Medicare General Information, Eligibility and Entitlement Manual (Pub. 100-01), Ch. 1 § 60.5
Responsibilities of Designated Agents Working With PROs;
60.5 - Responsibilities of Designated Agents Working With PROs;
Organizations Subcontracted for Review
(Rev. 1, 09-11-02)
The PRO has ultimate responsibility for monitoring the compliance of practitioners and
providers with statutory obligations. It is not relieved of any of the responsibility under the
sanction regulations in the event of non-performance by an organization with which it has
subcontracted for review.
An organization with which the PRO subcontracts to carry out review functions is responsible
for:
•
Ensuring that practitioners and other persons meet their obligations with respect to the
items and services it reviews; and
•
Reporting to the PRO (primary contractor) those instances where it appears a violation of
an obligation may have occurred or is occurring.