PSR Director's update for August 2026

Published date

17 September 2026

A. Section 92 agreements effective in August 2026

Twelve agreements entered into by the Director or an Associate Director and persons under review (under section 92 of the Health Insurance Act 1973 (Cth) (Act)) came into effect in August 2026.

General practitioner

The Chief Executive Medicare referred this practitioner to PSR for review. The Director reviewed this practitioner’s rendering of MBS item 36, 703, 721, 723, 900 and 5028 services, and had no concerns in relation to MBS item 5028 services.

In relation to the remaining items, the Director had persisting concerns that:

the MBS item requirements, including minimum time requirements, were not always met
the practitioner did not keep adequate and contemporaneous clinical records, including failing to record sufficient detail to explain the service
in some cases, the practitioner had amended or created patient records after a statutory notice to produce was issued to them
the practitioner did not always provide adequate clinical input when rendering MBS item 703 services, including that they did not establish an advanced care directive for older patients when relevant.

The practitioner acknowledged having engaged in inappropriate practice in connection with rendering MBS item 36, 703, 721, 723 and 900 services. The practitioner agreed to:

be reprimanded by the Director
be counselled by the Director
repay $318,000 to the Commonwealth
be disqualified from providing MBS item 36, 900, 91801 (video attendance lasting at least 20 minutes) and 91900 (phone attendance lasting at least 20 minutes on a patient registered under MyMedicare with the billing practice) services for 12 months.

Medical practitioner

The Chief Executive Medicare referred this practitioner to PSR for review. An Associate Director reviewed this practitioner’s rendering of MBS item 91803, 91893 and 92211 services and their prescribing of Pharmaceutical Benefits Scheme (PBS) item 1527J.

The Associate Director had persisting concerns that:

the practitioner did not always adhere to the PBS restrictions for PBS item 1527J which is only available for use where the patient has a serious staphylococcal infection
the practitioner’s clinical input when prescribing PBS item 1517J was inadequate, including not adequately assessing the suitability of this medication based on the patient’s presenting symptoms and previous prescriptions
the practitioner did not always provide adequate clinical input when rendering MBS item 91803, 91893 and 92211 services, including prescribing antibiotics to patients when it was not clinically indicated
the practitioner’s record keeping for some MBS item 91893 and 92211 services was inadequate, including failing to record a separate entry for each attendance by a patient or record the specific antibiotic medication prescribed.

The practitioner acknowledged having engaged in inappropriate practice in connection with providing MBS item 91803, 91893 and 92211 services and PBS item 1527J. The practitioner agreed to:

be reprimanded by the Associate Director
be counselled by the Associate Director
repay $9,000 to the Commonwealth, and
be disqualified from providing MBS item 92211 services for 6 months.

General practitioner

The Chief Executive Medicare referred this practitioner to PSR for review. An Associate Director reviewed this practitioner’s rendering of MBS item 23, 36, 707, 721, 723, 732, 5020, 11610, 91891, 92024, 92025, and 92028 services and initiating of MBS item 57341 and 66596 services.

The Associate Director had no persisting concerns in relation to MBS item 91891 services. For the remaining services, the Associate Director had persisting concerns that:

the MBS requirements were not always met, including failing to undertake all the clinically relevant tasks for a service such as taking a patient history or failing to meet the minimum time requirements
the practitioner’s record keeping was not always adequate, including failing to record a separate entry for each attendance or modify templates to reflect the correct details of each patient
the practitioner did not always provide adequate clinical input when providing MBS item 707, 11610, 57341 and 66596 services
rendering and initiating services that were not clinically indicated or where the patient was not eligible for the service.

The practitioner acknowledged having engaged in inappropriate practice in connection with providing MBS item 23, 36, 707, 721, 723, 732, 5020, 11610, 57341, 66596, 92024, 92025 and 92028 services. The practitioner agreed to:

be reprimanded by the Associate Director
be counselled by the Associate Director
repay $365,000 to the Commonwealth
be disqualified from providing MBS item 36, 967 and 92030 services for 6 months and providing MBS item 965, 92029 and 11610 services for 12 months.

General practitioner

The Chief Executive Medicare referred this practitioner to PSR for review. The Director reviewed this practitioner’s rendering of MBS item 36, 2713, 91891 and 92127 services and their rendering of a prescribed pattern of services. The Director had persisting concerns that:

the practitioner rendered 30 or more relevant phone services on each of 28 days during the review period, and exceptional circumstances did not exist that affected the rendering of services on those days
the practitioner’s clinical records were inadequate, including that their records did not contain sufficient information to explain the service, and
the MBS item requirements for these services were not always met, including failing to meet the minimum time requirements or failing to undertake all clinically relevant tasks for the service.

The practitioner acknowledged having engaged in inappropriate practice in connection with providing MBS item 36, 2713, 91891 and 92127 services and in providing services that constituted a prescribed pattern of services. The practitioner agreed to be counselled by the Director and to repay $243,000 to the Commonwealth.

General practitioner

The Chief Executive Medicare referred this practitioner to PSR for review. An Associate Director reviewed this practitioner’s rendering of MBS item 36, 30192, 91891 and 92127 services and their rendering of a prescribed pattern of services. The Associate Director had persisting concerns that:

the practitioner rendered 30 or more relevant phone services on each of 27 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 failing to meet the minimum time requirements or failing to undertake all clinically relevant tasks
the practitioner did not always provide adequate clinical input, including prescribing antibiotics which were not clinically indicated, failing to address the patient’s presenting condition, failing to adequately follow up on patients’ test results, failing to perform a full examination and take a patient history before excising skin lesions, and repeatedly applying cryotherapy to the same anatomical area in circumstances where this would not be clinically required,
the practitioner’s record keeping was inadequate.

The practitioner acknowledged having engaged in inappropriate practice in connection with providing MBS item 36, 30192, 91891 and 92127 services 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 $350,000 to the Commonwealth
be disqualified from providing MBS item 36 services for 6 months and providing MBS item 30192 services for 3 years.

General practitioner

The Chief Executive Medicare referred this practitioner to PSR for review. An Associate Director reviewed this practitioner’s rendering of MBS item 36, 2713, 5040 and 91891 services, their prescribing of PBS item 8254K, and their rendering of a prescribed pattern of services. After considering the practitioner’s submissions, the Associate Director had no persisting concerns in relation to their rendering of a prescribed pattern of services.

In relation to the MBS and PBS items reviewed, the Associate Director had persisting concerns that:

the practitioner’s record keeping was inadequate including failing to record sufficient detail to explain the service
the MBS requirements were not always met, including failing to meet the minimum time requirements
the practitioner’s prescribing of PBS item 8254K was not always appropriate, including where the PBS restrictions were not met, it was not clinically indicated, and the practitioner had not provided appropriate clinical management.

The practitioner acknowledged having engaged in inappropriate conduct in connection with providing MBS item 36, 2713, 5040 and 91891 services and prescribing PBS item 8254K. The practitioner agreed to:

be reprimanded by the Associate Director
be counselled by the Associate Director
repay $184,000 to the Commonwealth.

General practitioner

The Chief Executive Medicare referred this practitioner to PSR for review. An Associate Director reviewed this practitioner’s rendering of MBS item 23, 36, 707, 2715, 5028, 5049, 90035 and 91891 services and had no persisting concerns in relation to their rendering of MBS item 707 services.

The Associate Director had persisting concerns in relation to the remaining items that:

the practitioner’s record keeping was inadequate, including failing to record sufficient detail to explain the service
the MBS requirements were not always met, including failing to meet the minimum time requirements and where MBS items 23 or 91891 were billed for routine aftercare
the practitioner’s clinical input was not always adequate, including in prescribing second-line antibiotics and clinical management of patients with high blood pressure.

The practitioner acknowledged having engaged in inappropriate conduct in connection with providing MBS item 23, 36, 2715, 5028, 5049, 90035 and 91891 services. The practitioner agreed to be reprimanded by the Associate Director and to repay $159,251.85 to the Commonwealth.

Gastroenterologist and hepatologist

The Chief Executive Medicare referred this practitioner to PSR for review. The Director reviewed this practitioner’s rendering of MBS item 110, 116, 91824 and 91825 services.

The Director had persisting concerns that:

the practitioner’s record keeping was inadequate, including failing to record sufficient information to explain the service or where records were illegible
the MBS requirements were not always met, including billing consultation services where the patient’s referral was for a procedure only, co-billing consultation services with procedural items without sufficient clinical input for a consultation separate to the procedure, failing to meet the minimum time requirements, and billing a consultation service for standard aftercare relating to the procedure
the practitioner’s clinical input was not always adequate, including scheduling future colonoscopies that were not supported by the patient’s histology results or past procedures.

The practitioner acknowledged having engaged in inappropriate conduct in connection with providing MBS item 110, 116, 91824 and 91825 services. The practitioner agreed to be counselled by the Director and to repay $95,000 to the Commonwealth.

General practitioner

The Chief Executive Medicare referred this practitioner to PSR for review. An Associate Director reviewed this practitioner’s rendering of a prescribed pattern of services, their rendering of MBS item 23, 36, 5020, 91801 and 91891 services and their prescribing of PBS items 1215Y, 2622B, 3162K and 8254K.

The Associate Director had persisting concerns that:

the practitioner rendered 30 or more relevant phone services on each of 40 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 that the practitioner did not always attend the patient and failing to meet the minimum time requirements
the practitioner’s clinical input when prescribing under the PBS was not always adequate, including prescribing without appropriate clinical indication, prescribing to patients with a background of mental health issues or substance abuse without investigating concerns about potential drug‑seeking behaviour, prescribing multiple medications that created a significant polypharmacy risk, and repeatedly prescribing restricted medications based on very brief telehealth or phone attendances
the PBS restrictions were not always met, including repeatedly prescribing medications restricted to short term use.

The practitioner acknowledged having engaged in inappropriate conduct in connection with providing MBS item 23, 36, 5020, 91801 and 91891 services and PBS items 1215Y, 2622B, 3162K and 8254K, 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 $286,000 to the Commonwealth
be disqualified from providing MBS item 36 services for 6 months and providing MBS item 91801 and 91900 services for 12 months.

Gastroenterologist and hepatologist

The Chief Executive Medicare referred this practitioner to PSR for review. The Director reviewed this practitioner’s rendering of MBS item 110, 116 and 12533 services, and had persisting concerns that:

for MBS item 110 and 116 services, the practitioner did not always adequately correspond with the referring practitioner following the service or provide sufficient clinical details in the correspondence
co-billing consultation services and procedural items where there was insufficient clinical input for a consultation separate to the procedure
rendering MBS item 12533 services that were not always clinically indicated, including as a routine screening program.

The practitioner acknowledged having engaged in inappropriate conduct in connection with providing MBS item 110, 116 and 12533 services. The practitioner agreed to be counselled by the Director and to repay $29,000 to the Commonwealth.

General practitioner

The Chief Executive Medicare referred this practitioner to PSR for review. An Associate Director reviewed this practitioner’s rendering of MBS item 23, 36, 91801, 91891 and 92116 services, and their rendering of a prescribed pattern of services, and had persisting concerns that:

the practitioner rendered 80 or more relevant services on each of 27 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 failing to meet the minimum time requirement
some MBS item 36 services were not clinically relevant
the practitioner was not eligible to render some MBS item 91801 and 91891 services because they were not the ‘patient’s usual medication practitioner’.

The practitioner acknowledged having engaged in inappropriate conduct in connection with providing MBS item 23, 36, 91801, 91891 and 92116 services, 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 $450,000 to the Commonwealth
be disqualified from providing MBS item 91801 services for 12 months.

General practitioner

The Chief Executive Medicare referred this practitioner to PSR for review. An Associate Director reviewed this practitioner’s rendering of MBS item 23, 36, 699, 707, 721, 723, 732, 91891 and 93645 services, and had no persisting concerns regarding their rendering of MBS item 91891 services.

For the remaining services, the Associate Director had persisting concerns that:

the MBS requirements were not always met, including failing to meet the minimum time requirement, including time spent by a practice nurse with the patient as part of the attendance time, failing to perform all clinically relevant tasks, failing to meet the requirements for co‑billed items independently, and producing GPMP, TCA and GPMP/TCA review documents that were not sufficiently comprehensive or individualised to the patient
the practitioner’s record keeping was inadequate, including failing to record sufficient detail to explain the service.

The practitioner acknowledged having engaged in inappropriate conduct in connection with providing MBS item 23, 36, 699, 707, 721, 723, 732 and 93645 services. The practitioner agreed to:

be reprimanded by the Associate Director
repay $280,000 to the Commonwealth
be disqualified from providing MBS item 699, 967 and 92030 services for 12 months.

B. No further action decisions

General practitioner

The Chief Executive Medicare referred this practitioner to PSR for review. After reviewing the practitioner’s records and considering their submissions regarding their rendering of a prescribed pattern of services, an Associate Director formed the view that the practitioner had not rendered a prescribed pattern of services. The Associate Director decided 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.

Corporate entity

The Chief Executive Medicare referred a corporate entity to PSR for review. During the review period, the Director was concerned that the corporate entity might be engaging several practitioners whose billing of MBS items may have constituted inappropriate practice. The Director was concerned about the high volume of services per patient rendered by multiple providers and the various billing practices adopted by the corporate entity.

The Director determined that the corporate entity did not have an active role in the engagement, supervision, direction or control of the provision of services by the practitioners. Accordingly, the Director decided that there were insufficient grounds on which a Committee could reasonably find that the corporate entity had engaged in inappropriate practice.

C. PSR Committee final determinations

There were no PSR Committee final determinations that came into effect in August 2026.

D. Federal Court

There were no Federal Court decisions relating to PSR in August 2026.

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

No matters were referred to the major non-compliance (fraud) division in August 2026.

F. Referrals to AHPRA (106XA/B)

No matters were referred to AHPRA in August 2026.