In 2014 the Quality Improvement Organization Program was restructured following the passage of the Trade Adjustment Assistance Extension Act of 2011 (Trade Law). This gave the Centers for Medicare & Medicaid Services (CMS) flexibility to separate the QIO Program functions of quality improvement initiatives from Medicare beneficiary protection work. Two Beneficiary and Family Centered Care-QIOs (BFCC-QIOs) manage all beneficiary complaints and appeals across the nation. BFCC-QIOs work in partnership with providers to:
- Bring the voices of beneficiaries and families into health care case review activities to increase communication and improve the care experience.
- Inform health care providers about medical record review activity at their facility. This is done through the facility’s designated QIO Liaison. Your facility can select and designate its QIO Liaison by notifying your BFCC-QIO in writing.
- Collaborate with health care providers in supporting the beneficiary, family, and caregiver by referring them to the Beneficiary Care Management Program. The BCMP provides assistance with discharge instructions, post treatment plans, coordination of follow-up care, and assisting with referrals to community resources.
- Monitor and administer physician acknowledgement statements for hospitals.
- Monitor and administer provider Memorandums of Agreement (MOAs).
BFCC-QIO Contact Information by Region or State
Connecticut, Massachusetts, Maine, New Hampshire, Rhode Island, Vermont
New Jersey, New York, Puerto Rico, Virgin Islands
Delaware, DC, Maryland, Pennsylvania, Virginia, West Virginia
Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee
Illinois, Indiana, Michigan, Minnesota, Ohio, Wisconsin
Arkansas, Louisiana, New Mexico, Oklahoma, Texas
Iowa, Kansas, Missouri, Nebraska
Colorado, Montana, North Dakota, South Dakota, Utah, Wyoming
Arizona, California, Hawaii, Nevada, Guam, N. Mariana Islands, American Samoa
Alaska, Idaho, Oregon, Washington