Dr Margaret Faux was engaged to provide an independent expert opinion regarding the Medicare billing compliance of a medical specialist under review by the Professional Services Review (PSR) Agency. The PSR is responsible for investigating whether services billed to Medicare comply with Part VAA of the Health Insurance Act 1973.
This particular engagement required Dr Faux to conduct a detailed analysis of the full sample of claims under investigation. She reviewed all available evidence – including item numbers billed, service patterns, and supporting documentation – to determine whether the claims complied with Medicare legislation, regulations, and relevant policy frameworks.
Dr Faux’s role was to offer an objective, evidence-based opinion, addressing key compliance questions and provided clear, reasoned conclusions on whether the practitioner’s billing conduct met the applicable standards.
This matter forms part of a broader body of work in which Dr Faux has been engaged by legal representatives and regulatory bodies to provide expert opinions in multiple PSR investigations. Her deep legal expertise and practical understanding of Medicare billing make her a trusted authority in some of the most complex and sensitive billing compliance reviews in the country.