Accession Number : ADA188920

Title :   MEDICARE: Physician-Sponsored Organizations Receive Priority for Peer Review Contracts.

Corporate Author : GENERAL ACCOUNTING OFFICE WASHINGTON DC HUMAN RESOURCES DIV

PDF Url : ADA188920

Report Date : Jan 1988

Pagination or Media Count : 5

Abstract : As part of the Tax Equity and Fiscal Responsibility Act of 1982, the Congress amended part B of title XI of the Social Security Act to establish the utilization and quality control peer review organization program as the successor to the professional standards review program. The program is intended to assure that Medicare beneficiaries received appropriate, high-quality medical care. The legislation designated two categories of PROs, called physician-sponsored and physician-access. Physician-sponsored organizations must be composed of a substantial number of the licensed physicians in the area served by the PRO who are representative of the practicing physicians in that area. Physician-access organizations are required to have available a sufficient number of physicians to assure adequate peer review of the services provided by the various medical specialties and subspecialties. The act required the Health Care Financing Administration (HCFA), within the Department of Health and Human Services, to give physician-sponsored organizations priority in the award of PRO contracts.

Descriptors :   *MEDICAL SERVICES, *CONTRACTS, HEALTH, HUMANS, PHYSICIANS, TAXES, PUBLIC HEALTH

Subject Categories : Administration and Management
      Medicine and Medical Research

Distribution Statement : APPROVED FOR PUBLIC RELEASE