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AMA calls for more transparency in Section 92 agreement process

The AMA has called for greater procedural fairness in the section 92 agreement process including   clarity and transparency of the entire process as well as the provision of options for persons under review (PUR) especially the right to appeal.

The AMA’s submission to the review of section 92 agreements under the Professional Services Review (PSR) agency focuses on the procedural fairness of the process, noting that many medical professionals felt coerced into an agreement, were not aware of all options available to them including appeals, and that the PSR did not adequately explain the problem with their billing practices.

The AMA thanks members who provided input into the AMA submission, many dissatisfied with what they see as the adversarial and inquisition style of investigation, placing undue stress and pressure on the PUR.  

The AMA is recommending greater clarity and transparency of processes undertaken by the PSR ahead of the referral, for the initial review, about the findings and qualifications of the peer reviewer, and the scope and process of a PSR Committee review should the PUR opt for that instead of an S92.

The independent review of section 92 is being conducted by Emeritus Professor Robin Creyke AO and will examine how section 92 of the Health Insurance Act 1973 is being applied by the PSR.

The PSR states it “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.”

The full AMA submission is available here.

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