Professional Standards Review Organizations: Hearings Before the Subcommittee on Oversight of the Committee on Ways and Means, House of Representatives, Ninety-fifth Congress, First Session, April 4 and 6, 1977U.S. Government Printing Office, 1977 - 426 strani |
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administrative admission ambulatory American Hospital Association appropriate approved assessment basis Bureau of Quality certification concurrent review conditional PSRO covered benefit criteria and standards decision designated determination of coverability developed effective established Federal fiscal intermediaries GEPHARDT GORAN health care health care services health services hospital review impact implementation Internal Revenue Service issue legislation length of stay MEDICAID BENEFITS Medicaid program medical care evaluation medical necessity medical record medically necessary Medicare Medicare and Medicaid ment monitoring norms notify NYCHSRO patient payment peer review performance period physician pital prior problems procedures Professional Standards Review proposed PSRO area PSRO determinations PSRO program PSRO review PSRO's pursuant quality assurance regulations reimbursement request review activities review responsibility review system Secretary skilled nursing facility Social Security Act Social Security Administration specific Standards Review Organization STARK Subpart surgery tion utilization review York York County
Priljubljeni odlomki
Stran 111 - These include the American College of Physicians, the American College of Surgeons, the American Dental Association, the American Hospital Association, and the American Medical Association.
Stran 184 - ... person for the furnishing or arranging for the furnishing of any item or service for which payment may be made in whole or in part under...
Stran 404 - Act for the purpose of determining whether — (A) such services and items are or were medically necessary; (B) the quality of such services meets professionally recognized standards of health care ; and (C) in case such services and items arc proposed to be provided in a hospital or other health care facility on an inpatient basis...
Stran 182 - Corporations, and any community chest, fund, or foundation, organized and operated exclusively for religious, charitable, scientific, testing for public safety, literary, or educational purposes, or for the prevention of cruelty to children or animals...
Stran 225 - New York . Niagara . . Oneida . . . Onondaga Ontario . . Orange. . Orleans . Oswego . Otsego . . Putnam . Queens Rensselaer . . Richmond . . . Rockland St. Lawrence Saratoga Schenectady. Schohane . . . Schuyler Seneca Steuben . . Suffolk . . . Sullivan . . Tioga Tompkins.
Stran 400 - ... hospital services (or services which would constitute inpatient hospital services if the institution met the conditions of participation for hospitals (see Subpart J of this Part 405), except those relating to utilization review and health and safety), or post-hospital extended care services during the related hospital or skilled nursing facility stay...
Stran 58 - ... (b) It shall be unlawful for any person to disclose any such information other than for such purposes, and any person violating the provisions of this section shall, upon conviction, be fined not more than $1,000, and imprisoned for not more than six months, or both, together with the costs of prosecution.
Stran 58 - Organization, in the exercise of its duties and functions, shall be held in confidence and shall not be disclosed to any person...
Stran 186 - Such transfer would involve only those records pertinent to medicare and medicaid patients and would be made solely for purposes of permitting orderly continuity of review activities by a successor PSRO. Properly established and properly implemented throughout the Nation, professional standards review mechanisms can help relieve the tremendous strain which soaring health costs are placing upon the entire population. Emphasis, wherever possible, upon the provision of necessary care on an outpatient...
Stran 58 - When an agency provides by a contract for the operation by or on behalf of the agency of a system of records to accomplish an agency function, the agency shall, consistent with its authority, cause the requirements of this section to be applied to such system.