Nurse practitioner admits $85k in inappropriate MBS claims

A nurse practitioner has been ordered to repay Medicare $85,000 after admitting to inappropriate MBS claims for long consultations and unwarranted pathology tests.
The nurse practitioner was claiming long and extended consultations “at a variance” to other nurse practitioners and was investigated by the Professional Services Review (PSR).
The watchdog said the nurse failed to take the minimum time required to claim the consultation items, while their pathology orders, such as for iron studies under MBS item 66596, were “not always clinically indicated”.
They also prescribed PBS-funded antibiotics such as cefalexin and amoxicillin without any clinical indication documented, the PSR said in its director’s update for June.