Eli's Hospice Insider

Published on Tue Jan 18, 2011 PDF

Make sure patients know QIOs are looking out for their quality concerns.

If your patients don't know who to contact if they aren't satisfied with their qualityof care, you could be in trouble if a new proposal passes.

The Centers for Medicare & Medicaid Services has issued a proposal that "would require most Medicare participating providers and suppliers to give Medicare beneficiaries written notice about their right to contact a Medicare Quality Improvement Organization (QIO) with concerns about the quality of care they receive under the Medicare program," the agency says in a release.

Currently, only hospital inpatients are given this type of information about contacting a QIO. But if the new proposal is finalized, a long list of provider types, including home health agencies and hospices, would have to inform beneficiaries about how to complain to a QIO.

"By requiring providers and suppliers to furnish QIO contact information to all beneficiaries, we are protecting beneficiaries' rights to bring their worries about quality of care to a third party for review," CMS Administrator Donald Berwick says in the release. QIOs investigate complaints, gather facts from all parties involved, and recommend action to help providers and suppliers improve quality of care.

CMS is also proposing a special requirement for hospices only. In addition to the QIO notices, hospices must amend the hospice patient's rights to include a requirement that "the hospice provide patients with the mailing address, electronic mail address, and telephone number of the state survey agency in the event they wish to report a grievance," notes the National Association for Home Care & Hospice.

Problem: Not only do these proposals create twice the work for hospice providers, they will also create a heavier burden for paperwork-heavy hospice patients who are already bogged down in notices.

CMS is accepting comments on the proposed rule through April 3. The rule is in the Feb. 2 Federal Register at http://edocket.access.gpo.gov/2011/pdf/2011-2275.pdf.