Implementation of PSRO Legislation, Hearings Before the Subcommittee on Health of ..., 93-2 ... |
From inside the book
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Page 483
... Utilization review committees and PSRO relationship_ 15 16 18 18 19 20 20 21 21 24 24 25 26 Flexibility needed___ . AMA attacks on PSRC . Role of doctors in PSRO__ Need for PSRO's ... Medical society PSRO - type reviews__ . PSRO and ...
... Utilization review committees and PSRO relationship_ 15 16 18 18 19 20 20 21 21 24 24 25 26 Flexibility needed___ . AMA attacks on PSRC . Role of doctors in PSRO__ Need for PSRO's ... Medical society PSRO - type reviews__ . PSRO and ...
Page 485
... Utilization review requirements . 387 Confidentiality 388 Powers of the Secretary under PSRO___ 389 Second - class citizenship seen for some under PSRO__ . 389 PSRO seen violating constitution_ . 390 Powers of the Secretary under PSRO ...
... Utilization review requirements . 387 Confidentiality 388 Powers of the Secretary under PSRO___ 389 Second - class citizenship seen for some under PSRO__ . 389 PSRO seen violating constitution_ . 390 Powers of the Secretary under PSRO ...
Page 493
... utilization review committees may be an example ) can defeat the program as well because of cronyism factors - a hesitancy on the part of physicians to review strictly and sometimes levy sanctions on their friends . ' The balance lies ...
... utilization review committees may be an example ) can defeat the program as well because of cronyism factors - a hesitancy on the part of physicians to review strictly and sometimes levy sanctions on their friends . ' The balance lies ...
Page 507
... utilization , and ( 2 ) review of the quality of care provided . To be effective , utilization review must be an interdisciplinary undertaking . In conclusion ANA commends the Finance Committee for its leadership evident in this ...
... utilization , and ( 2 ) review of the quality of care provided . To be effective , utilization review must be an interdisciplinary undertaking . In conclusion ANA commends the Finance Committee for its leadership evident in this ...
Page 518
... utilization of these services . That utilization controls are particularly important was extensively revealed in hearings conducted by the subcommittee on medicare and medicaid . Witnesses testified that a significant proportion of the ...
... utilization of these services . That utilization controls are particularly important was extensively revealed in hearings conducted by the subcommittee on medicare and medicaid . Witnesses testified that a significant proportion of the ...
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Common terms and phrases
administrative admission certification agreement amendment American appropriate approval area designation assistance assure challenged legislation Chapter Issue Date conditional PSRO contract costs criteria and standards determination DHEW diagnosis Directors doctor of medicine duties and functions effective Federal fifth amendment guidelines health care facility health care practitioners health care services hospital institutions Manual Chapter Issue medical necessity Medical Society medicare and medicaid meeting membership National Professional Standards non-physician health norms OPSR organiza osteopathy P.S.R.O. Program Manual patients payment peer review performance physicians Plaintiffs practitioner or provider procedures profes Professional Review Organization Professional Standards Review Program Manual Chapter proposed PSRO area PSRO program PSRO review PSRO's Region regulations review activities Review Organization area ROBERT DOLE Secretary Senate Social Security Act Standards Review Council Standards Review Organization Statewide Professional Standards Subcommittee tion U.S. Senate utilization review
Popular passages
Page 501 - Nothing in this title shall be construed to authorize any Federal officer or employee to exercise any supervision or control over the practice of medicine or the manner in which medical services are provided...
Page 884 - 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 are proposed to be provided in a hospital or other health care facility on an inpatient basis, such services and items could, consistent with the provision of appropriate medical care, be effectively provided on an outpatient basis or more economically in an inpatient...
Page 965 - ... denotes not merely freedom from bodily restraint, but also the right of the individual to contract, to engage in any of the common occupations of life, to acquire useful knowledge, to marry, establish a home and bring up children, to worship God according to the dictates of his own conscience, and, generally, to enjoy those privileges long recognized at common law as essential to the orderly pursuit of happiness by free men.
Page 965 - It is undoubtedly the right of every citizen of the United States to follow any lawful calling, business, or profession he may choose, subject only to such restrictions as are imposed upon all persons of like age, sex and condition.
Page 559 - ... (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.
Page 972 - Few professions require more careful preparation by one who seeks to enter it than that of medicine. It has to deal with all those subtle and mysterious influences upon which health and life depend...
Page 965 - Without doubt it denotes not merely freedom from bodily restraint, but also the right of the individual to...
Page 524 - Hospitals, which is sponsored by the American Medical Association, the American Hospital Association, the American College of Physicians, and the American College of Surgeons, was also considering the establishment of an accreditation program for inpatient care institutions other than hospitals.
Page 542 - ... (2) A determination made by the Secretary under this subsection shall be effective at such time and upon such reasonable notice to the public and to the person furnishing the services involved as may be specified in regulations. Such determination shall be effective with respect to services furnished to an individual on or after the effective date of such determination (except that in the case of...
Page 963 - ... accrued" interests violative of the Due Process Clause of the Fifth Amendment. II. This is not to say, however, that Congress may exercise its power to modify the statutory scheme free of all constitutional restraint. The interest of a covered employee under the Act is of sufficient substance to fall within the protection from arbitrary governmental action afforded by the Due Process Clause.