Unpacking the Medicare compliance process - RACGP

Posted Friday 15 November 2024 | RACGP

This webinar is a joint presentation between the Department of Health and Aged Care (DoHAC) and the Professional Services Review (PSR) on the Medicare compliance process. It will aim to alleviate some of the fear and misconceptions that exist around compliance.
 
Dr Sarah Mahoney from DoHAC will be presenting on the principles of how to claim Medicare items appropriately as well as how the Department’s compliance work relates to and differs from the work of PSR.
 
Dr Antonio Di Dio will provide an overview of the PSR process for GPs. He will cover how the PSR determines if a practitioner has engaged in inappropriate practice, including the following stages of the process:

1. Initial review of a case by the PSR Director
2. Referral to a peer review Committee
3. Role of the Determining Authority, including possible sanctions.

The presenters will also take questions from attendees.

Learning outcomes

1. Outline the key stages of the Medicare compliance process.
2. Identify MBS item numbers that are most commonly the subject of DoHAC/PSR referrals and investigations.
3. Employ resources to assist with MBS interpretation and Medicare compliance.