31 Pa. Code § 69.54. PRO reporting responsibility.

§ 69.54. PRO reporting responsibility.

(a)  A PRO shall submit an annual report to the Commissioner. The report shall include, at a minimum:
   (1)  The number of determinations performed.
   (2)  The results of initial determinations delineated by the provider and insurer.
   (3)  The number of reconsiderations requested.
   (4)  The number of initial determinations overturned.
   (5)  The number of determinations where the review period was tolled under §  69.52(d) and (l) (relating to peer review procedures).
(b)  A PRO shall file this report with the Commissioner by March 1 of each year with the information for the preceding calendar year.
(c)  The initial annual report is due by March 1, 1992 and shall cover the period from June 1, 1990 through December 31, 1991.

Cross References

   This section cited in 31 Pa. Code §  69.55 (relating to criteria for Department approval of a PRO).

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