Bill to exempt dentists from PSR investigation

AN INQUIRY was due to have commenced this week into proposed legislation that would allow dentists to keep incorrectly billed Medicare payments and exempt them from investigation by the Professional Services Review.

The proposed Health Insurance (Dental Services) Bill 2012 would require the health minister to waive the repayment of up to $21.6 million in Medicare benefits incorrectly claimed by dentists under the Chronic Disease Dental Scheme.

The bill has the support of the Australian Dental Association, which claimed in a submission to the inquiry dentists had been given inconsistent advice by Medicare as to the administrative requirements of the scheme and not warned of the penalties for non-compliance.

But the AMA claimed in its own submission the bill would create a two-tier system in which GPs and other doctors were subject to Medicare’s legal requirements but dentists were not.

“All health practitioners whose services attract Medicare benefits should be subject to the regulatory requirements of the Medicare benefits arrangements,” the AMA argued in its submission.

“We do not consider it appropriate that dentists can use ‘I did not know’ as a defence against future non-compliance with the determination.”

The submission said instead of creating legislative loopholes for dentists who misinterpreted the requirements, the government should focus on reforming the MBS which was “rife with red tape”.

Meanwhile, the human services department general manager recovery health and public compliance division, Jennifer Cooke, told MO the department was keen to work with the profession to ensure the integrity of the Medicare system.

“We do want to work with stakeholders and practices [and] we’re looking for a partnership in the interests of effective operation of the scheme,” she said.

Ms Cooke said while the Medicare audit process in relation to unusual claiming patterns could be stressful, GPs who had been through it generally rated it more positively than those who had only heard about it second-hand.

“We find people generally appreciate the fact the process involves dealing with a practising medical adviser and they have been given the opportunity to explain and, if necessary, alter their claiming patterns,” she said.