Major realignment is scheduled for this weekend.
As reported last week by RACmonitor, in a restructuring of the Beneficiary and Family-Centered Care Quality Improvement Organization (BFCC-QIO) jurisdictions, the Centers for Medicare & Medicaid Services (CMS) created 10 regions across the United States and awarded KEPRO, a BFCC-QIO, a new five-year contract that includes five additional regions. The change is effective on June 8, 2019.
KEPRO currently operates in 33 states and the District of Columbia.
Beginning Saturday, June 8, KEPRO will be responsible for Regions 1,4,6,8, and 10. Livanta, the other BFCC-QIO, will be responsible for regions 2, 3, 5, 7, and 9.
It seems, however, that many hospitals have not been informed that as of June 8, the BFCC-QIO provider areas are changing. As a reminder, the BFCC-QIO reviews discharge appeals by patients and quality complaints.
For some hospitals, they will retain the same QIO, but its phone number will change. Others will get a new QIO.
With this transition, every hospital will need to prepare a new memorandum of agreement (MOA) and update their Important Message from Medicare with the new contact information by June 8.
Each hospital should refer to the links below to find its new QIO, and follow their guidance for the MOA.
KEPRO website: https://www.keproqio.com/providers/transition
Livanta website: https://bfccqioarea5.com/en/provider/transition
Hospitals are required to sign a memorandum of agreement with their BFCC-QIO. But it is interesting to note that Livanta encourages hospitals to complete their MOA prior to the June 8 start date, yet KEPRO does not allow providers to even access the MOA for review and signature until June 8. It raises the question of whether the QIO can carry out its duties and perform a discharge appeal review if the new MOA is not yet signed. And since June 8 is a Saturday, it is quite likely that the person at the hospital with the authority to review and sign the KEPRO MOA will not be available.
RACmonitor and Monitor Mondays will continue to track this developing story.