PSR ‘may waive’ 80/20 rule during pandemic

The watchdog says two clinics have raised concerns that they might breach the rule due to a spike in patients.
Professor Julie Quinlivan.

Doctors who breach the 80/20 rule because of an influx in coronavirus consultations won’t get into trouble if they have otherwise followed the rules, the Professional Services Review says.

Currently, the Department of Health automatically refers every GP who provides more than 80 services in 20 or more days in a 12-month period to the PSR for investigation.

The Medicare watchdog says the rule is intended to prevent doctors from conducting a high volume of consultations in a short amount of time due to concerns that this could result in inadequate clinical care to patients and potentially cause them harm.

However, it has always stressed that if exceptional circumstances mean there is a higher need for services, then a breach of the 80/20 rule wouldn’t necessarily be regarded as inappropriate practice.