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Economic Profiling

Provider Type

  • Physicians
  • Participating Physician Groups (PPG)

Economic profiling is defined as any evaluation of a provider or participating physician group (PPG) based in whole or in part on the economic costs or use of services associated with medical care provided or authorized by the provider or PPG.

To the extent that a PPG maintains economic profiles of its individual providers, it must provide on request a copy of the individual economic profiling information to the individual providers who are profiled. This information must be provided on request until 60 days after the contract between the PPG and provider terminates.

Last Updated: 10/31/2019