A PSR matter can be lengthy due to the investigative and procedural nature of the process.
Indicative timeframes for finalisation of the different pathways that can occur are:
- If the Director undertakes a review and decides to take no further action – 5 months from the Department of Health letter to the Director referring your matter to PSR.
- If the Director undertakes a review and decides to enter into a Negotiated Agreement with you that is then ratified by the Determining Authority – 9 months from the Department of Health letter to the Director referring your matter to the PSR.
- If the Director undertakes a review and refers your matter to a Committee, which then conducts a review and refers its finding to the Determining Authority which makes a Final Determination – 2.5 years from the Department of Health letter to the Director referring your matter to the PSR.
During the PSR process there will be times when you will need to be away from your practice. Occasions when this may occur include meetings with your medical defence organisation and/or lawyer, and the meeting with the Director. If the matter is referred to a PSR Committee you will also be required to attend hearing days. A Committee hearing will normally occur across 4 to 6 full days (usually held in 2 day sessions, with an interval of a week or two between each 2 day session). You will receive sufficient notice of these dates ahead of time. The legislated minimum requirement for notification of a Committee hearing is 14 days.
You will also be required to produce documents to the Director and the Committee as a part of the process. Under the Act both the Director and the Committee have the power to require that you supply them with clinical records of the patients to whom you provided services during the review period. You will be provided with a written notice that sets out the documents that are required to be supplied.
PSR will provide you with a reasonable amount of time to provide the clinical records and, if required, will provide you with lockable plastic tubs for secure courier transport of documents to and from your practice. When they arrive at PSR, case officers will arrange for your records to be electronically scanned, and returned to you at the first available opportunity. This ensures the impact to your practice is minimised. You may wish to copy the records prior to sending to allow the continued treatment of your patients whilst the original records are with PSR. If your clinical records are in an electronic system, you will be asked to provide them electronically. Staff at PSR may be able to assist you in providing them in a suitable format.
The Director generally asks for 10 patient files per item investigated for the review period, and the Committee generally asks for 30 patient files per item investigated for the review period. There is no statutory limit on the number of records that can be requested. This is an important part of the process, and it could take some time for you, or your authorised representatives, to gather the requested documents. It is also important for you to be aware that you may be disqualified from Medicare for intentionally failing to comply with a request for documents.
There is a possibility that the completion of the PSR process could result in an impact on your ability to practise (if a disqualification period is imposed) or your financial situation (if an order for a financial repayment is made).