Medicaid Management Information System, General Systems Design for Title 19. Volume 3. Surveillance and Utilization Review Subsystem

摘要

The 29 September 1982 revised edition of the Surveillance and Utilization Review Subsystem (S/URS) of the Medicaid Management Information System, General Systems Design (MMIS-GSD) is an addendum to Volume III of the MMIS-GSD. The document represents a composite view of State experiences in the surveillance and utilization review processes. The revised S/URS includes systems enhancements based on the State S/UR operating experiences, reduces the reporting burden on States, and provides systems options that are directed at the overall improvement in S/UR methodologies. States are encouraged to review their surveillance and utilization review processes using the revised S/URS-GSD as a basis for the review and determine where specific system improvements can be made in their unique S/UR operations. The applicable Federal approval requirements for systems improvements and enhancements apply as cited in Chapter 2, Part 11 of the State Medicaid Manual.