Quality Improvement Organization Update

The DHS-Division of Quality Assurance sent out the following notification earlier this week… As of August 1, 2015, the phone number for the previous state Quality Improvement Organizations (QIO) will no longer be forwarding to the new QIO phone lines as has occurred over the last year.

The Quality Improvement Organization (QIO) Program is the cornerstone of Medicare’s efforts to improve the quality of care and health outcomes for beneficiaries. KEPRO is the Beneficiary and Family Centered Care QIO (BFCC-QIO) for more than 30 states, including Wisconsin.

Medicare beneficiaries have the right to appeals their discharge from any Medicare participating facility (hospital, skilled nursing facility, outpatient rehabilitation, home health care and hospice).  Medicare beneficiaries can file a quality of care complaint regarding any medical service that happened within 3 years that was covered by Medicare from any Medicare participating facility.

Hospitals should change their “Important Message from Medicare” and non-acute care settings should change their “Notice for Non-coverage” to include KEPRO’s information:

Attention: Beneficiary Complaints
5201 West Kennedy Boulevard, Suite 900
Tampa, Florida 33609

Wisconsin’s toll free Beneficiary helpline (855)-408-8557
TTY for all areas: 855-843-4776
Fax: (844)-834-7130

Lines are staffed 7 days a week (M-F 9AM-5PM, weekends and holidays 11AM-3PM) and voicemails are returned the following day.  Complaints may also be emailed to beneficiary.complaints@hcqis.org.