Special Open Door Forum: Quality Improvement Organization Beneficiary Protection Program

 

Centers for Medicare & Medicaid Services

Special Open Door Forum:

Quality Improvement Organization Beneficiary Protection Program

Thursday, October 30, 2008

2pm-3:30pm ET

Conference Call Only

 

The Centers for Medicare & Medicaid Services (CMS) will host this Special Open Door Forum (ODF) to discuss improvements to the Quality Improvement Organization (QIO) Beneficiary Protection Program (BPP). The BPP incorporates several QIO functions, including quality of care reviews, reviews of beneficiary complaints, higher-weighted Diagnostic Related Group reviews, utilization reviews, early readmission reviews, EMTALA reviews, appeals of discharges from various provider settings (fee for service and Medicare Advantage), and hospital preadmission reviews. The purpose of this Special ODF is to gain insight regarding changes and improvements needed to the regulations governing the QIO program, specifically 42 CFR Parts 475, 476, 478, and 480. The feedback will facilitate CMS' efforts to make the BPP more transparent to stakeholders, increase the effectiveness of QIOs in improving the quality of health care, and ensure the QIO regulations accurately convey all current legal requirements.

 

This Special ODF will focus on the following areas of the BPP:

• Beneficiary Complaint Reviews
• Quality of Care reviews
• Transparency
• Process Requirements for QIO BPP functions

 

As CMS moves forward on transforming the Beneficiary Protection Program, additional Forums may be scheduled based on need.

 

We look forward to your participation.

 

Open Door Forum Instructions:

 

**Capacity is limited so dial in early. You may begin dialing into this forum as early as 1:45 PM ET.**

 

Dial: 1-800-837-1935

Reference Conference ID 67947865

 

Note: TTY Communications Relay Services are available for the Hearing Impaired. For TTY services dial 7-1-1 or 1-800-855-2880 and for Internet Relay services click here http://www.consumer.att.com/relay/which/index.html . A Relay Communications Assistant will help.

 

An audio recording of this Special Forum will be posted to the Special ODF website at http://www.cms.hhs.gov/OpenDoorForums/05_ODF_SpecialODF.asp and will be accessible for downloading beginning November 6, 2008 and available for 30 days.

 

For automatic emails of Open Door Forum schedule updates (E-Mailing list subscriptions) and to view Frequently Asked Questions please visit our website at: http://www.cms.hhs.gov/OpenDoorForums/

 

Thank you.

 

 

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