About the PSR scheme

Through the performance of its statutory role, PSR protects patients and the community from the risks associated with inappropriate practice, and protects the Commonwealth from having to meet the cost of medical / health services provided as a result of inappropriate practice.

What is the PSR Scheme

In its administration of the Scheme, PSR is responsible for reviewing and examining possible inappropriate practice by practitioners when they provide Medicare services or prescribe Government subsidised medicines under the PBS.

PSR examines suspected cases of inappropriate practice which have been referred by delegates of the Chief Executive Medicare. PSR cannot initiate its own reviews of a practitioner.

The PSR review process

Legislation and regulations

Inappropriate practice

Inappropriate practice is conduct by a practitioner in connection with rendering or initiating services that a practitioner’s peers could reasonably conclude was unacceptable to the general body of their profession.

History of the PSR Scheme

The PSR Scheme was introduced in 1994 to replace the previous Medical Services Committees of Inquiry. These were standing committees appointed by the Minister to deal with excessive servicing by medical practitioners.

The 3 stages of a review

The PSR Scheme provides for the separation of the decision-making process and has three main stages, which may not apply to all cases.

Review by the Director

The PSR process begins when a Delegate of the Chief Executive Medicare requests the Director to undertake a review of the provision of services by a practitioner over a specified period.

Investigation by a Committee

If the Director considers that the conduct of the practitioner needs further investigation, or the practitioner chooses not to enter a Negotiated Agreement, a Committee of the practitioner’s peers is established.

Determining Authority

When a Committee makes a finding of inappropriate practice against a practitioner, the Determining Authority will invite submissions from the practitioner on the sanctions it should impose.

More about the 3 stages of review

Preparing yourself for the review

At the start of the review process, you should take 3 key steps.