Physicians and the Peer Review Organization Review

Quality Assurance Program : AHA's Attempt to Keep the Medical Review Functions in the Hospital . Mod Hospital March 1973;40.

20 CFR §405.1035(b)(2) (changed 1974). For a discussion of the history and failures of utilization review leading to the PSRO program , see Gosfield AG: PSROS: The Law and the Health Consumer . Philadelphia, Ballinger Publishing Co., 1975, pp 67-108.

20 CFR §405.1045(g) (changed 1974).

Medicare and Medicaid: Problems, Issues and Alternatives. Report of the Staff to the Committee on Finance, U. S. Senate. 91st Cong., 1st sess, (February 9, 1970).

The Social Security Amendments of 1972, §249F, P.L. 92-603. Title XI-B of the Social Security Act, §§1151 et seq. repealed, 1982.

§1155(e) of the PSRO law.

The Tax Equity and Fiscal Responsibility Act of 1982, § 143, P.L. 97-248. Peer Review Improvement Act of 1982, Title XI-B of the Social Security Act, §1151 et seq.

§1153(b) of the PRO law.

Conference Report on H.R. 4961, August 19, 1982 at 443.

49 Fed Reg 34728 (August 31, 1984) and 50 Fed Reg 35709 (Sept. 3, 1985).

PRO Interim Manual 2050.5C at 57.

42 CFR §474.30.

PRO Interim Manual 2050.4 (b) at 42-44.

Medicare Carrier's Manual §4169A.

Payment denial policy for Medicare tightened. AMA News, October 18, 1985:2.

§1157(c) of the PRO law.

Report of the Senate Finance Committee to accompany H.R. 1, Social Security Amendments of 1972. 92nd Cong, 2nd sess, at 267 (Rpt. No 92-1230).

Id.

42 CFR §466.98; PRO Interim Manual 2002.1 at 4; 42 CFR §473.28.

42 CFR §466.93, PRO Interim Manual 9002.

42 CFR §476.101(b).

§1157(b) of the PRO law.

§1157(d) of the PRO law.

PRO Manual Transmittal No. 5, August 1985. Unnecessary readmissions and transfer.