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Agency and scheme objectives

The role and functions of PSR are set out in Part VAA of the Health Insurance Act 1973 (the Act), which establishes the PSR Scheme. Section 79A of the Act states that:

The object of this Part is to protect the integrity of the Commonwealth Medicare benefits, dental benefits and pharmaceutical benefits programs and, in doing so:

  • (a) protect patients and the community in general from the risks associated with inappropriate practice; and
  • (b) protect the Commonwealth from having to meet the cost of services provided as a result of inappropriate practice.

Section 81 of the Act includes a definition of ‘practitioner’, which, together with the Health Insurance (Professional Services Review - Allied Health and Others) Determination 2012, lists the categories of medical, midwifery, nurse practitioner and allied health practitioners that are subject to review under Part VAA of the Act.