PSR was established in July 1994 as an Agency within the Health Portfolio to protect the integrity of Medicare and the PBS. Part VAA of the Health Insurance Act 1973 establishes the agency, sets out its role and powers and the process that it must follow when conducting its work.
Through the performance of its statutory role, PSR protects patients and the community from the risks associated with inappropriate practice. It also protects the Commonwealth from having to meet the cost of medical / health services provided as a result of inappropriate practice.
Telehealth Is Under Investigation
PSR’s current investigation of telehealth services serves as a warning for healthcare practitioners to implement robust billing practices for telehealth consultations.
At Tego, we recommend that all medical practitioners consider the need for patient examination in performing any telehealth consultations. This is because PSR is investigating the failure/inability to undertake a patient examination in conjunction with a telehealth consultation and whether it constitutes ‘inappropriate practice’.
Inappropriate Practice
Inappropriate Practice is defined as rendering or initiating services that a practitioner’s peers could reasonably conclude was unacceptable to the general body of their profession, such as:
- whether a practitioner’s practice/conduct when providing or initiating Medicare services would be unacceptable to the general body of their peers.
- whether a practitioner’s conduct in prescribing or dispensing PBS medicines would be unacceptable to the general body of their peers.
If your practice is deemed to have conducted ‘inappropriate practice’, you could be exposed to substantial repayment orders of MBS item numbers for services found by PSR.
Protecting Your Practice – Tego Insurance
In conclusion, while Telehealth is now more than ever a needed and desired patient interaction, medical practitioners whether in private practice or part of a large group cannot afford to be conducting ‘inappropriate practice.’ There is the possibility that these actions will cause not only financial ramification but also threaten your good standing with medical peers and community.
As medical indemnity insurance providers in Australia, we will cover your practice with medical indemnity insurance, medical malpractice insurance, doctors indemnity insurance, medical practice insurance, GP medical indemnity insurance, and more. If you are a health practitioner with Tego, your medical indemnity insurance comes with 24/7 medico-legal advice and support to guide you through the perils of telehealth.
This publication is general in nature and is not comprehensive or constitute legal or medical advice. You should seek legal, medical or other professional advice before relying on any content, and practice proper clinical decision making with regard to individual circumstances. Persons implementing any recommendations contained in this publication must exercise their own independent skill or judgment or seek appropriate professional advice relevant to their own particular practice. Compliance with any recommendations will not in any way guarantee discharge of the duty of care owed to patients and others coming into contact with the health professional or practice. Tego Insurance Pty Ltd is not responsible to you or anyone else for any loss suffered in connection with the use of this information.