5c. Navigating Medicare compliance: your guide to the PSR review process
Tracks
Stream 3
| Sunday, May 24, 2026 |
| 10:30 - 11:15 |
| Cockle Bay 2 |
Details
The Professional Services Review (PSR) is a vital component of the Commonwealth healthcare regulation system, aimed at protecting the integrity of the Medicare system. PSR is a peer review system ensuring that appropriate Medicare billing occurs for the benefit of everyone.
In this session PSR will outline its review process, explain how medical practitioners are central to the PSR system and provide an opportunity for attendees to have direct access to the PSR Director via a Q and A session. We will also touch on the stress referrals may cause and the importance of supporting colleagues during the review process. To explain their role, PSR will provide feedback on the most frequently reviewed general practice MBS items in recent years, including outlining common areas that give rise to concern. There are several emerging themes that PSR has seen in recent referrals which include: - an increase in automatic referrals following a breach of the prescribed pattern of services rules (80/20 and 30/20). - an increase in the review of telehealth services. PSR has identified telehealth services being provided without an attendance on the patient. - an increase in review of services provided in residential aged care facilities. PSR will discuss the real-world difficulties experienced in record-keeping and how practice owners can support their staff. - a continuing high number of reviews of therapeutic procedures (skin excision items) and an ongoing lack of awareness about the requirements when co-billing an attendance alongside a procedural item.
In this session PSR will outline its review process, explain how medical practitioners are central to the PSR system and provide an opportunity for attendees to have direct access to the PSR Director via a Q and A session. We will also touch on the stress referrals may cause and the importance of supporting colleagues during the review process. To explain their role, PSR will provide feedback on the most frequently reviewed general practice MBS items in recent years, including outlining common areas that give rise to concern. There are several emerging themes that PSR has seen in recent referrals which include: - an increase in automatic referrals following a breach of the prescribed pattern of services rules (80/20 and 30/20). - an increase in the review of telehealth services. PSR has identified telehealth services being provided without an attendance on the patient. - an increase in review of services provided in residential aged care facilities. PSR will discuss the real-world difficulties experienced in record-keeping and how practice owners can support their staff. - a continuing high number of reviews of therapeutic procedures (skin excision items) and an ongoing lack of awareness about the requirements when co-billing an attendance alongside a procedural item.
Speaker
Dr Clair Bannerman
JMO
Canberra Health Services
Chairperson
10:30 - 11:15
Dr Clair Bannerman is a current GP Registrar from Canberra, ACT. She is the ACT representative on the RACGP GP in Training Faculty Council, the Registrar Liaison Officer (RLO) for the Murrumbidgee-ACT training subregion, and is currently completing her Rural Generalism Core Emergency Training / ED Extended Skills term with Canberra Health Services.
Prior to working in Medicine, Clair was a NSW high school teacher, Commonwealth public servant and part-time Training Systems Officer with the RAAF. She has previously served on the Board of the AMA ACT and currently sits on the ACT Council of Doctors in Training.
Clair aspires to be a caring, compassionate, knowledgeable and skilled GP.
A/Prof Antonio Di Dio
Director
Professional Services Review (PSR)
Navigating Medicare compliance: your guide to the PSR review process
10:30 - 11:15
Associate Professor Antonio Di Dio grew up in rural Italy and Australia and has been a GP for over 30 years. He practises part-time in Canberra and is the full-time Director of the Professional Services Review. Antonio has been deeply involved in practitioner wellbeing for more than three decades and continues to support doctors through state and national Drs4Drs bodies.
He sits on the Boards of the Medical Benevolent Association and Drs Health Services and is Executive Chair of the National Leadership Alliance on Practitioner Wellbeing. He was awarded the AMA Presidential Medal in 2020 for services to doctors’ health and refugees.
Associate Professor Di Dio chairs the Australian Health Regulators Network, working to improve patient safety and regulatory experience. A former AMA ACT President, he has served on AMA Federal Council and Board and presents nationally on workplace culture, psychosocial safety and burnout prevention.
Ms Georgia O’Keefe
General Counsel a/g
Professional Services Review (PSR)
Navigating Medicare compliance: your guide to the PSR review process
10:30 - 11:15
Georgia O’Keefe is the acting General Counsel at Professional Services Review. Georgia has spent 10 years working in regulatory and administrative law in both private and public practice with a particular focus on the health regulation space. Georgia has worked for PSR since 2018 in a number of capacities. Georgia has a Masters of Health and Medical Law from the University of Melbourne and a Bachelor of Laws/Arts from the Australian National University.
