title: PRO update. Transition from the third to fourth scope of work.
abstract: The Health Care Financing Administration (HCFA) began implementation of the transition from the Third Peer Review Organization (PRO) Scope of Work to the Fourth PRO Scope of Work on October 1, 1991. PROs in 11 states are currently implementing newly-established medical review requirements under the "Scope of Work," the contract by which PROs are obligated to carry out their statutorily-mandated duties of determining the medical necessity, appropriateness and quality of care delivered to Medicare beneficiaries. Michigan's PRO (MPRO) is scheduled to implement requirements outlined in the Fourth Scope of Work beginning April 1, 1992. This article discusses the American Medical Association's (AMA) relationship to the PRO program and the transition from the Third to the Fourth Scope of Work including the status of the Uniform Clinical Data Set.
authors.forename: N A
authors.initials: NA
authors.lastname: Baker
mesh_terms: D000574:American Medical Association / Q000458:organization & administration*; D006291:Health Policy / Q000331:legislation & jurisprudence*; D006801:Humans; D007373:Interinstitutional Relations; D008824:Michigan; D011366:Professional Review Organizations / Q000458:organization & administration* / Q000639:trends; D011785:Quality Assurance, Health Care / Q000331:legislation & jurisprudence* / Q000639:trends; D012955:Societies, Medical / Q000458:organization & administration*; D014481:United States