Physician Payment Review Commission
The Physician Payment Review Commission (PPRC) was a non-partisan legislative branch agency established in the United States in 1986 to provide independent analysis and recommendations on issues related to Medicare payment policies for physicians and other healthcare professionals. The PPRC's primary role was to review and evaluate the impact of Medicare's payment policies on beneficiary access to care, quality of care, and overall program costs. It conducted studies, held public hearings, and issued reports with recommendations to Congress on how to improve physician payment systems within Medicare. The PPRC was later replaced by the Medicare Payment Advisory Commission (MedPAC) in 1997, which continues to carry out similar functions today.
Medicare-anvisning
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Medicare-granskningskommission
A Medicare review commission, also known as a Medicare administrative contractor or MAC, is a private health care company that has been contracted by the Centers for Medicare & Medicaid Services (CMS) to handle claims processing and payment for Medicare Part A and Part B services. The commission is responsible for reviewing claims for medical necessity, accuracy, and compliance with coverage and payment rules, and for making decisions about whether to pay or deny claims. They also provide education and support to healthcare providers to help them understand and comply with Medicare's billing and coding requirements.