Independent Peer Review

Engages in advocacy by monitoring state and federal legislative and regulatory developments affecting medical review and managed care, providing monthly updates to members, and advocating before regulatory bodies. Supports the development of external review processes, appeals regulations, surprise billing dispute resolution (IDR), and HUM/WCUM regulations, and facilitates member input to agencies.

Supports professional exchange and organizational development through an online collaboration portal (Basecamp), a member referral program, and an industry directory listing all members in good standing. Also governs the association through elected executive officers and an Executive Committee.

Organizes an annual conference featuring educational content, networking opportunities, and professional development for stakeholders in the independent medical review industry, including executives, medical directors, and compliance officers. Also conducts quarterly member conference calls and virtual webinars to inform members about industry developments.

Conducts and publishes research, including white papers and consumer-facing guides, on the independent medical review process and challenges facing payors. Also co-developed and disseminated educational materials such as webinar presentations on external appeals for health plans.

Publishes and distributes the Drugs of Choice Handbooks, which summarize evidence-based drug recommendations for clinicians, supporting treatment decision-making in primary care and specialty practice.

Provides online access to a complete archive of The Medical Letter issues from 1988 to the present, enabling subscribers to search and retrieve historical drug evaluations and clinical reviews.

Offers free continuing medical education (CME) and continuing education (CE) credits with each issue of The Medical Letter, allowing healthcare professionals to earn up to 52 credits annually, including credits applicable to ABIM MOC and ABS Continuing Certification.

Produces and distributes a biweekly publication, The Medical Letter on Drugs and Therapeutics, that provides peer-reviewed, evidence-based appraisals of new and previously approved prescription drugs, including comparative reviews of treatments for common diseases based on efficacy, safety, adverse effects, drug interactions, and cost. The print version is published 26 times per year and distributed by mail to subscribers.

Publishes detailed reports on recent FDA drug approvals, safety warnings, and postmarketing adverse event data, such as coverage of ensitrelvir for COVID-19 prophylaxis, orlistat-related kidney injury risks, bemotrizinol in sunscreens, icotrokinra for psoriasis, insulin icodec, olezarsen for hypertriglyceridemia, and difamilast for atopic dermatitis.

Worked with over 1,200 healthcare providers to achieve Meaningful Use attestation by supporting EHR selection, implementation, and performance analysis, along with recommending targeted improvements.

Conducts evidence-based literature reviews, identifies best practices, establishes benchmarks for healthcare data tracking and reporting, and performs scientific analysis of clinical data to support quality reporting, process improvement, and study development for clients.

Operates an accredited Independent Review Organization (IRO) and maintains a panel of over 250 board-certified physicians across nearly all specialties to evaluate medical cases for clients nationally and internationally. Recruits, manages, and coordinates external peer review activities as part of URAC-accredited services.

Provides clinical, analytical, and technological services to improve healthcare outcomes, including clinical quality improvement, data analytics using claims, enrollment, pharmacy, and clinical registries, and application of advanced statistical techniques. Employs expert SAS programmers and applies internationally accepted statistical parameters to validate and analyze healthcare data.

Provides free technical assistance to eligible healthcare professionals in California for adopting, implementing, and optimizing certified electronic health record (EHR) technology, including support through all stages of Meaningful Use. Anticipates enrolling over 1,000 providers through the California Technical Assistance Program (CTAP) as the Local Extension Center for Northern California.

Provides consulting and technical assistance to help healthcare providers optimize certified EHR systems, including practice assessment, implementation support, workflow redesign, and troubleshooting across more than 40 certified EHR platforms. Engages in rapid-cycle improvement methods to enhance quality and efficiency.

Assists healthcare providers with attestation for the Medi-Cal EHR Incentive Program and Meaningful Use requirements, including managing submissions, tracking progress, and ensuring timely reporting. Examples include multi-year support for Open Door Community Health Centers and Contra Costa Health Services.

Evaluates dental products for safety and effectiveness as part of the ADA Seal of Acceptance program, supporting consumer trust and professional standards.

Provides age-specific oral health education materials via MouthHealthy.org and offers classroom- and community-ready tools to promote oral health awareness and preventive care.