Two of the Senates most outspoken critics of Medicares Quality Improvement Organization program today introduced legislation that would strip the programs QIO groups of their investigatory duties and instead give that responsibility to Medicare Provider Review Organizations, or MPROs.
The CMS contracts with QIOsthere are more than 50 nationwideto oversee and improve the quality of care that Medicares more than 40 million beneficiaries receive.
The bill, introduced by Senate Finance Committee Chairman Max Baucus (D-Mont.) and ranking member Chuck Grassley (R-Iowa), would streamline the function of QIOs to focus on technical assistance in aiding quality and performance improvementwith an emphasis on underserved or rural provider communitiesaccording to a news release issued by the senators offices.
Its an oxymoron to have a quality improvement program that turns out to be poor quality, Grassley said. It needs a major overhaul. This program has evolved to have many different functions. Some of them are at cross purposes, and the QIOs arent performing any of the functions well.
Additionally, the bill would also eliminate noncompetitive renewals for the organizations; strengthen board governance rules; and create a level of transparency for the quality data the QIOs cull together.
Under another provision, the bill would also financially reward high-performing QIOs, while imposing a financial penalty for those that under-perform. -- by Matthew DoBias
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