CMS Names New Case Review Contractors

Senior managers at the Centers for Medicare & Medicaid Services (CMS) have announced new Medicare QIO case review contract awards to two organizations that will be responsible for five newly-created geographic regions encompassing the entire U.S. Previously, QIOs were defined as state-based organizations responsible for conducting Medicare case reviews as well as working collaboratively on quality improvement (QI) activities with providers. But federal legislation enacted in late 2011 permits CMS to separate case review from QI and to regionalize both activities. Accordingly, CMS announced May 9 that Livanta LLC of Annapolis Junction, MD and KePRO of Seven Hills, OH will be responsible for Beneficiary and Family-Centered Care (BFCC) QIO case review and quality complaint investigation activities in all five regions, under five year contracts. (Livanta will be responsible for case review in Region 1, which includes New York). CMS plans to award regional, five-year Quality Improvement Network (QIN) QIO contracts later this summer. CMS will shortly be offering guidance to providers regarding the change-over. To read the initial May 9 CMS press announcement, “CMS Launches Improved Quality Improvement Program,” visit www.cms.gov.