Clinical Practice Guidelines Directions for a New Program (1990) / Chapter Skim
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Pages 3-4
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clinically relevant guidelines that may be used by physicians, educatom, and health care practitioners to assist in determining how diseases, disorders, and other health conditions can most effectively and appropriately be prevented, diagnosed, treated, and managed clinically; and (V standards of quality, performance measures, and medical review cntena through which health care providers and other appropriate entities may assess or review the provision of health care and assure the quality of such care. The phrase "arrange for" is one key indicator of the extent to which the drafters of OBRA 89 sought to create a public-private enterprise with respect to guidelines development.
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From page 4... ...
Presumably, providing for the use of the guidelines will require that the Health Care Financing Administration (HCFA) and its contracting fiscal intermediaries, carriers, and peer review organizations take steps to incorporate review criteria and other evaluation instn~ments into their programs for reviewing care provided to Medicare beneficiaries.
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