Category: Medicaid Administrative Memos

TO: Hospital Chief Executive Officerss IPRO Liaisons FROM: Theodore O. Will, FACHE Chief Executive Officer DATE: December 6, 2010 RE: Changes to the Medicaid High Cost Outlier Review Process (201202) IPRO CONTACT: Kathleen M. Fox, RN, Senior Director – Medicaid/State Healthcare Assessment at extension 361 or Doreen Walz, RN, Assistant

November 16, 2010 Patti G. Weinberg, RPA, MPS Vice President Medicaid/State Healthcare Assessment 1979 Marcus Avenue Lake Success, New York 11042 Dear Administrator: IPRO, as a new review component of the Medicaid UR/QI contract, has been instructed by the New York State Department of Health (NYSDOH) to conduct a retrospective

201005 FROM: Theodore O. Will, Chief Executive Officer DATE: August 20, 2010 RE: IPRO Sample Selection Modification IPRO CONTACT: Kathleen M. Fox, Sr. Director, Medicaid/State Health Assessment, Ext. 361 This administrative memorandum is to advise you that the New York State Department of Health has instructed IPRO to modify the

FROM: Theodore O. Will, Chief Executive Officer DATE: Jan 10, 2007 SUBJECT: Revised List of Approved Independent Professional Review Agents (IPRA’S) IPRO CONTACTS: Kathleen M. Fox, RN, MSA, Ext. 361 The New York State Department of Health (NYSDOH) has requested that IPRO notify hospitals of the revised list of approved

FROM: Theodore O. Will, Chief Executive Officer DATE: Oct 16, 2006 SUBJECT: IPRA Discharge Review Criteria IPRO CONTACTS: Doreen Walz, RN, Assistant Director, Ext. 444 IPRO has served as the New York State Department of Health Medicaid Independent Professional Review Agent (IPRA) since December 17, 1987. At this time, IPRO

FROM: Theodore O. Will, Chief Executive Officer DATE: Oct 16, 2006 SUBJECT: IPRA Discharge Review Criteria IPRO CONTACTS: Doreen Walz, RN, Assistant Director, Ext. 444 IPRO has served as the New York State Department of Health Medicaid Independent Professional Review Agent (IPRA) since December 17, 1987. At this time, IPRO

FROM: Theodore O. Will, Chief Executive Officer DATE: Oct 05, 2005 SUBJECT: CHANGES TO THE MEDICAID HIGH COST OUTLIER REVIEW PROCESS IPRO CONTACTS: Kathleen M. Fox, RN, Senior Director – Medicaid/State Healthcare Assessment at extension 361 or Doreen Walz, RN, Assistant Director at extension 444 IPRO, at the direction of

FROM: Theodore O. Will, Chief Executive Officer DATE: Oct 22, 2004 SUBJECT: Revised IPRO NYPORTS Review Process IPRO CONTACTS: Kathleen M. Fox, Senior Director of Medicaid Review Operations, Extension 361 The New York State Department of Health (NYSDOH) has revised the IPRO NYPORTS review process. IPRO’s retrospective NYPORTS review process

FROM: Theodore O. Will, Chief Executive Officer DATE: Sep 30, 2004 SUBJECT: DISCONTINUATION OF PREADMISSION/PREPROCEDURE REVIEW PROGRAM IPRO CONTACTS: Doreen Walz, Medicaid Review Operations, Ext. 444 Please be advised that effective October 1, 2004 the New York State Department of Health will no longer require prior approval for procedures reimbursed

FROM: Theodore O. Will, Chief Executive Officer DATE: Jun 22, 2004 SUBJECT: CHANGE IN IPRO ONSITE WORK HOURS IPRO CONTACTS: Kathleen M. Fox RN, MSA, Senior Director, Medicaid/State Healthcare Assessment, Ext. 361 Beginning on July 12, 2004, IPRO will be modifying the onsite time that nurse reviewers spend at a