...professionally recognized standards of health care; and (ili) Those services and items proposed to be provided on an inpatient basis could, consistent with the provision...inpatient health care facility of a different type. (2) Section 1155(e) of the Act allows PSROs to use the services, and accept the findings, of hospital...

...procedures are performed. A procedure may be medically necessary but denied if the PRO determines that it could, consistent with the provision of appropriate medical care, be effectively provided more economically on an outpatient basis or in an inpatient health care facility of a different type....

...procedures are performed. A procedure may be medically necessary but denied if the PRO determines that It could, consistent with the provision of appropriate medical care, be effectively provided more economically on an outpatient basis or in an inpatient health care facility of a different type....

...Meet professionally recognized standards of health care; and C. In the case of inpatient services, could, consistent with the provision of appropriate...inpatient health care facility of a different type. The decisions made by PSRO's with respect to these three issues are binding on Medicare intermediaries...

...provided to an Individual only when, to the extent, that the health care needs of such Individual cannot, consistent with the provision of appropriate medical...on an outpatient basis or more economically In an Inpatlent health care facility of a different type ; "(B) Costs of or charges for services by physicians...

...and services cannot, consistent with professionally recognized health care standards, effectively be provided on an outpatient basis or more economically...inpatient health care facility of a different type, as determined in the exercise of reasonable limits of professional discretion ; or " ' (F) to determine...

...provided in a hospital or other health care facility on an inpatient basis, such services and items could, consistent with the provision of appropriate...inpatient health care facility of a different type. "(2) Each Professional Standards Review Organization shall have the authority to determine, in advance,...

...provided in a hospital or other health care facility on an inpatienl basis, such services and items could, consistent with the provision of appropriate...on an outpatient basis or more economically in an inpatienl health care facility of a different type. "(2) Each Professional Standards Review Organization...

...provided in a hospital or other health care facility on an inpatient basis, such services and items could, consistent with the provision of appropriate...inpatient health care facility of a different type." 42 USCA 1320C-4. Health care practitioners and providers of health care services also have specific...

...provided in a hospital or other health care facility on an inpatient basis, such services and items could, consistent with the provision of appropriate...inpatient health care facility of a different type." It is argued that the doctor is not compelled to adhere to these prefabricated norms of care, diagnosis,...