The Professional Service Review (PSR) is an Agency within the Health Portfolio whose work protects the integrity of Medicare, Dental Benefits, and the Pharmaceutical Benefit Scheme (PBS). PSR is established under Part VAA of the Health Insurance Act 1973, which sets out the role and powers of the Agency, as well as the process that it must follow when conducting its work.
PSR includes a number of entities with their own statutory functions. The Agency Head is the Director of PSR who receives matters for investigation from the Chief Executive Medicare. The Director may resolve matters or refer matters to a PSR Committee which is constituted by medical or allied health practitioner members. Matters from both the Director and Committees are referred to a body constituted by medical members and a community representative, the Determining Authority. The PSR staff support each of the PSR entities as required. The outcome from a PSR investigation can include the repayment of Medicare or Dental benefits or disqualification from Medicare, the CDBS or the PBS.
