Lack of transparency and reliance on statistics alone make doctors vulnerable
The Professional Services Review (PSR) was established to investigate and manage situations where the Medicare system was being used inappropriately by doctors. Undoubtedly, the PSR’s activities have identified and addressed instances of doctors knowingly exploiting Medicare. However, over the past 5 years, an initial general disquiet about the increased effect of the PSR’s investigative system and processes on general practice grew into widespread concern among broad sections of the medical profession and others. The PSR committees were disbanded because they were not ratified by the Australian Medical Association (AMA), 39 cases under review were dropped, and a senate inquiry into the entire running of the PSR scheme was conducted. The inquiry resulted in the publication of seven recommendations for improvements in the system,1 with a review with all relevant stakeholders planned for 12 months later.
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- 1. Parliament of Australia. Senate Community Affairs Committees. Review of the Professional Services Review (PSR) Scheme; 25 October 2011. Recommendations. http://www.aph.gov.au/Senate/committee/clac_ctte/prof_serv_rev/report/b01.htm (accessed Nov 2011).
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- 3. Parliament of Australia. Senate Community Affairs Committees. Review of the Professional Services Review (PSR) Scheme; 25 October 2011. Submissions received by the Committee. Answers to questions on notice. 1. Answers to questions on notice from the Australian Medical Association, received 23 September 2011. http://www.aph.gov.au/Senate/committee/clac_ctte/prof_serv_rev/submissions.htm (accessed Oct 2011).
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- 6. Parliament of Australia. Senate Community Affairs Committees. Review of the Professional Services Review (PSR) Scheme; 25 October 2011. Submissions received by the committee. http://www.aph.gov.au/Senate/committee/clac_ctte/prof_serv_rev/submissions.htm (accessed Oct 2011).
- 7. Tisdall v Webber [2011] FCAFC 76.
Scott Masters has been audited three times by Medicare Australia. On the first two occasions, no concerns were identified except statistical anomalies. On the third occasion, he entered into a “negotiated agreement” with the Director of the Professional Services Review.