Question

instructions: select the most appropriate response.
which entity did cms authorize to perform utilization and quality control review of health care furnished, or to be furnished, to medicare beneficiaries?
a. ama
b. pros
c. qios
d. macs

Explanation:

PROs (Professional Review Organizations) were entities authorized by CMS (Centers for Medicare & Medicaid Services) to perform utilization and quality control review of health care furnished, or to be furnished, to Medicare beneficiaries. AMA (American Medical Association) is a professional association for physicians. QIOs (Quality Innovation Networks) are a more recent iteration focused on quality improvement. MACs (Medicare Administrative Contractors) handle claims processing.

Answer:

B. PROs