The Peer Review Improvement Act of
1982 amended Title XI of the Social Security Act to create the
Utilization and Quality Control Peer Review Organization (PRO)
program which replaces the Professional Standards Review
Organization (PSRO) program and streamlines peer review activities.
The term PRO has been renamed quality Improvement Organization
(QIO). This collection describes the review functions to be
performed by the QIO. It outlines relationships among QIOs,
providers, practitioners, beneficiaries, intermediaries, and
carriers.
The implementation of a new
coding system (International Classification of Disease (ICD) 10)
resulted in hospitals learning the new system and an increase in
higher weighted DRG payment requests. Thus, a reduction in
participating facilities has led to an increased workload of
934,590 reviews annually resulting in a burden from 100,065 to
1,034,655.
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.