Medicare program; utilization and quality control peer review organization (PRO) area designations--HCFA. Notice

Area of Science:

• Health Policy
• Public Administration

Background:

• The Peer Review Improvement Act of 1982 (Pub. L. 97-248) introduced requirements for program oversight.
• Title I, Subtitle C of the Act specifically addresses improvements in peer review processes.

Purpose of the Study:

• To implement provisions of the Peer Review Improvement Act of 1982.
• To establish designated geographic areas across the United States.
• To facilitate contracting under the PRO program within these areas.

Main Methods:

• Legislative implementation of federal act.
• Designation of national geographic service areas.
• Development of contractual frameworks for the PRO program.

Main Results:

• Establishment of a framework for geographic contracting under the PRO program.
• Defined regions for program implementation nationwide.
• Compliance with the Peer Review Improvement Act of 1982.

Conclusions:

• The established geographic areas are crucial for the operationalization of the PRO program.
• This implementation ensures adherence to the legislative mandate for improved peer review processes.
• The PRO program will now function within a structured, geographically defined system.