Medicare Participation Review Committee

The Minister must refer a practitioner to a the Chairperson of Medicare Participation Committees if the practitioner has been convicted of a relevant offence or had a pecuniary penalty order made against them in respect of a relevant civil contravention. The Chairperson must establish a Committee comprising 'peers' of the practitioner under review, choosing one from a list nominated by the Minister and one from a list nominated by a peak body (currently the Australian Medical Association, the Australian Dental Association or Optometry Australia). An Approved Pathology Provider or an Approved Pathology Authority may be referred to the Chairperson of Medicare Participation Review Committees if the Minister has reasonable grounds for believing that they have breached their pathology undertaking and they fail to satisfy the Minister that no further action should be taken. A Committee can: take no further action or; counsel; reprimand; and/or partially or fully disqualify a practitioner from billing Medicare for a period of up to 5 years. In the case of APP or APA, a Committee can also order repayment of Medicare benefits when the APP or APA was in breach of their undertaking. A new Committee is established for each matter referred.