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. 

Due to requirements by the Centers for Medicare & Medicaid Services (CMS), KEPRO is beginning its transition back to the CMS-designated case review system – QMARS, resulting in new fax numbers for select cases. Healthcare providers should pay close attention to the fax number listed on the medical record request.

We are aware that there have been delays, due to this transition, including long wait times. We are working diligently to resolve any issues and appreciate your patience and cooperation during this time.

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.

For information about the availability of auxiliary aids and services, please visit: http://www.medicare.gov/about-us/nondiscrimination/nondiscrimination-notice.html This website has been designed to comply with Section 508 of the U.S. Rehabilitation Act. If you have a disability and have trouble accessing information on any of these pages, please call the Helpline.