CMS demands more from QIOs
The Centers for Medicare & Medicaid Services said it is increasing oversight of the 53 largely state-by-state contractors under a new contract (or "statement of work") that begins Aug. 1. QIOs will have to meet performance-measure goals to continue receiving CMS contracts. Instead of being reviewed at the end of a three-year contract, an organization will be reviewed after 18 months and could lose a contract, and the chance for future contracts, at that point.
The new rules clearly are in response to reports by the Institute of Medicine and the Government Accountability Office that assailed Medicare's management of QIOs.