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• Overview
• Appeals
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• Other Reviews
• Medical Record Electronic Submission
• Educational Resources
• Physician Acknowledgement Monitoring
• QIO Liaison
• Update Your Contact Information
• Become a Peer Reviewer
• Case Status Check

overview

Effective June 8, 2019, the states served by Kepro as the Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) changed. All providers are required to complete a new Memorandum of Agreement (MOA), even if one was submitted to Kepro prior to June 8, 2019.

If you submitted your organization’s MOA information on/after June 8, 2019, and have not received a copy of your fully executed MOA, please have the individual listed as your organization’s authorized signor check his/her junk or spam folder for an email from DocuSign. If the email is not able to be located, or if you have any further questions, please reach out to moa@kepro.com.

Please note that there should be no changes made to the MOA document. The wording is mandated and approved by the Centers for Medicare & Medicaid Services (CMS).

instructions

1. Click on the button below to complete your organization’s MOA.
2. When you complete this form, you will be given an option to download and/or print a copy for your records.
3. After your completion, the MOA will automatically route for Kepro signature.
4. Once signed by Kepro, the fully executed copy of your organization's MOA will be returned to you via a DocuSign email.
   
    Complete Memorandum of Agreement

documents

Kepro MOA Frequently Asked Questions (PDF)

MOA Sample (PDF) This document is for review purposes only. MOAs are acceptable only through the electronic submission link above.

background

Kepro is the Quality Improvement Organization (QIO) authorized by the Medicare Program to review healthcare services provided to Medicare beneficiaries. As you may already know, we review patient medical records to determine whether services delivered to these beneficiaries meet professionally recognized standards of care, are medically necessary, and delivered in the most appropriate setting. In addition, we conduct reviews generated by requests from Medicare beneficiaries that include appeals related to notices of discharge and/or notices of service terminations and written complaints about the quality of Medicare services they have received. We may refer confirmed quality of care concerns to another QIO entity under contract with CMS to work with your organization on healthcare quality improvement initiatives.

In order to participate in the Medicare program, hospitals, critical access hospitals, skilled nursing facilities, hospices, comprehensive outpatient rehabilitation facilities (CORF), and home health agencies are required to have an MOA with a QIO under Section 1866(a)(1)(F) of the Social Security Act.

MOAs facilitate the review process by outlining the QIO’s administrative and review responsibilities and the provider’s responsibility in assisting us in accomplishing our review requirements. MOAs are also informational. Kepro wants to inform hospitals, critical access hospitals, skilled nursing facilities, hospices, CORFs and home health agencies of (a) Kepro’s procedures with respect to certain contract obligations, (b) review and appeal rights, which providers have with respect to these obligations These requirements are based on the Statutory citations provided below:

• Section 1866(a)(1)(E) of the Act requires providers of services to release to QIOs any data related to patients.
• Section1866(a)(1)(F)(i) of the Act requires hospitals, which provide inpatient hospital services paid under the Prospective Payment System (PPS) to maintain an agreement with a QIO (or with a professional standards review organization if there is such an organization in existence in the area in which the hospital is located) to review the validity of diagnostic information provided by such hospital, the completeness, adequacy and quality of care provided, the appropriateness of admissions and discharges, and the appropriateness of care provided.
• Section 1866(a)(1)(F)(ii) of the Act requires hospitals, critical access hospitals, skilled nursing facilities, hospices, CORFs, and home health agencies to maintain an agreement with a QIO to perform certain functions.
• Section 1869(b)(1)(F) of the Act requires the Secretary to provide an expedited determination or an expedited reconsideration for Medicare beneficiaries who have been notified of their impending termination of services or discharge from a comprehensive outpatient rehabilitation facility, home health agency, hospice, or skilled nursing facility; under 42 CFR Part 405, Subpart J, the QIO for a region is required to hear and make these determinations and reconsiderations.

Please click to review and sign: Memorandum of Agreement