IPRO

Island Peer Review Organization (known as IPRO) is one of the federally designated Quality improvement organizations in the United States. Headquartered in Lake Success, New York, IPRO has offices in New York City and Albany, New York.

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The core business of IPRO include:

• Utilization review and quality assurance
• Quality improvement
• Data collection, abstraction and analysis
• Retrospective claims review
• Independent review of health plans' decisions to deny, reduce or terminate care
• Encounter data validation
• Health Plan Employer Data and Information Set Compliance Audits

Brief history

• The Peer Review Improvement Act of 1982 (a part of the Tax Equity and Fiscal Responsibility Act of 1982) established Peer Review Organizations (PROs), replacing Professional Standards Review Organizations, which had provided services to the Medicare and Medicaid programs since 1972.
• In 1983, IPRO was incorporated as a peer review organization in New York area.
• In 1984, IPRO is designated the New York State Medicaid Review Agent and Medicare Review Subcontractor.
• In 1989, IPRO is awarded the New York contract for Medicare's 3rd Scope of Work.

IPRO is now under contract with the U.S. Centers for Medicare and Medicaid Services (CMS) to improve health care for people with Medicare in New York State. IPRO also holds major contracts with four U.S. State governments to assess and improve care for persons with Medicaid.

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