GP ordered to repay $450,000 for inappropriate billing

by | Feb 5, 2017 | Health Blog

In 2015 the Professional Services Review Committee found a GP had failed to keep contemporaneous records in connection with rendering or initiating services. This amounted to inappropriate practice and the doctor was ordered to repay $453,646.75 and be disqualified from rendering MBS services for two years.

Dr Nicholas Sevdalis maintained that he made handwritten records which he subsequently transferred to an electronic record. However, the Committee held that the handwritten documents which were tendered in evidence were not contemporaneous and were “recent fabrications”.

Dr Sevdalis unsuccessfully appealed the Committee’s decision to the Federal Court, and ultimately appealed to the Full Bench of the Federal Court.

The Full Bench upheld the Committee’s decision. Their Honours found that the standard of timeliness for record keeping had not been met and it was acceptable that this was reasoned on the basis that the notes would not have been available to another practitioner. There was no requirement that handwritten records be transferred into an electronic database, but there was no evidence that contemporaneous handwritten notes had existed or been accessible prior to the electronic entries.

In relation to the penalty, Dr Sevdalis argued that the 2 year ban was too harsh and was intended to punish him rather than to protect the public.  However, the Full Bench said the fact that there was less sympathy than other minds may have brought to the decision was not a legal error. The Determination Authority took account of his personal circumstances and conduct, and engaged with the submissions made by Dr Sevdalis for a less restrictive penalty, but still decided that a heavier penalty was proportionate to his conduct. The Court also confirmed that Dr Sevdalis was not entitled to be paid Medicare benefits in respect of services that were the subject of his inappropriate practice, and so the repayment direction was also upheld.

To read the decision in Sevdalis v Director of Professional Services Review [2017] FCAFC 9, click here.

Emma Jack

Emma Jack