The Quality Improvement Organization (QIO) Program is the cornerstone of Medicare’s efforts to improve the quality of care and health outcomes for beneficiaries. KEPRO is the Beneficiary and Family Centered Care QIO (BFCC-QIO) for 29 states. We offer information regarding beneficiary complaints, hospital discharge and skilled service termination appeals, and Immediate Advocacy. 

Important Announcements:

• Attention healthcare providers – KEPRO’s fax number recently changed. Please review the medical record request carefully and use the fax number listed.
• During the current COVID-19 situation, please know that KEPRO’s BFCC-QIO services remain available. KEPRO has plans in place to continue to serve Medicare providers, beneficiaries, and their families while also protecting our staff in an effort to minimize the spread of the illness.
• COVID-19 information for healthcare providers: KEPRO Special Bulletin, a Virtual Toolkit released by the Centers for Medicare & Medicaid Services (CMS) to help you stay up-to-date on CMS materials, and a CMS press release announcing new measures to protect nursing home residents. During this time, KEPRO staff will be working remotely away from our offices. To help avoid any delays with cases, we are asking providers to please submit all medical records electronically by faxing instead of mailing copies of paper records.
• CMS made changes to the Important Message from Medicare (IM) and Detailed Notice of Discharge (DND) forms and is requiring providers to begin using the new forms by April 1, 2020. Please visit our appeals page for more information.

action items for healthcare providers

The Centers for Medicare & Medicaid Services (CMS) recently restructured the BFCC-QIO’s coverage area. If you are a provider in one of the areas shaded above in the map, you will need to take the following actions:

1. Update Your Appeals Notices
   Acute care providers will need to update the Important Message from Medicare, and post-acute providers will need to update the Notice of Medicare Non-coverage with KEPRO’s phone number for your region. Please note that it is acceptable to use labels to cover the existing BFCC information on the appeals notices.
   
   
2. Complete a Memorandum of Agreement (MOA) and Provider Update Form
   Visit www.keproqio.com/moa to complete the MOA and Provider Update Form. All providers are required to complete a new MOA, even if one was submitted in 2014.

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