Dealing with the Professional Services Review Agency

by | Mar 29, 2019 | Health Blog

The Professional Services Review Agency (PSR) has reported bumper levels of recovery for the past 2 years with repayments exceeding $20,000,000 in the last year alone.

There have also been record increases in the number of referrals made and in the number of services falling under scrutiny in each review.

Whereas, traditionally, general practitioners have been the PSR’s primary focus, greater diversity of speciality is a continuing trend with more dentists, chiropractors, nurse practitioners, independent midwives and optometrists finding themselves subject to the PSR’s processes in the last year.

Once referred, the prospects of escaping any adverse outcome have plummeted with a significant reduction in the percentage of reviews undertaken in which no further action was taken being reported.

We expect these trends to continue. With amendments to legislation enhancing its capacity to review employers and corporations and a public commitment to greater focus on enhancing Medicare compliance, the PSR is preparing itself and staffing levels for further growth in activity.

The PSR process can be time consuming and exhausting and the consequences of a finding of inappropriate practice significant, both financially and professionally.

If you are a healthcare professional finding yourself in receipt of any correspondence from the PSR, we offer the following tips:

  • Take the matter seriously.

  • Contact your medical defence organisation before you send any response and seek their assistance and guidance.

  • Respond promptly and fully to each issue raised, supporting your responses with corroborating evidence where possible.

  • Be prepared to recognise mistakes and consider a voluntary repayment if appropriate.

  • Ensure your knowledge and understanding of relevant MBS criteria is up to date and accurate to ensure future compliance in all respects- once you have fallen under the microscope you may remain there for some time.

Julia Wilcock

Julia Wilcock