An ophthalmologist has agreed to repay $750,000 for engaging in inappropriate practice in connection with rendering Medical Benefits Schedule items 42702, 42740 and 42788.
The ophthalmologist’s rendering of the three MBS items were reviewed by the director of the Professional Services Review.
According to the director’report, the ophthalmologist acknowledged engaging in inappropriate practice in connection with rendering all of those items; agreed to repay $750,000; and will be reprimanded by the director.
Due to the nature of negotiated agreements and secrecy limitations imposed by the legislative scheme, no practitioners who have entered into agreements with the director are named.
However, the director has the power to disclose the names and addresses of practitioners who are found by a committee to have engaged in inappropriate practice and who are subject to a final determination.
- Item 42702 is for ‘Lens extraction and insertion of intraocular lens, excluding surgery performed for the correction of refractive error except for anisometropia greater than 3 dioptres following the removal of cataract in the first eye.
- Item 42740 is for ‘Intravitreal injection of therapeutic substances, or the removal of vitreous humour for diagnostic purposes, 1 or more of, as a procedure associated with other intraocular surgery.
- Item 42788 is for ‘laser capsulotomy – each treatment episode to one eye, to a
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