 91891 services. The Associate Director had no concerns in relation to MBS item 5020 services, but had persisting concerns in relation to the remaining items that:

• the practitioner did not always meet the MBS requirements, including not always meeting the minimum time requirements for MBS item 23 and 91891 services 
• the practitioner did not always meet the MBS requirements for CDM services, including that:
  • GPMPs and TCAs were created or coordinated for patients who did not have a qualifying chronic condition
  • the GPMPs and TCAs created by the practitioner were often generic and not personalised to the patient, and any review under MBS item 732 did not meaningfully assess the patient’s progress 
  • for MBS item 723 services, there were often no record of two-way communication with two other health care providers as required
• the practitioner’s record keeping often failed to include sufficient clinical information to adequately explain the service. 

The practitioner acknowledged having engaged in inappropriate practice in connection with rendering MBS item 23, 721, 723, 732 and 91891 services. The practitioner agreed to: 

• be reprimanded by the Associate Director
• be counselled by the Associate Director
• repay $420,000 to the Commonwealth
• be disqualified from providing MBS item 965, 967, 92029 and 92030 services for 12 months.

General practitioner

During the review period, the practitioner rendered MBS item 92731 (phone attendance for the provision of services related to blood borne viruses, sexual or reproductive health lasting less than 5 minutes) and 92734 (phone attendance for the provision of services related to blood borne viruses, sexual or reproductive health lasting between 5 and 20 minutes) services in excess of 99% of their peers.

An Associate Director reviewed this practitioner’s rendering of MBS item 92731 and 92734 services, and their rendering of a prescribed pattern of services (rendering of 30 or more relevant phone services on 20 or more days in a 12‑month period).

The Associate Director had no persisting concerns regarding the practitioner’s rendering of MBS item 92731 and 92734 services, but had persisting concerns that the practitioner had rendered a prescribed pattern of services, being 30 or more relevant phone services on each of 26 days in a 12-month period, and exceptional circumstances did not exist that affected the rendering of services on those days. 

The practitioner acknowledged having engaged in inappropriate practice in connection with providing services that constituted a prescribed pattern of services and agreed to repay $9,500 to the Commonwealth. 

General practitioner 

During the review period, the practitioner rendered the second highest volume nationally of MBS item 93716 (phone attendance lasting at least 20 minutes to determine eligibility for treatment for person with COVID-19) services and rendered MBS item 585 (urgent after-hours attendance), 599 (urgent after-hours attendance in unsociable hours) and 93716 services in excess of 99% of their peers. 

The Director reviewed this practitioner’s rendering of MBS item 23, 36, 585, 599 and 93716 services. The Director had no concerns in relation to MBS item 23 services, but had persisting concerns in relation to the remaining services that the practitioner did not always meet the MBS requirements, including: 

• not always meeting minimum time requirements for MBS item 36 and 93716 services
• clinically relevant actions were not always undertaken for MBS item 36 services
• some of the MBS item 585 and 599 services were not ‘urgent’ as required.

The practitioner acknowledged having engaged in inappropriate practice in connection with rendering MBS item 36, 585, 599 and 93716 services and agreed to be counselled by the Director.

Rehabilitation medicine specialist

During the review period, the practitioner rendered the highest volume of MBS item 91824 (video attendance by physician lasting less than 5 minutes) services nationally and rendered MBS item 91825 (video attendance by physician lasting more than 5 minutes) and 91836 (phone attendance by physician lasting more than 5 minutes) services in excess of 99% of their peers. 

The Director reviewed this practitioner’s rendering of MBS item 91824, 91825 and 91836 services, and their rendering of a prescribed pattern of services (rendering of 30 or more relevant phone services on 20 or more days in a 12-month period).

The Director had no persisting concerns that the practitioner had rendered a prescribed pattern of services because there were sufficient days on which exceptional circumstances applied which affected the provisions of services. The Director had persisting concerns in relation to MBS items 91824, 91825 and 91836 that:

• the practitioner provided services which did not appear to be in the practice of rehabilitation medicine, such as services assessing patients for medicinal cannabis 
• the MBS requirements were not always met, including that:
  • there was sometimes no valid referral for MBS item 91825 services
  • the practitioner did not always attend the patient on the date of service for MBS item 91836 services 
• the practitioner failed to provide adequate clinical input for MBS item 91825 and 91836 services
• the practitioner’s record keeping was inadequate, including where the practitioner failed to record sufficient clinical information to adequately explain the service. 

The practitioner acknowledged having engaged in inappropriate practice in connection with rendering MBS item 91824, 91825 and 91836 services. The practitioner agreed to repay $45,000 to the Commonwealth and to be counselled by the Director. 

General practitioner 

During the review period, the practitioner rendered MBS item 91891 and 92721 (telehealth attendance for the provision of services related to blood borne viruses, sexual or reproductive health lasting between 20 and 40 minutes) services in excess of 99% of their peers. 

The Associate Director reviewed this practitioner’s provision of MBS item 23, 2713, 91891 and 92127 services, PBS item 1891M (amoxicillin 500 mg + clavulanic acid 125 mg), and their rendering of a prescribed pattern of services (rendering of 30 or more relevant phone services on 20 or more days in a 12-month period). 

The Associate Director had no persisting concerns in relation to MBS item 23 and 91891 services, and PBS item 1891M, but had persisting concerns in relation to the prescribed pattern of services and the provision of MBS items 2713 and 92127 that:

• the practitioner had rendered a prescribed pattern of services, being 30 or more relevant phone services on each of the 22 days in a 12-month period, and exceptional circumstances did not exist that affected the rendering of services on those days
• the practitioner did not always meet the MBS requirements, including that:
  • the minimum time requirements for MBS item 2713 and 92127 services were not always met
  • there were often no clinical notes indicating why either an MBS item 2713 or 92127 service was required for the patient’s presenting condition. 

The practitioner acknowledged having engaged in inappropriate practice in connection with rendering MBS item 2713 and 92127 services. The practitioner agreed to repay $19,000 to the Commonwealth, and to be reprimanded by the Associate Director. 

B. No further action decisions

There were 2 no further action decisions in April 2026 and no such decisions in May 2026:

General practitioner

During the review period, the practitioner rendered MBS item 585, 599, 5028, 93644 and 93653 services in excess of 99% of their peers.

An Associate Director reviewed a random sample of MBS item 23, 585, 599, 5020, 5028, 93644 and 93653 services, and the practitioner’s prescribing of PBS item 13334T (oral liquid methadone hydrochloride 25 mg per 5 ml in 200 ml bottle, 1 ml). After reviewing the practitioner’s records, the Associate Director formed the view that no further action was required as there were insufficient grounds on which a Committee could reasonably find that the practitioner engaged in inappropriate practice during the review period.

General practitioner

During the review period, the practitioner rendered MBS item 36, 707, 2715, 31365 and 31366 services in excess of 99% of their peers.

After reviewing the circumstances of the case, including the personal situation of the practitioner, an Associate Director formed the view that no further action was required as circumstances existed that would make a proper investigation by a PSR Committee impossible.

C. PSR Committee final determinations

There were 4 final determinations that came into effect in April 2026, and one final determination that came into effect in May 2026:

PSR Committee regarding a nurse practitioner

On 17 April 2026, a final determination came into effect regarding a nurse practitioner. In the final report of the PSR Committee, the practitioner was found to have engaged in inappropriate practice in connection with the rendering of the following MBS item services during the review period:

• 82205 (attendance by nurse practitioner lasting between 6 and 20 minutes)
• 82210 (attendance by nurse practitioner lasting at least 20 minutes)
• 82215 (attendance by nurse practitioner lasting at least 40 minutes)
• 82222 (attendance by nurse practitioner providing clinical support to patient on a video consultation with a specialist or consultant physician, lasting at least 40 minutes)
• 91180 (video attendance by nurse practitioner lasting at least 40 minutes)

The Determining Authority directed that the practitioner:

• be reprimanded
• repay the amount of $500,000 to the Commonwealth
  • This amount reflects approximately 100% of the Medicare benefits paid for the services in connection with which the practitioner was found to have engaged in inappropriate practice during the review period.
• be disqualified from rendering all MBS items for 36 months 
• be disqualified from providing all PBS items for 12 months.

In relation to MBS item 82215, 82222 and 91180 services which were provided in association with a spa treatment provider, the Committee made findings based on one or more of the following:

• The nurse practitioner was impermissibly billing Medicare to subsidise the cost of associated spa treatments; the cost of the spa treatment was reduced if the customer brought their Medicare card with them and had a pre-treatment consultation with the nurse practitioner.  The associated spa treatments were not clinically relevant services.
• The nurse practitioner’s provider number was used in contravention of section 20A of the Health Insurance Act because the benefit they received was not accepted as the full payment for the service, but patients were charged an additional fee. 
• Pre-treatment consultations were not clinically indicated. Services were provided to multiple family members on the same day (consistent with those persons attending together for subsidised spa treatments) as well as to owners of the spa treatment provider, where conflicts of interest were not managed appropriately.
• The nurse practitioner’s clinical input was inadequate in that they provided limited preventative health care only and failed to address clinically relevant needs of the patient. 
• MBS requirements were not met, including relevant minimum time requirements of at least 40 minutes. 
• For video attendances, the nurse practitioner inappropriately allowed and relied on physical examinations performed by unqualified staff of the spa provider. For MBS item 82222 services there was no specialist or consultant physician involved in the service and the nurse practitioner did not provide clinical support for patients. 

In relation to MBS item 82205, 82210 and 82215 services provided in a conventional practice setting, the Committee made findings based on one or more of the following: 

• MBS item requirements were not met, including minimum time requirements.
• The nurse practitioner’s clinical input was inadequate, including prescribing pain medications without trialling other treatments, non-steroidal anti-inflammatory drugs (NSAIDs) or lower dosages and failing to take an appropriate history or perform relevant examinations for the patient’s presenting problem. 

PSR Committee regarding Dr Shaukat Javed, general practitioner

On 10 April 2026, a final determination came into effect regarding Dr Shaukat Javed, general practitioner of Riverstone, NSW. In the final report of the PSR Committee, Dr Javed was found to have engaged in inappropriate practice in connection with the rendering of the following MBS item services during the review period:

• 23
• 36 
• 2713
• 5023 (after-hours, home visit, attendance lasting less than 20 minutes)
• 5043 (after hours, home visit, attendance lasting at least 20 minutes)
• 91800 (telehealth attendance lasting less than 20 minutes)

Dr Javed was directed to:

• be reprimanded 
• repay the amount of $512,000 to the Commonwealth
  • This reflects approximately 90% of the Medicare benefits paid for the individual services rendered in relation to MBS items 23, 36, 2713, 5023, 5043 and 91800, in connection with which the practitioner was found to have engaged in inappropriate practice. 
• be disqualified from rendering all MBS items for a period of 24 months. 

The Committee made findings of inappropriate practice across all services on the following bases:

• Dr Javed failed to make an adequate and contemporaneous record of the service.
• Where there was a contemporaneous record, records largely illegible, and overall incomprehensible. Relevant clinical information such as diagnoses, histories and past and current medications including doses, were not clearly documented in the file. Investigation results, referrals, medical certificates and correspondence with other practitioners were not always maintained on the files and in no clear order. It was otherwise unclear from each entry, and the record as a whole, what occurred at the service and there was insufficient information to enable another practitioner to assume patient care in reliance on the record.
• The deficiencies in the record keeping were compounded by a large number of entries made non-contemporaneously a significant time after the date of service. The Committee disregarded any non‑contemporaneous content as it did not form part of the contemporaneous record for the service, but this added to the overall incomprehensibility of the records. 
• MBS requirements were not always met, including minimum time requirements. 
• Dr Javed’s clinical input was sometimes inadequate, including a failure to take or explore relevant histories, perform or follow up on examinations and investigations, or appropriately address and manage the patient’s presenting and existing issues.

In relation to MBS item 5023 and 5043 services, the Committee also made findings based on one or more of the following:

• Where there was no contemporaneous record of the service, Dr Javed either did not attend or did attend but did not provide a medical service to the patient on the date of service.  Alternatively, if Dr Javed did attend, then in the absence of any clinical content having been recorded he failed to make an adequate and contemporaneous record and the MBS requirements for the service were not met. 
• Services were not necessary for the appropriate treatment of the patient and therefore were not a clinically relevant service. Services were initiated by Dr Javed on a weekly or fortnightly basis where there was no underlying condition that required weekly or fortnightly monitoring or review and where there was no presenting complaint at the service to warrant an attendance (and in the context of Dr Javed having attended the patient the week prior).
• The Committee also noted for these services that all persons in a home (partner, sibling, relative or carer) were billed an attendance, including where there was no underlying condition or presenting complaint to warrant an attendance and without any real clinical management provided or documented (and in the context of Dr Javed having attended the home the week or fortnight prior). 
• Further, the schedule fee applicable for these home visit items is a derived fee, taking into account the number of patients seen at the same location. All MBS item 5043 services were billed as a single patient attendance (attracting the highest applicable fee), notwithstanding multiple family members were seen together on the same day.

PSR Committee regarding a consultant physician

On 21 April 2026, a final determination came into effect regarding a consultant physician. In the final report of the PSR Committee, the practitioner was found to have engaged in inappropriate practice in connection with rendering of the following MBS item services during the review period:

• 132 (attendance by consultant physician, lasting at least 45 minutes, for an initial assessment of a patient with at least 2 morbidities to prepare a consultant physician treatment and management plan of significant complexity)
• 133 (attendance by consultant physician lasting at least 20 minutes for a patient with at least 2 morbidities to review a consultant physician treatment and management plan)
• 820 (attendance by a consultant physician to organise a community case conference of between 15 and 30 minutes)

The practitioner was directed to:

• be counselled by the Director or their nominee
• repay the amount of $200,000 to the Commonwealth.
  • This reflects approximately 80% of the Medicare benefits paid for the class of MBS item 132, 133 and 820 services in connection with which the practitioner was found to have engaged in inappropriate practice during the review period.

In relation to MBS item 132 and 133 services, the Committee made findings based on one or more of the following:

• The patients did not have the required 2 morbidities to be eligible for these services, including where they had multiple symptoms that were the result of a single underlying condition.
• Where the patient did have 2 morbidities, only one was addressed by the practitioner as part of their clinical input during the service.
• The MBS requirements were not met in relation to MBS item 132, including where the service was for an ongoing review rather than an initial attendance or where the practitioner did not take a comprehensive patient history.
• The MBS requirements were not met in relation to MBS item 133, including where the practitioner did not prepare a modified consultant physician treatment and management plan as part of the service.
• If the above deficiencies were addressed by the practitioner, the clinical record was inadequate in failing to reflect this.

In relation to MBS item 820 services, the Committee made findings based on one or more of the following:

• The practitioner’s clinical record of the case conference service was inadequate, including where they documented a generic management plan rather than recording the specific care needs of the patient.
• The case conference was not clinically indicated, including in circumstances where the patient was clinically stable and there was no benefit to a number of new providers discussing their care.
• The MBS requirements were not met, including where:
  • the record did not reflect that the conference would have taken at least 15 minutes based on the patient’s condition and management, or
  • the case conference did not include a multidisciplinary team of at least 3 other formal care providers of different disciplines that were providing services relevant to the patient’s condition.

PSR Committee regarding a general practitioner

On 7 April 2026, a final determination came into effect regarding a general practitioner. In the final report of the PSR Committee, the practitioner was found to have engaged in inappropriate practice in connection with the provision of the following MBS item services and PBS items provided during the review period:

• 69317 (one test for the detection of a virus, microbial antigen or microbial nucleic acid and one test for the detection of chlamydia trachomatis)
• 69319 (two tests for the detection a virus, microbial antigen or microbial nucleic acid and one test for the detection of chlamydia trachomatis)
• 69387 (quantification of 2 microbial antigen antibodies)
• 69390 (quantification of 3 microbial antigen antibodies)
• 69481 (three tests for hepatitis antibodies or antigens to investigate the infectious causes of acute or chronic hepatitis)
• 11276L (tenofovir disoproxil fumarate 300 mg + emtricitabine 200 mg tablet, 30)

The practitioner was directed to:

• be reprimanded by the Director or their nominee
• be counselled by the Director or their nominee
• repay the amount of $647 to the Commonwealth
  • This reflects approximately 100% of the Medicare benefits paid for the individual services provided as MBS items 69317, 69319, 69387, 69390 and 69481 in connection with which the practitioner was found to have engaged in inappropriate practice during the review period.

In relation to MBS item 69317, 69319, 69387, 69390 and 69481 services, the Committee made findings based on one or more of the following:

• The practitioner’s clinical input was inadequate, including for the following reasons:
  • The questionnaire for patients to fill out prior to receiving these pathology tests did not ask relevant questions about their symptomology and recent sexual activity, which would have informed their clinical management plan.
  • Patients would receive the same advice in relation to their tests regardless of their risk profile, including because relevant information on their risk profile was not obtained.
  • Patients who received positive results, or results that they were not immune to certain conditions, were not followed up to ensure they had commenced treatment.

In relation to the practitioner’s prescribing of PBS item 11276L, the Committee made findings based on one or more of the following:

• The practitioner’s clinical input was inadequate, including where they did not obtain sufficient information prior to prescribing this medication to ensure the patient’s suitability for it.
• The practitioner failed to provide appropriate education and counselling regarding patients’ use of the medication, including in relation to medication adherence, drug interactions, side effects and preventative health measures.
• The practitioner failed to provide appropriate care which was individualised to the patient’s needs.

PSR Committee regarding an endocrinologist

On 12 May 2026, a final determination came into effect regarding an endocrinologist. In the final report of the PSR Committee, the practitioner was found to have engaged in inappropriate practice in connection with the rendering of services billed as the following MBS item:

• 110 (initial attendance by a consultant physician)
• 116 (subsequent attendance by a consultant physician) 
• 91834 (initial attendance by a consultant physician, via telehealth)
• 91835 (subsequent attendance by a consultant physician, via telehealth).

The practitioner was directed to:

• be reprimanded by the Director
• repay $400,000 to the Commonwealth
  • This reflects approximately 90% of the Medicare benefits paid for the class of MBS item 110, 116, 91834 and 91835 services in connection with which the practitioner was found to have engaged in inappropriate practice during the review period.

In relation to MBS item 110, 116, 91834 and 91835 services, the Committee made findings based on one or more of the following:

• Services billed as MBS items 110 or 91834 were not an initial attendance in a single course of treatment. In these instances, the practitioner also did not always provide sufficient clinical input that would be expected from an initial attendance.
• The practitioner’s clinical input was otherwise inadequate, including where the record did not reflect that they addressed all of the patient’s relevant presenting concerns.
• The practitioner billed these items when they did not attend on the patient, including in the following circumstances:
  • MBS item 116 was billed where the practitioner did not attend on the patient but rather provided telephone advice to nursing staff.
  • MBS items 91834 and 91835 were billed where the practitioner did not attend on the patient via telehealth but rather communicated via text messages.
• In relation to MBS items 91834 and 91835, the minimum time requirements were not met.
• The practitioner’s record keeping was inadequate. There was no record for some reviewed services, and in other instances the records failed to include sufficient details of a patient history or examination.

D. Federal Court

There was one Federal Court decision handed down in April 2026:

On 11 December 2023, Dr Foong filed a judicial review application seeking to challenge the Committee’s final report which made multiple findings that he had engaged in inappropriate practice. 

The court heard the application for judicial review on 3 September 2024 and 18‑19 February 2025, with judgment reserved following the end of the trial on 19 February 2025. On 29 August 2025, Dr Foong filed an application to reopen the proceeding.

On 2 April 2026, the court dismissed both the judicial review application challenging the Committee’s final report and the application to reopen the proceeding - ordering Dr Foong to pay PSR’s costs.

On 7 May 2026, Dr Foong filed an appeal.

E. Referrals to the major non-compliance (fraud) division (89A & 106N)

There were no matters referred to the major non-compliance (fraud) division in April 2026. There was one matter referred in May 2026.

F. Referrals to AHPRA (106XA/B)

There were no matters referred to AHPRA in April 2026. There was one matter referred in May 2026.