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 case selection criteria for retrospective chart review conducted as part of the NYS Medicaid Utilization Review & Quality Improvement contract.

The selection criteria has been modified to include discharges occurring between January 1, 2006 through November 30, 2009 for claims billed under the AP-DRG case payment system, as well as, per diem claims billed for discharges occurring during this time period.

This change will go into effect for reviews scheduled as of September 201 0 and will continue through the remainder of the current contract period (ending March 2011), and may continue into the next contract period (April 2011 through March 2012).

Should you have any questions or comments, please feel free to contact Kathleen M. Fox, Sr. Director at (516) 326-7767, Extension 361.