Fed Regist. 1985 Apr 17;50(74):15312-35.
This rule describes the review functions to be performed by a utilization and quality control peer review organization (PRO). It outlines the relationships that will be established among PROs, Medicare fiscal intermidiaries and carriers, providers, practitioners, and beneficiaries when a PRO assumes its review responsibilities. It also describes the relationship that should exist between PROs and State Medicaid agencies that contract with PROs to perform review. This rule implements portions of the following statutes: Peer Review Improvement Act of 1982 (Title I, Subtitle C of the Tax Equity and Fiscal Responsibility Act of 1982, Pub. L. 97-248), Social Security Amendments of 1983 (Pub. L. 98-21), Deficit Reduction Act of 1984 (Pub. L. 98-369).
本规则描述了由利用与质量控制同行评审组织（PRO）执行的评审职能。它概述了PRO在承担评审职责时，将在PRO、医疗保险财务中介机构和承保人、提供者、从业者及受益人之间建立的关系。它还描述了与PRO签订合同以进行评审的PRO与州医疗补助机构之间应存在的关系。本规则实施了以下法规的部分内容：1982年同行评审改进法案（1982年税收公平与财政责任法案第一编C子编，公法97 - 248）、1983年社会保障修正案（公法98 - 21）、1984年赤字削减法案（公法98 - 369）。
