PSR to consider impact of COVID-19 on 80/20 rule
The 80/20 rule refers to a practitioner rendering 80 or more attendance items on 20 or more days in any 12 month period and the Department of Health is required under the Health Insurance Act 1973 to refer these practitioners to the Director of the Professional Services Review. When high levels of servicing are seen, there is a concern that patients do not receive adequate clinical input and that patients might be harmed as a result of high volumes of services being provided in a day. A breach of the 80/20 rule can result in a finding of inappropriate practice.
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