Medicare program; Peer Review Organizations: revised scopes of work for Delaware, Missouri, Montana, Nebraska, New Jersey, Nevada, Oklahoma, Rhode Island, South Carolina, Washington, and Wyoming--HCFA. Final notice.
This notice describes requirements for the review activities of Utilization and Quality Control Peer Review Organizations (PROs) for the next contract cycle in the States listed above. Section 1153(h)(1) of the Social Security Act requires us to publish any new policy or procedure adopted by the Secretary that affects substantially the performance of PRO contract obligations at least 30 days before the date the policy or procedure is to be used. Specifically, this notice describes significant changes in the way in which cases will be selected for review and also describes continuing requirements. This notice also implements provisions of the Omnibus Budget Reconciliation Act of 1990 and announces the future direction of the PRO program.
D014487:Centers for Medicare and Medicaid Services, U.S.; D003284:Contract Services / Q000331:legislation & jurisprudence; D003625:Data Collection / Q000592:standards; D006761:Hospitals / Q000592:standards; D006278:Medicare / Q000592:standards; D011366:Professional Review Organizations / Q000331:legislation & jurisprudence*; D014481:United States; D014600:Utilization Review / Q000331:legislation & jurisprudence*