Powerful senator wants extensive information about your QIO.
Your Medicare Quality Improvement Organ-ization might not be helping you as much as it should, one influential senator believes.
Senate Finance Committee Chair Charles Grassley (R-IA) sent a letter Aug. 11 to Centers for Medicare & Medicaid Services Administrator Mark McClellan, requesting a plethora of information about Medicare's QIOs.
Following a recent Washington Post article and a Journal of the American Medical Association report that challenged QIOs' effectiveness (see Eli's HCW, Vol. XIV, No. 25), Grassley asked CMS for materials including current quality improvement contracts, QIO board member rosters, recent reports to Congress and a list of all QIO performance audits in the past five years.
The American Health Quality Association, the QIOs' trade group, says "the Post has done the public a disservice by presenting an incomplete and unbalanced picture of the QIO program." Recent studies show QIO assistance is "clearly helping" home health agencies and other providers furnish better care, AHQA maintains in a release.
The Institute of Medicine is currently conducting a review of the QIO program, which AHQA supports, the trade group says. Separately, CMS has released its "Quality Improvement Roadmap," which details the actions the agency is undertaking to improve the quality of health services. These include five "system strategies," including working with providers, paying more for higher quality, and promoting information technology.
CMS will focus on specific areas, such as improving immunization in home health. The agency hopes to create performance measurement systems and increase public reporting of "expanded quality measures." To reach these goals, CMS has strengthened its Quality Council, now chaired by the CMS administrator, and formed work groups to address information technology, prevention and quality measures.
The roadmap is at
www.cms.hhs.gov/quality/quality%20roadmap.pdf.
CMS treatment of power mobility suppliers may be violating the Paperwork Reduction Act, according to a petition the Washington-based Power Mobility Coalition and five of its member suppliers have filed with the federal Office of Management & Budget.
The complaint charges CMS and its contractors with conducting an illegal general investigation by targeting the top 50 or 100 power mobility suppliers in a specific region. It also claims that CMS is requiring suppliers to submit documentation to the durable medical equipment regional carriers that has yet to be approved by OMB.
CMS last August issued a proposed rule requiring physicians to document DME necessity in their medical records; meanwhile, DMERCs are demanding these unapproved records from DME suppliers.
"The OMB-approved physician's certificate has been acknowledged by both the courts and Congress as the Medicare document of record for payment of claims," PMC Counsel Stephen Azia says. The full complaint is at
www.pmcoalition.org.
CMS has launched its newest disease management initiative, Medicare Health Support. Pilot programs in eight states [...]
