Optometrist directed to repay $57,000 to Commonwealth; disqualified from making certain claims for 6 months
An optometrist whose name will not been revealed in accordance with section 92 of the Health Insurance Act , has been directed to repay $57,059.01 to the Commonwealth.
The optometrist was also disqualified from rendering MBS items 10913 and 10914 for six months.
Professional Services Review committee decision
The directions were made by the Professional Services Review committee on 27 October, after it concluded that the optometrist engaged inappropriate practice in connection with rendering MBS items10913 and 10914.
The committee found that the practitioner’s record-keeping in connection with the MBS items 10913 and 10914 services that it reviewed was, on occasion, inadequate. That occurred when, for example, history, diagnoses, follow-up arrangements or examination findings were either not recorded or not recorded in sufficient detail.
Patient must be seen by optometrist at same practice
MBS item 10913 requires, amongst other things, that a patient with new signs or symptoms previously been seen at the same practice as the providing optometrist. In the committee’s view, that meant the patient must be seen by an optometrist at the same physical practice, not at another practice within a corporate group.
The committee’s view was that failure to meet that regulatory requirement on its own and in the absence of any other conduct of concern would be considered unacceptable to the general
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