Medicaid Second Surgical Opinion Programs and Inpatient Hospital Review Programs
Results of a 1987 Survey
In 1986, concerned about stemming the steady increase in health care costs, Congress mandated a study of state Medicaid utilization review programs that would identify high-volume and high-cost procedures, the payment rates for such procedures, the rates at which such procedures are performed, and the number of board-certified or board-eligible physicians who perform such procedures. In addition, for states that have mandatory second surgical opinion programs (SSOPs) or inpatient hospital preadmission review programs, the study was required to determine the extent to which such programs impede access to care for Medicaid patients. This Note reports the results of the 1987 survey of all state Medicaid agencies, including the District of Columbia, regarding Medicaid SSOPs and programs of inpatient hospital preadmission review.