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Dealing with the Professional Services Review Agency
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Dealing with the Professional Services Review Agency

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....

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Medicare Benefits Schedule Review Taskforce

Reporting to the Minister for Health, the Taskforce consists of a cross-section of private and public practitioners, academics and consumer representatives, Via the Taskforce, clinical committees and working groups are required to make recommendations as to whether MBS items are obsolete and should be removed, as well as identify any services that require priority reviews, develop a program considering ...

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GP ordered to repay $450,000 for inappropriate billing

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....

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Professional Services Review Annual Report 2015-16

In 2015/16 there was an increase in the number of investigations of Chronic Disease Management and MBS Health Assessment items. Many practitioners providing high numbers of these services were found to use computer-generated templates leading to plans with minimal content specific to the patient for whom it had been prepared. Further, some team care arrangement plans were made without ...

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Abuse of MBS privileges improper and unethical

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....

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