Thousands of GPs around Australia received letters from Medicare. Medicare asked GPs to review compliance with the rules in relation to item 10997. Provision of monitoring and support for a person with a chronic disease by a practice nurse or Aboriginal and Torres Strait Islander health practitioner (item 10997) is Read more…
Medicare has introduced a new rule for Telehealth. GPs cannot bill more than 30 Telehealth consultations in one day. The rule came into force on 1 January 2022. The 30/20 rule means that if any GP bills 30 or more telehealth consultations per day for 20 days in any 12 Read more…
Guide to General Practitioners. This post is not legal advice but rather a recollection of Medicare audits encountered by the author. My name is Paul Soloviev. I have had 20 years of consulting career in General Practice. Why GPs need to improve Medicare compliance and minimise the risk of Medicare Read more…
Where to find help? Indemnity insurance, consultants. What to expect? There are various professionals that help with audits. However, none of them can be the only resource for getting through the audit. Advice by your indemnity insurance provider is useful. They engage lawyers to act in your interests. However, the Read more…
You have reached an agreement with Medicare. What is next? How to reduce the impact of the ‘penalty’. Your accountant will assist you in recalculating the relevant tax returns. Repayments to Medicare are, essentially, refunds to customers and considered an expense. Ask for repayments to be arranged by instalments. BACK Read more…
Medicare proposed the ‘punishment’. It is not the end of the game. Your options. You CAN negotiate with Medicare stating financial commitments, carer’s commitments, charity work etc. You will need statements and statutory declaration to justify that. BACK NEXT Share Tweet Share Share Follow
Things got worse – you are in front of PSR (Professional Services Review). What to do and what not to do. Most important is not to progress to a full Panel Review. In other words, agree and negotiate with the Director of Professional Services Review. Do not let the situation Read more…
First response did not work. What is next? You are invited to attend an interview with the Medicare official. Do not argue. Be as calm as possible. Try to negotiate 6 months review and promise that in 6 months you will address all of the Medicare concerns. It works (sometimes). Read more…
First response is the most important in dealing with the audit. How to produce the first response. Must not be too formal. Must not be too long. Must include Introduction, itemised Body and a Conclusion. Introduction: 2-3 small paragraphs telling about yourself, your guiding principles in medicine. Body. addressing all Read more…
You have received the letter of audit. What to do? Do not panic. Most audits result in no action other than caution. Do not pick up the phone and call Medicare demanding answers to the question: “Why me? Withdraw your audit, please, I am innocent”. Do not write any replies Read more…