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Medicare program; Utilization and Quality Control Peer Review Program; third Scope of Work for Peer Review Organizations. 1989

This notice describes new requirements for the third Scope of Work for Utilization and Quality Control Peer Review Organizations (PROs) for fiscal year 1989, beginning October 1, 1988. This notice implements section 4091(b)(1) of the Omnibus Budget Reconciliation Act of 1987 (Pub. L. 100-203), which requires us to publish a new policy or procedure adopted by the Secretary that affects substantially the performance of contract obligations at least 30 days before the date the policy or procedure is to be used. It also implements other provisions of Pub. L. 100-203, as well as requirements of the Omnibus Budget Reconciliation Act of 1986.

UI MeSH Term Description Entries
D011366 Professional Review Organizations Organizations representing designated geographic areas which have contracts under the PRO program to review the medical necessity, appropriateness, quality, and cost-effectiveness of care received by Medicare beneficiaries. Peer Review Improvement Act, PL 97-248, 1982. PRO Professional Review Organizations,PSRO,Peer Review Organizations,Professional Standards Review Organizations,Utilization and Quality Control Peer Review Organizations,Organizations, Peer Review,Organizations, Professional Review,Review Organizations, Professional,Organization, Peer Review,Organization, Professional Review,Peer Review Organization,Professional Review Organization
D011786 Quality Control A system for verifying and maintaining a desired level of quality in a product or process by careful planning, use of proper equipment, continued inspection, and corrective action as required. (Random House Unabridged Dictionary, 2d ed) Control, Quality,Controls, Quality,Quality Controls
D006278 Medicare Federal program, created by Public Law 89-97, Title XVIII-Health Insurance for the Aged, a 1965 amendment to the Social Security Act, that provides health insurance benefits to persons over the age of 65 and others eligible for Social Security benefits. It consists of two separate but coordinated programs: hospital insurance (MEDICARE PART A) and supplementary medical insurance (MEDICARE PART B). (Hospital Administration Terminology, AHA, 2d ed and A Discursive Dictionary of Health Care, US House of Representatives, 1976) Health Insurance for Aged and Disabled, Title 18,Insurance, Health, for Aged and Disabled,Health Insurance for Aged, Disabled, Title 18,Health Insurance for Aged, Title 18
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014481 United States A country in NORTH AMERICA between CANADA and MEXICO.

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