Medicare Makes Changes to Beneficiary and Family Center Care QIO

The Centers for Medicare & Medicaid Services (CMS) recently restructured the Quality Improvement Organization (QIO) Program in order to enhance the quality of services to Medicare beneficiaries. KEPRO, the new Beneficiary and Family Centered Care QIO for the District of Columbia, will strive to keep a local presence by having outreach staff throughout the area and using state-specific physician reviewers, whenever possible, to provide review determinations at the local level.

Additional information regarding the appropriate telephone number to update the appeal notices can be found at The fax numbers for sending medical records in each CMS Area are also available. Contact information for appeals can be sent using the Provider Update Form, which is also available on the website. For any additional questions regarding the beneficiary complaint or appeal process, please contact KEPRO at 1-800-385-5080.

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