PSR Director's Update for March 2019

A. Director’s Section 92 agreements effective in March 2019

The following agreements entered into by the Director and persons under review (in accordance with s 92 of the Act) came into effect:

• An agreement with a haematologist. The Director reviewed this practitioner’s rendering of MBS items 112, 116, 132, 133 and 14221. The practitioner acknowledged they engaged in inappropriate practice in connection with providing these items, except for Medicare Benefit Schedule (MBS) items 13706 and 13750 in relation to which the Director had no concerns. The practitioner agreed to repay $510,000, and will be reprimanded by the Director.
   
• An agreement with a medical practitioner. The Director reviewed this practitioner’s rendering of MBS items 598 and 600, and prescribing of Pharmaceutical Benefit Scheme (PBS) item 8254K. The practitioner acknowledged they engaged in inappropriate practice in connection with providing these items. The practitioner agreed to repay $300,000, to be disqualified from providing MBS items 585, 588, 591, 594 for six months, and will be reprimanded by the Director.
   
• An agreement with a medical practitioner The Director reviewed this practitioner’s rendering of MBS items 54, 5040 and 73805. The practitioner acknowledged they engaged in inappropriate practice in connection with providing these items. The practitioner agreed to repay $120,000, to be disqualified from providing MBS items 54, 5040, 73805 for 12 months, and will be reprimanded by the Director.
   
• An agreement with a medical practitioner. The Director reviewed this practitioner’s rendering of MBS items 597, 598, 599 and 600. The practitioner acknowledged they engaged in inappropriate practice in connection with providing these items.  The practitioner agreed to repay $390,000, to be disqualified from providing MBS items 585, 588, 591, 594 for 12 months, and will be reprimanded by the Director.
   
• An agreement with a general practitioner. The Director reviewed this practitioner’s rendering of MBS items 23, 36, 715, 721, 723, 732, 10987, 10997, 11204, 11610, 11612, 11700, 11709, 11712, 55113 and 55116, and prescribing of PBS item 8254K. The practitioner acknowledged they engaged in inappropriate practice in connection with providing these items. The practitioner agreed to repay $390,000, to be disqualified from providing MBS items 715, 721, 723, 732, 10987, 10997, 11204, 11610, 11612, 11709, 11712, 55113, 55116 for 12 months, and will be reprimanded by the Director.
   
• An agreement with a medical practitioner. The Director reviewed this practitioner’s rendering of MBS items 597 and 5023, and prescribing of PBS items 5470X, 5471Y and 8411Q. The practitioner acknowledged they engaged in inappropriate practice in connection with item 597. The Director had no concerns in respect of the other items reviewed. The practitioner agreed to repay $270,000, and will be reprimanded by the Director.
   
• An agreement with a medical practitioner. The Director reviewed this practitioner’s rendering of MBS items 597 and 599, and prescribing of PBS item 8254K. The practitioner acknowledged they engaged in inappropriate practice in connection with providing these items. The practitioner agreed to repay $450,000, to be disqualified from providing MBS items 585, 588, 591, 594 for 12 months, and will be reprimanded by the Director.
   
• An agreement with a general practitioner. The Director reviewed this practitioner’s rendering of MBS items 23, 5020, 56220, 56223, 57341 and 63560, and prescribing of PBS items 3119E, 3162K, 8254K and 8935G. The practitioner acknowledged they engaged in inappropriate practice in connection with providing these items. The practitioner agreed to repay $352,088.91 to be disqualified from providing MBS items 56220, 56223, 63560 for 12 months, and will be reprimanded by the Director.
   
• An agreement with a general practitioner. The Director reviewed this practitioner’s rendering of MBS items 23, 36, 721, 723, 2713, 5020, 5040, 16500, 55032, 55036, 55065, 63551, 63554, 66716, 66719, 66734 and 66900, and PBS items 3119E, 5457F and 8254K. The practitioner acknowledged they engaged in inappropriate practice in connection with providing these items, except for MBS items 23, 5020, 16500, 66716, 66719 and 66734, and PBS items 3119E and 5457F in relation to which the Director had no concerns. The practitioner agreed to repay $175,000, to be disqualified from providing MBS items 721, 723, 63551, 63554, 66900 for 12 months, and will be reprimanded by the Director.
   
• An agreement with a general practitioner. The Director reviewed this practitioner’s rendering of MBS items 23, 721, 723, 732, 2715 and 5020, and prescribing of PBS items 1215Y, 1434L, 1916W, 2622B, 3162K and 9156X. . The practitioner acknowledged they engaged in inappropriate practice in connection with items 721, 723 and 3162K. The Director did not have concerns in relation to the other items reviewed. The practitioner agreed to repay $10,000, and will be reprimanded by the Director.
   
• An agreement with a general practitioner. The Director reviewed this practitioner’s rendering of MBS items 23, 36, 44, 703, 707, 721, 723 and 2713. The practitioner acknowledged they engaged in inappropriate practice in connection with providing these items. The practitioner agreed to repay $185,000, to be disqualified from providing MBS items 44, 703, 707, 721, 723, 2713 for 12 months, to be disqualified from providing MBS item 36 for 6 months, and will be reprimanded by the Director.

B. PSR Committee final determinations

No determinations became effective in March 2019.

C. Federal Court

No decisions from the Federal Court were handed down in March 2019.

D. Referrals to the major non-compliance (fraud) division

No matters were referred to the major non-compliance (fraud) division in March 2019.

E. Referrals to AHPRA

One matter was referred to AHPRA in March 2019.