HCFA mandates new quality screens (more emphasis on histories and physicals and perioperative monitoring).

As standards of care are redefined based on new technology or new constructs of what constitutes quality, we can expect changes in the criteria by which our clinical activities are assessed. This is certainly true for peer review conducted under PRO programs, since the starting point for review is the application of criteria and screens. Review criteria are essentially developed by the PROs and, in Pennsylvania, with assistance of specialty society liaisons. The generic quality screens are HCFA-developed, and their use is mandated. Recently, all PROs received a Directed Change Order (DCO) in which newly revised outpatient generic quality screens were released.