BFCC-QIO Changes that Affect Medicare Patients and Health Care Providers

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Beneficiary and Family Centered Care Quality Improvement Organizations (BFCC-QIOs) work under contract with the Centers for Medicare & Medicaid Services (CMS) to help people with Medicare exercise their right to high-quality health care. BFCC-QIOs manage complaints from Medicare patients and quality of care reviews.

On June 7, 2019, the 11thScope of Work (current contracts) between the BFCC-QIOs and CMS ended. 

What does this mean? 

Medicare beneficiaries may have a different BFCC-QIO serving their state beginning June 8, 2019. All case review services will continue and there will be no disruption in services even if a particular state transitioned to a different organization will provide BFCC-QIO services. 

BFCC-QIOs enter into new contracts with CMS on June 8, 2019. Beginning on that date: 

  • KEPRO is the BFCC-QIO that will provide services to the following states: Alabama, Alaska, Arkansas, Colorado, Connecticut, Florida, Georgia, Idaho, Kentucky, Louisiana, Maine, Massachusetts, Mississippi, Montana, New Hampshire, New Mexico, North Carolina, North Dakota, Oklahoma, Oregon, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Washington and Wyoming. 
  • Livanta is the BFCC-QIO that will provide services to the following states: Arizona, California, Delaware, District of Columbia, Hawaii, Illinois, Indiana, Kansas, Iowa, Maryland, Michigan, Minnesota, Missouri, Nebraska, Nevada, New Jersey, New York, Ohio, Pennsylvania, Virginia, West Virginia and Wisconsin. 

BFCC-QIOs will continue to help Medicare patients file an appeal if patients (or their families) think they are being discharged from the hospital (or services are ending) too soon. Medicare patients can also file a complaint when they have a concern about the quality of medical care they are receiving from a health care professional or facility.

How do the new contracts affect health care providers?

As a result of BFCC-QIOs providing services to different states (view above to see which BFCC-QIO covers your state), you may or may not have the same BFCC-QIO. To learn more about how this may affect your facility, as well as any action you may need to take, please visit www.keproqio.com/transition or https://livantaqio.com/en/provider/transition.