CMS’s restructuring of the QIO program, which splits the previous body of work into two separate contracts, one for medical case review and appeals and one for quality improvement and technical assistance, goes into effect August 1, 2014. Medical case review and appeals previously performed by each individual state’s QIO will now be handled by one of two Beneficiary Family Centered Care QIOs (BFCC-QIO). Maryland-based Livanta, LLC has the contract for the New England area and the west coast (Geographic Areas 1 & 5) and Ohio-based KePRO has the contract for the rest of the country (Geographic Areas 2, 3, and 4).
Beneficiary notices which give the contact information for the QIO (primarily expedited appeal notices) should be updated to reflect these changes. Contact info for the new BFCC-QIO’s is as follows:
Livanta 1-866-815-5440 (P)
KePRO 1-855-408-8557 (P)
Quality improvement and technical assistance will now be handled by one of fourteen Quality Innovation Network QIOs (QIN-QIO). The New England States will be served by Healthcentric Advisors, RI’s incumbent QIO, in strategic partnership with Qualidigm, CT’s incumbent QIO.
For more information on the BFCC-QIOs, click here.
For more information on the QIN-QIOs, click here.