New York County Health Services Review Organization (NYCHSRO) was founded as a 501 (c) (3) not-for-profit corporation in 1974 under the Federal Law mandating Professional Standards Review Organizations (PSROs) for Medicare and Medicaid review. In 2013, NYCHSRO is observing its thirty-ninth (39th) year of continuous active service in medical review in New York State.
MedReview, Inc. is a wholly owned subsidiary of NYCHSRO, and a for-profit corporation, formed in 1984 to offer utilization management and analysis services to the private sector, including labor organizations, corporations, insurance companies, and managed care organizations.
NYCHSRO/MedReview’s mission is to provide health care assessment services that assist clients in improving the appropriateness, quality, and cost-effectiveness of health care.
NYCHSRO/MedReview has a well-established reputation in medical reviews and in programs for prospective, concurrent and retrospective monitoring. It is dedicated to working with clients to tailor review programs specific to their needs, corporate philosophy, and benefit structure. In the era of increased reliance on managed care, NYCHSRO/MedReview provides its clients with guaranteed cost-effective case management and utilization analysis approaches that can assist them in developing more cost-effective benefit plan strategies.
NYCHSRO/MedReview is governed by a Board of Directors, and is administered by its Chief Executive Officer, Joseph B. Stamm, who reports to the Board. NYCHSRO/MedReview’s senior staff is comprised of a an Executive Vice President/Chief Financial Officer, Senior Vice President/Chief Operating Officer, five (5) Vice Presidents and a Chief Medical Officer. NYCHSRO/MedReview has a staff of more than 200 full-time employees.
NYCHSRO/MedReview was among the first organizations registered as a certified Utilization Review (UR) agent in New York when UR registration began in 1997 and it achieved PRO-like entity status in 1995. That designation was updated to a QIO-like entity in 2008. The QIO-like entity status means that NYCHSRO/MedReview is a physician-access organization that has:
- Access to doctors of medicine or osteopathy, licensed and practicing in the State, to conduct review for the organization,
- Availability of at least one physician, licensed in the State, from every generally recognized specialty and subspecialty who is actively practicing in the area they review , and
- NYCHSRO/MedReview is not a health care facility, health care facility association, or health care facility affiliate.
NYCHSRO/MedReview is accredited by URAC as an Independent Review Organization (IRO) and as a Health Utilization Management (HUM) organization. NYCHSRO/MedReview only uses medical professionals who are licensed and registered in their specific disciplines. Over the past twenty years, NYCHSRO/MedReview has conducted over 2 million peer reviews to evaluate clinical decisions and services rendered by medical practitioners at all levels of the health care continuum. NYCHSRO/MedReview maintains a physician review panel of more than 100 clinicians, in 74 specialties and subspecialties.
Presently, NYCHSRO/MedReview has its headquarters in New York City, with a new office recently established in Massachusetts. As NYCHSRO/MedReview’s services are provided around the country, it is anticipated that additional offices will be established to facilitate provision of service to those local markets.
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