A nurse practitioner was found to have engaged in professional misconduct after billing Medicare inappropriately and engaging in multiple boundary violations.

The nurse practitioner provided therapy at centres providing crisis and homeless accommodation to adults and worked in collaboration with 3 psychiatrists. He also provided psychotherapy at his own Clinic where the majority of patients were referred from the crisis centres.

Nurse practitioners can hold a Medicare provider number and have certain professional attendances payable under the Medicare Benefits Scheme (MBS) if they are working in a collaborative arrangement with a medical practitioner and are not operating “group sessions”.

The practitioner contended that, although there were a number of people present at the same time, the sessions were not group sessions and still involved the provision of individual therapy.  He said that patients who attended the sessions did not mingle, kept to themselves and focused on their own projects. However, prior to the proceedings, the practitioner had given a number of statements in which he had described the sessions as group sessions involving interactive activities such as singing, playing chess and skill sharing. Other evidence suggested that the patients had formed friendships which extended beyond the sessions. The Tribunal considered the practitioner’s evidence was wholly unconvincing and found the billing conduct and boundary violation matters “improper and unethical”.

The Practitioner’s professional judgment and practice was found to be very seriously lacking, and the complaints of such seriousness, as to require a finding of professional misconduct.

To read the full decision in Health Care Complaints Commission v Stone [2016] NSWCATOD 117, click here.