Glossary

the Act
means the Health Insurance Act 1973.

AMA
means the Australian Medical Association.

Case officer
means the PSR staff member who coordinates the administration of Professional Services Review matters.

Committee
means a PSR Committee comprising at least three practitioners appointed under section 93 of the Act. Sometimes referred to as PSRC.

Committee member
means a member of a Committee, who must be a current Panel member.

Deputy Director
means a Deputy Director of PSR appointed under section 85 of the Act; who serves as the chair of the Committee.

Determining Authority
means the independent statutory body established under the section 106Q of the Act.

Director
means the Director of PSR appointed under section 83 of the Act. Sometimes referred to as the DPSR.

Director's Review
means the process undertaken by the Director under Division 3A of Part VAA of the Act.

DHS
means the Department of Human Services

Draft Determination
means the draft document containing what action is proposed to be taken in a case as required by section 106T of the Act.

Draft Report
means the preliminary findings of a Committee following a hearing as required by section 106KD of the Act.

Final Determination
means the final document containing what action will be taken in a case as required by section 106TA of the Act.

Final Report
means the final findings of a Committee following assessment of further submissions by a practitioner following the Draft Report as required by section 106L of the Act.

Health
means the Department of Health who have portfolio responsibility for the Professional Services Review Scheme. Delegates of the Chief Executive Medicare, located in the Department of Health, refer matters to PSR for investigation.

Inappropriate practice
is defined under section 82 of the Act as conduct in connection with rendering or initiating services that a Committee of the practitioner's peers could reasonably conclude was unacceptable to the general body of their profession.

MBS
means the Medicare Benefits Schedule.

Medicare
means the Medicare program.

Medicare Services
means services provided by a practitioner which generated a Medicare Benefit.

Minister
means the Minister for Health.

Negotiated Agreement
means a written Agreement made under section 92 of the Act.

Over-servicing
means providing a patient with services in excess of the patient's actual medical need.

Panel
means the PSR Panel established under subsection 84(1) of the Act, members of which are available for appointment to a Committee.

Panel member
means a practitioner appointed under subsection 84(2) of the Act.

PBS
means Pharmaceutical Benefits Scheme.

Peers
means the members of the Professional Services Review Panel who are appointed to represent the general body of their profession.

Practitioner
means a medical practitioner, dental practitioner, optometrist, midwife, nurse practitioner, chiropractor, physiotherapist, podiatrist, osteopath, as well as an audiologist, diabetes educator, dietician, exercise physiologist, mental health nurse, occupational therapist, psychologist, social worker, speech pathologist, Aboriginal and Torres Strait islander health practitioner, Aboriginal health worker and orthoptist.

PSR
means Professional Services Review.

Ratify
means to authorise or approve - used when the Determining Authority is deciding if an Agreement with the Director will come into effect.

Review period
means a period of no more than two years prior to the date of the request for review from the Delegate of the Chief Executive Medicare as specified in the request to PSR.

Sanction
means a penalty from a range of directions specified in section 106U of the Act.