‘No objection’ to PSR improvement bill: RACGP

Jolyon Attwooll

13/07/2023 3:05:16 PM

The college will not oppose legislation prompted by the Medicare compliance review, but still wants to be consulted on panel appointments. 

Law book and stethoscope
Legislation has been introduced following a high-level review of Medicare compliance.

The RACGP has said it has ‘no objection’ to legislation designed to improve the Professional Services Review (PSR) process, provided it does not lead to reduced consultation on PSR panel appointments.  
In a letter to the Committee Secretary of the Senate Standing Committees on Community Affairs, RACGP President Dr Nicole Higgins welcomed the opportunity to provide feedback on the Health Insurance Amendment (Professional Services Review Scheme) Bill 2023.
‘We support efforts to strengthen the fairness and transparency of the PSR process, which can cause a great deal of stress and anxiety for practitioners under review,’ she wrote.
The legislation, which followed recommendations from the Independent Review of Medicare Integrity and Compliance conducted by Dr Pradeep Philip, would remove the need for the AMA to approve the appointment of the PSR Director.

If passed, it will also establish a new PSR Associate Director role designed ‘to assist with managing conflicts of interest, unexpected absences and workload pressures’.
The Bill also removes the need for Medicare’s Chief Executive to consult with professional bodies before issuing a notice to produce documents.
The RACGP President said she does not think the removal of the AMA veto on the PSR Director role will have an adverse effect.
However, she urged the agency to continue consulting with the RACGP when making appointments to the PSR Panel ‘to ensure [it] consists of GPs with appropriate skills and expertise’.
Dr Higgins also expressed hope that a new Associate Director role will ‘expedite the PSR process for practitioners involved’.
The Bill was shaped by recommendations put forward in Dr Philip’s report, which was produced at the request of Federal Health and Aged Care Minister Mark Butler after high-profile media allegations of widespread Medicare fraud and non-compliance.
One of the review’s terms of reference was to identify potential improvements to the PSR.
Dr Philip concluded that the PSR regime causes ‘significant fear’ among practitioners, while noting that only a very small number are ever referred to the PSR.
‘Many stakeholders agree it is important for there to be an effective, independent Medicare regulator, and current referrals to PSR are based on rigorous analysis of claiming behaviour of those preselected for review,’ he wrote.
‘But the sample size is limited by virtue of there not being any continuous monitoring of all transactions.’
In the letter about the Bill, Dr Higgins acknowledged recent steps to address gaps in many GPs’ knowledge about the PSR process, including the publication of an ‘updated comprehensive guide’ for GPs who are referred to the agency.
She said the college looks forward to continuing a ‘productive and collaborative’ relationship with the PSR.
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