Legal Definitions - peer-review organization

PEER-REVIEW ORGANIZATION

A peer-review organization is a government agency that checks if private hospitals are following health regulations when they ask for public funds, like Medicare payments. It is abbreviated as PRO.

• A private hospital wants to receive Medicare payments for the services they provided to a patient. Before they can get the payment, a peer-review organization will check if the hospital followed all the health regulations.
• A peer-review organization may also check if a hospital is providing quality care to patients and meeting certain standards.

The examples illustrate how a peer-review organization works. It is responsible for ensuring that private hospitals are following health regulations and providing quality care to patients before they receive public funds. This helps to protect patients and ensure that public funds are being used appropriately.