Home Beneficiary Helpline Careers About Us Contact Us
KEPRO - Beneficiary and Family Centered Quality Improvement Organization (BFCC-QIO)
A A A
  
Sign up for the KEPRO newsletter
Senior couple at a computer, reading Short Stay Reviews
We are the Medicare Quality Improvement Organization, working to improve the quality of care for Medicare beneficiaries. Our site offers beneficiary and family-centered care information for providers, patients, and families. Welcome!

Update:

The Centers for Medicare & Medicaid Services (CMS) has temporarily paused the performance of both Short Stay reviews and Higher Weighted Diagnosis-Related Group (HWDRG) reviews by the Beneficiary and Family Centered Care Quality Improvement Organizations (BFCC-QIOs). Short Stay reviews and HWDRG reviews will stop for a brief time beginning on May 8, 2019.

 CMS took this action to procure a new BFCC-QIO contractor. Two BFCC-QIOs have done HWDRG reviews since 2014 and Short Stay reviews since 2015 for all 50 states and 3 territories. Going forward, Short Stay reviews and HWDRG reviews will resume with a single organization performing reviews on a national basis. CMS anticipates a contract award to be issued by the 3rd quarter of calendar year 2019.


BFCC-QIO Short Stay reviews focus on making sure doctors and hospitals are following the Part A payment policy for inpatient admission and also provide an educational opportunity for cases that did not meet the benchmark. Recovery Auditor Patient Status reviews will be conducted by the Recovery Auditors, after consultation with CMS, for those hospitals that have consistent trends of high denial rates based on the BFCC-QIO Short Stay review outcomes.

Additional updates will be posted on this webpage, as they become available, and through the KEPRO newsletter, Case Review Connections. Click here to sign up to receive this electronic mailing.

Key elements that providers need to know:


If you have specific questions related to Short Stay Reviews, please call 813-280-8256 x7480.

Download Acrobat Reader

Provider Minute: The Importance of Proper Documentation


Disclaimer/Privacy Policy Accessibility Site Map
Follow us on Twitter Watch our videos on YouTube Resource for the Visually Impaired Get Adobe Acrobat Reader