S 1648 · 100th Congress · Social Welfare

Peer Review Organization Reform Act of 1987

Introduced 1987-08-07· Sponsored by Sen. Mitchell, George J. [D-ME]· Senate

Bill Progress

Introduced
2
Committee
3
Senate Vote
4
House
5
Enacted
Latest: Read twice and referred to the Committee on Finance.(1987-08-07)

Plain Language Summary

[AI summary unavailable — showing source text] Peer Review Organization Reform Act of 1987 - Directs the Secretary of Health and Human Services to report to the Congress, within one year of this Act's enactment, on improved procedures for imposing sanctions against Medicare (title XVIII of the Social Security Act) providers which furnish items or services which are not medically necessary or do not meet professionally recognized health care standards. Amends part B (Peer Review) of title XI of the Social Security Act to require peer review organizations (PROs) to give providers whose services are denied Medicare coverage an opportunity for discussion and review of the determination before patients and organizations responsible for paying claims are notified of such determination. Amends the Medicare program to require that the Secretary's budget separately state the amount of budget authority for inpatient hospital services and the amount of budget authority for the PRO program. (Currently, PRO costs are included as costs incurred by hospitals in providing inpatient hospital services.) Amends part B of title XI of the Act to require the Secretary to publish in the Federal Register: (1) any new policy or procedure affecting PRO …

Summarized by Claude AI · Non-partisan · For informational purposes only

Cosponsors (2)

1 Democrat1 Republican