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Revised PRO Sanctions for Failing to Meet Statutory Obligations

This final rule addresses revised procedures governing the imposition and adjudication of program sanctions , based on recommendations from State utilization and quality control peer review organizations (PROs), resulting from enactment of sections 214 and 213(f) of the Health Insurance Portability and Accountability Act (HIPAA) of 1996.

Issued by: Office of Inspector General (OIG)

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.