The Department of Health conducts program audits to check practices are complying with the PIP eligibility requirements for payments including the Procedural GP Payment.
This may include practice visits or a review of practice documents.
If your practice is unable to provide information to substantiate your eligibility and claims for incentives, Health may recover past PIP payments for up to 6 years.
Evidence of eligibility may include:
- copies of public liability insurance including amount covered
- copies of a practitioner’s professional indemnity insurance that shows cover to perform procedural services
- confirmation of details contained in the annual confirmation statements
- documents showing the GP’s procedural activity and volume has met the requirements of the relevant payment tier, and
- evidence of the GP’s after hours commitments
Copies of the evidence should be kept on practice files.
If a practitioner leaves a practice and an audit is conducted for the time the practitioner was there, a practice will still need to provide evidence that the professional indemnity insurance was maintained during their employment.