Common use of Patterns of Practice Committee Clause in Contracts

Patterns of Practice Committee. (a) The MSC has the right and responsibility to appoint inspectors to audit the patterns of practice of medical practitioners as part of a random review or in response to service verification irregularities. (b) The Patterns of Practice Committee shall continue to act as an advisory committee to the MSC under section 5(l)(o) of the Medicare Protection Act. (c) The approved costs of the Patterns of Practice Committee will be shared equally by the MSP and the Doctors of BC. (d) The Patterns of Practice Committee will: (i) inform medical practitioners of their billing patterns and provide education to the medical practitioners as necessary; (ii) prioritize a review of selected new guidelines of the Guidelines and Protocols Advisory Committee to determine their expected impact on Fee utilization and provide related education material and information to medical practitioners; (iii) work with the Guidelines and Protocols Advisory Committee to jointly review a set number of guidelines per year, evaluate their impact on utilization management, and report back to the MSC as to their effectiveness; and (iv) meet with the Guidelines and Protocols Advisory Committee regularly to propose ideas for new guidelines, based on the Patterns of Practice Committee’s work and analysis of new areas for which guidelines could be developed.

Patterns of Practice Committee. (a) The MSC has the right and responsibility to appoint inspectors to audit the patterns of practice of medical practitioners as part of a random review or in response to service verification irregularities. (b) The Patterns of Practice Committee shall continue to act as an advisory committee to the MSC under section 5(l)(o) of the Medicare Protection Act. (c) The approved costs of the Patterns of Practice Committee will be shared equally by the MSP Government and the Doctors of BC. (d) The Patterns of Practice Committee will: (i) review, inform and educate medical practitioners in regard to their pattern of their billing patterns practice and provide education to the medical practitioners as necessarybilling; (ii) provide nominations for medical inspectors to the Audit and Inspection Committee; (iii) provide nominations for physician audit hearing panel members to the MSC; (iv) prioritize a review of selected new guidelines of the Guidelines and Protocols Advisory Committee to determine their expected impact on Fee utilization and provide related education material and information to medical practitioners; (iiiv) work with the Guidelines and Protocols Advisory Committee to jointly review a set number of guidelines per year, evaluate their impact on utilization management, and report back to the MSC as to their effectiveness; and (ivvi) meet with the Guidelines and Protocols Advisory Committee regularly to propose ideas for new guidelines, based on the Patterns of Practice Committee’s work and analysis of new areas for which guidelines could be developed.