Medicare program; utilization and quality control peer review organizations; imposition of sanctions on health care practitioners and providers of health care services--HCFA. Proposed rule

Abstract

This proposal would implement the portion of the Peer Review Improvement Act of 1982 that imposes certain obligations on health care practitioners and other persons who provide health care services to Medicare beneficiaries. The proposal would also establish sanctions that the Secretary may impose for violations of the obligations. The proposal would also impose certain responsibilities on utilization and quality control peer review organizations and provides that an exclusion sanction recommended to the Secretary by utilization and quality control peer review organizations would automatically become effective if the Secretary fails to act within a 120-day review period. These regulations are intended to assure that the public receives medically necessary, quality health services.