The latest insights from our Health Law team:

Fraudulent pharmacist sentenced to six years’ prison

On 17 June 2022, a former pharmacist was sentenced before the Sydney Downing Centre District Court to more than six years’ imprisonment for falsely claiming benefits under the Pharmaceutical Benefits Scheme (PBS) under a conspiracy to defraud the Commonwealth. The pharmacist conspired to claim more than $19 million from the PBS.

The former NSW pharmacist was sentenced to 6 years and 4 months imprisonment, with a non-parole period of 4 years.

The conviction was a result of collaboration between the Department of Health (Department), the Australian Federal Police and the Commonwealth Director of Public Prosecutions, following information which was received via the Department’s tip-off hotline.

In a statement, the Department said it "takes allegations of fraud and non-compliance by health providers very seriously” and that they “recognise that the overwhelming majority of health providers are aware of and comply with their obligations to claim benefits honestly and correctly.”

For more information, see the Department’s media release here.

Increase in professional boundary notifications – AHPRA Annual Report 2020/21

AHPRA’s 2020 – 2021 report provided updates on violations of professional boundaries with patients. Notifications regarding violations are assessed and considered against the relevant National Board’s Code of Conduct. Boundary violations came in many different forms. For example, comments made by practitioners to patients during consultations or online.

There was a significant increase of notifications received, from 464 to 568 notifications. Notifications came from three primary professions:

  • Medical practitioners (53.2%)
  • Nurses (19.5%)
  • Psychologists (10.7%)

The seriousness and high risk profile of boundary violation notifications was reflected in AHPRA considering immediate action on 258 occasions and taking immediate action 161 times. AHPRA closed 53.5% of these boundary violation matters following an investigation, 34.5% at assessment and 9.2% after referral to a tribunal, reflecting the serious nature of notifications.

For more information, you can access the Annual Report or view summaries for various areas here.

Pharmaceutical company hit with significant infringement notices for failing to comply with COVID-19 rapid antigen test requirements

The Therapeutic Goods Administration (TGA) has issued eight infringement notices to Hough Pharma Pty Ltd totalling $106,560 for failing to comply with the Therapeutic Goods Act 1989 (Cth) (Act).

This Act requires Sponsors of medical devices that are approved by the TGA to provide evidence that demonstrates the safety and performance of their products, in this case being COVID-19 rapid antigen tests (RATs). The ultimate aim of the Act is to ensure that medical devices perform as expected and are safe for users. It is also required that Sponsors have a telephone help-line operational to provide customer support services from 9am to 7pm (AEST).

Through investigation, the TGA has verified that there is a lack of customer support available to consumers of Hough Pharma’s products. This, in addition to Hough Pharma not meeting deadlines for providing information is why they have received multiple infringement notices.

This compliance action is a reminder to companies producing therapeutic goods to take their obligations seriously. For more information, you can read the Department of Health’s full media release here.

OPAN launches ‘Ready to Listen’ campaign

The Older Persons Advocacy Network (OPAN) in partnership with Celebrate Ageing Ltd and the Older Women’s Network NSW launched its Ready To Listen campaign in June, encouraging people to listen to older people when they report sexual assault.

According to estimates, approximately fifty people, many of whom have dementia, are sexually assaulted in Australian aged care homes every week. OPAN suggests that the testimony of people with cognitive impairment can be seen as unreliable by service providers and investigating authorities.

OPAN CEO, Craig Gear, noted that the most recent Aged Care Quality and Safety Commission Sector performance report identified 530 cases of unlawful sexual conduct or inappropriate sexual conduct in the three months to December 2021, noting that the sector has seen little improvement since the recent aged care royal commission handed down its findings.

The Ready To Listen campaign outlines ten ways in which residential aged care service providers can improve their responses to, and prevent, sexual assault. Resources relating to the campaign may be accessed here.

To speak to someone about the risk of abuse in residential aged care, call OPAN on 1800 700 600 or Elder Abuse on 1800ELDERHELP. To read more about the campaign launch, click here.

NDIS Pricing Arrangements and Price Limits 2022-23

The National Disability Insurance Agency (NDIA) published its updated National Disability Insurance Scheme (NDIS) Pricing Arrangements and Price Limits 2022-23 (NDIS Pricing Arrangements) on 22 June 2022, which took effect on 1 July 2022.

Under the new NDIS Pricing Arrangements, price limits for most NDIS supports provided by disability support workers will increase by 9 per cent. The decision, made largely in light of the financial impact of COVID-19, the Fair Work Commission’s 2022 Annual Wage Review, and the increase in the Superannuation Guarantee Charge, is expected to assist in disability support worker retention and promote participant outcomes more effectively.

The NDIA has also committed up to $514 million for distribution among registered providers of activities of daily living and community participant supports. Delivered as a one-off payment calculated by the NDIA, providers have 28 days to accept the payment and commit to undertaking an audit to demonstrate the amount received relates to actual costs incurred.

The NDIS Pricing Arrangements and Price Limits 2022-23 may be downloaded here.

Minimally Invasive Glaucoma Surgery (MIGS) devices market

The minimally invasive glaucoma surgery (MIGS) devices market was valued at US$298.75 million in 2020 and is forecasted to generate US$5 billion by 2030, according to Allied Market Research.

Following the Australian Government’s approval of MIGS as a standalone procedure in 2020, the growth of the MIGS devices market specifically within the Asia-Pacific region between 2022 and 2030, is expected to be led by Australia.

GlobalData published its analysis and forecast of the glaucoma surgery devices market on 28 April 2022, predicting a 9 per cent compound annual growth rate for MIGS within Australia by 2030. It reported that the key drivers of this growth include Australia’s ageing population, government-led initiatives, and a rise in patient awareness of MIGS.

An overview of Allied Market Research’s MIGS report may be viewed here, and an overview of GlobalData’s glaucoma surgery devices market analysis may be viewed here.

Medicare Benefits Schedule (MBS) telehealth services – July 2022 update

On 30 June 2022, the federal government struck various specialist telehealth phone items from the Medicare Benefits Schedule (MBS). The relevant items mostly impacting the delivery of consultation services to patients with complex and chronic conditions, the elderly and children with autism.

Several medical colleges have referred to the decision as a backwards step for healthcare, noting that curtailing flexible forms of medical care can add to existing inequities experienced by the elderly, some Aboriginal and Torres Strait Islander people, some people living with disability and some members of rural and remote communities.

Information relating to MBS changes effective 1 July 2022 may be viewed here and here.