Utilization and Quality Control Peer Review Organization definition

Utilization and Quality Control Peer Review Organization means an entity that is designated by the Health Care Financing Administration as a peer review organization (PRO).
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Examples of Utilization and Quality Control Peer Review Organization in a sentence

  • Concerns regarding quality of care or premature discharge will also be referred to the appropriate Utilization and Quality Control Peer Review Organization (PRO).

  • Extension of a currently approved collection; Title of Information Collection: Final Peer Review Organizations Sanction Regulations; Use: The Peer Review Improvement Act of 1982 amended Title XI of the Social Security Act (the Act), creating the Utilization and Quality Control Peer Review Organization Program.

  • The grievance process must include a mechanism for timely referral of patient concerns regarding quality of care or premature discharge to the appropriate Utilization and Quality Control Peer Review Organization.

  • See Medicare Program; Acqui- sition, Protection, and Disclosure of Utilization and Quality Control Peer Review Organization (PRO) Information, 50 Fed.

  • Section 1157 of the Act limits liability and provides for the payment of legal expenses of an Utilization and Quality Control Peer Review Organization (PRO) that contracts to carry out functions under section 1154(e) of the Act.

  • The Social Security Act established the Utilization and Quality Control Peer Review Organization Program, now known as the QIO Program.

  • The Michigan State Plan further states that the medical and utilization review requirements will be met through a contract with a Utilization and Quality Control Peer Review Organization as designated under 42 CFR 475.

  • The Peer Review Improvement Act of 1982 established the Utilization and Quality Control Peer Review Organization (PRO) program.

  • Since all Medicare-participating hospitals must have an agreement with the Utilization and Quality Control Peer Review Organization (PRO) in the State in which the hospital is located as a condition of payment in accordance with the regulations at § 466.86(b), PRO review activities fulfill the UR requirements for hospitals.

  • Extension of a currently approved collection; Title of Information Collection: Quality Improvement Organization (QIO) Assumption of Responsibilities and Supporting Regulations; Use: The Peer Review Improvement Act of 1982 amended Title XI of the Social Security Act to create the Utilization and Quality Control Peer Review Organization (PRO) program which replaces the Professional Standards ReviewOrganization (PSRO) program and streamlines peer review activities.

Related to Utilization and Quality Control Peer Review Organization

  • Electric Reliability Organization or “ERO” means the organization that is certified by the Commission under Section 39.3 of its regulations, the purpose of which is to establish and enforce Reliability Standards for the Bulk Power System in the United States, subject to Commission review. The organization may also have received recognition by Applicable Governmental Authorities in Canada and Mexico to establish and enforce Reliability Standards for the Bulk Power Systems of the respective countries.

  • Utilization review organization means an entity that conducts utilization review, other than a health carrier performing a review for its own health plans.

  • Coordinated care organization means an organization meeting criteria adopted by the

  • Nominated Energy Efficiency Value means the amount of load reduction that an Energy Efficiency Resource commits to provide through installation of more efficient devices or equipment or implementation of more efficient processes or systems.

  • Independent review organization means an entity that is accredited to conduct independent external reviews of adverse benefit determinations.

  • Managed Care Organization (MCO) means a contracted health delivery system providing capitated or prepaid health services, also known as a Prepaid Health Plan (PHP). An MCO is responsible for providing, arranging, and making reimbursement arrangements for covered services as governed by state and federal law. An MCO may be a Chemical Dependency Organization (CDO), Dental Care Organization (DCO), Mental Health Organization (MHO), or Physician Care Organization (PCO).

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  • Review organization means a disability insurer regulated

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  • General air quality operating permit or "general permit" means an air quality operating permit that meets the requirements of ARM 17.8.1222, covers multiple sources in a source category, and is issued in lieu of individual permits being issued to each source.

  • Indicators of student progress and growth means the results of assessment(s) of students as defined in N.J.A.C. 6A:8, Standards and Assessment.

  • National Ambient Air Quality Standards or “NAAQS” means national ambient air quality standards that are promulgated pursuant to Section 109 of the Act, 42 U.S.C. § 7409.

  • Natural Resources Assistance Council means the natural resources assistance council created pursuant to Ohio Revised Code Section 164.21 as well as its members and officers.

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  • Electric power supplier means a person or entity that is duly

  • Water quality volume means the volume equal to the first one-half inch of runoff multiplied by the impervious surface of the land development project.

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  • Data qualifier means a specified character (or string of characters) that immediately precedes a data field that defines the general category or intended use of the data that follows.

  • Regional economic integration organization means an organization constituted by sovereign States of a given region to which its member States have transferred competence in respect of matters governed by this Convention and which has been duly authorized, in accordance with its internal procedures, to sign, ratify, accept, approve or accede to this Convention;

  • Health maintenance organization means that term as defined in section 3501 of the insurance code of 1956, 1956 PA 218, MCL 500.3501.

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