Identify which of the following is the organization (composed of physicians and other healthcare professionals)established by TEFRA to review quality of care and appropriateness of admissions,readmissions,and discharges for Medicare and Medicaid patients.
A) Managed care organization (MCO)
B) Peer review organization (PRO)
C) American Medical Association (AMA)
D) Resource Utilization Group (RUG)

Question

Quizplus · Accepted Answer

Peer review organization (PRO) was established by TEFRA to review quality of care and appropriateness of admissions, readmissions, and discharges for Medicare and Medicaid patients. MCOs are organizations that manage and finance healthcare services for a particular group of enrollees. AMA is a professional organization representing physicians. RUGs are a system for classifying patients in long-term care settings based on their expected resource utilization.

Identify Which of the Following Is the Organization (Composed of Physicians