Preparing a written submission for the Practitioner Review Program

The Practitioner Review Program gives you an opportunity to respond to concerns about your claiming or prescribing through a written submission.

Page last updated: 15 January 2016

What you need to know

A written submission may help the delegate to better understand your practice and the reasons for the differences in your Medicare claims or Pharmaceutical Benefits Scheme prescribing data. The delegate will then either close the matter, or request the Director, Professional Services Review to review your service provision.

The role of a delegate of the Chief Executive Medicare

Health professionals and senior staff employed by us have been delegated certain powers of the Chief Executive Medicare.

In particular, a delegate can make a request to the Director of Professional Services Review (PSR) to review a practitioner's Medicare service provision or prescribing under the Pharmaceutical Benefits Scheme.

If one of our delegates has concerns after examining your data, you may be invited to provide a written submission prior to the delegate deciding whether a request should be made to the Director of PSR.

A written submission is optional

Deciding to write a submission is up to you, it is not mandatory.

If a written submission isn't made the delegate will make a decision based on the available information. This information will include the report of the interview, if one has been held, and the relevant Medicare claims and Pharmaceutical Benefits Scheme prescribing data. If there has been a period of review after the interview, the delegate will also consider the Medicare and Pharmaceutical Benefits Scheme data for that period. If concerns remain after consideration of the information, a request will be made to the Director of Professional Services Review to review your provision of services.

Useful information to include in your submission

If you prepare a written submission it does not have to follow any specific format. You can provide any material that you think may address our concerns.

The following may help in writing a submission:
    • consider the reasons for our concerns and address each concern
    • consider whether you can provide any additional information about your practice which might address our concerns
    • include information relevant to our concerns. If you are not sure, include the information and explain why you think it is relevant
    • you may want to use the data we provide you to help illustrate your response. You may also consider commenting, for example, on particular interests and skills you have, your patient demographics or specific characteristics of the locality in which you practice
    • if you want to include testimonials, consider whether they are relevant and specific to our concerns
    • your submission will be more effective if the most relevant points are explained clearly and succinctly. An index and a summary of the key points at the beginning may be useful, especially if there are several concerns to be addressed