The Peer Review Improvement Act replaces PSROs with Utilization and Quality Control Peer Review Organizations (PROs) and expands Medicare’s quality oversight efforts through the PROs. The PRO program continues to focus on medical necessity and standards of care reimbursed through Medicare. PROs were established to review the quality, necessity, reasonableness and appropriateness of healthcare services furnished to Medicare patients. PSRO regions consolidated into 54 PROs, one for each state and territory.
