Senate calls for greater scrutiny of quality organizations

Share this content:

The Senate Finance Committee is calling for an expanded probe of Quality Improvement Organizations (QIOs), which Medicare pays about $300 million a year to investigate complaints and improve nursing home care, as well as care provided by doctors and hospitals.

Sen. Charles Grassley (R-IA) sent a letter to a New Jersey QIO contractor on Thursday to get a detailed accounting of the group's operations and finances. Grassley questioned why the contractor paid more than $500,000 to the 21 members of its nonprofit board and spent an additional $100,000 on retreats for the directors in the Cayman Islands and California in 2003 and 2004.

The nonprofit New Jersey QIO, which recently changed its name from PRONJ to Healthcare Quality Strategies Inc., reported revenue of $11.8 million from Medicare and other sources, according to reports on its tax return.

"It is difficult to understand why an entire board would need to travel from New Jersey to the Grand Cayman to discuss improving quality of care for [Medicare] beneficiaries, but I am eager to receive your detailed and documented explanations," Grassley wrote in the letter. 

Healthcare Quality Strategies Inc. is one of 53 QIOs nationwide. The Senate Finance Committee has sent letters to more than a dozen QIOs, requesting preliminary information. Senate staff also have requested more detailed information and have asked the Government Accountability Office and the Department of Health and Human Services' inspector general to help them review the QIOs' finances and operations.