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What's New with the BFCC-QIOs

Published on 

Wednesday, May 22, 2024

 | Case Management 
 | Documentation 

Kepro

Kepro’s service areas include CMS Regions 1,4, 6, 8, and 10. In December 2022, Kepro merged with CNSI. Six months later, they announced the organization had been rebranded as Acentra Health indicating that “the name Acentra Health derives from the root words “accelerate” and “central,” reflecting the company’s uncompromising resolve to be a vital partner to public sector health agencies in the delivery of comprehensive healthcare solutions and services, with “Health” being its central business focus.”

 

On April 30, 2024, Kepro published a special bulletin letting providers know about their name change. They encouraged providers to update their beneficiary notices, the Important Message from Medicare (IM) and the Notice of Medicare Non-Coverage (NOMNC), by replacing “Kepro” with “Acentra Health.” However, they did note that notices that still have the name “Kepro” listed will be accepted and validated and posted a list of FAQs on their website about this change. Key things to be aware of include:

 

  • Phone numbers and fax numbers will not be changing,
  • Their “go live” target date for rebranding to “Acentra Health” is August 1st and plan to have all their items changed by fall 2024,
  • Kepro has been contracted to perform Medicare’s mandatory reviews through 2029 and its CMS Regions will not be changing,
  • There will be a new website with a new web address, and will be available when the name change occurs by fall 2024, and
  • They encourage you to sign up to their newsletter, Case Review Connections, which includes updates and news from Kepro.

     

    A day after the special bulletin was published, on May 1, 2024, Kepro began a new process for hospital discharge appeals. Specifically, when a Medicare Fee-for-Service beneficiary calls Kepro to file a discharge appeal due to concerns with their discharge planning will be transferred to the Immediate Advocacy (IA) team. This team will review the concerns, identify any gaps or misunderstandings, and determine if additional guidance is needed. You can read more about this new process on Kepro’s Hospital Discharge Appeals webpage.

     

    Livanta

    Livanta’s service areas include CMS Regions 2, 3, 5, 7, and 9. On May 17, 2024 they distributed Provider Bulletin # 21 announcing that they had been awarded the BFCC-QIO contract for case reviews from May 1, 2024, through April 30, 2029. Livanta will also continue to serve as the national Medicare Claim Review contractor.

     

    Livanta’s announcement includes the following four sections:

  • Section 1: Beneficiary Case Review versus Claim Review,
  • Section 2: What is changing, and what is staying the same?
  • Section 3: Updating Contact Information and Memoranda of Agreement, and
  • Section 4: Stay in Touch with Livanta.

 

If you are unsure who your BFCC-QIO is, you can use the QIO “Locate Your BFCC-QIO” tool at https://qioprogram.org/locate-your-bfcc-qio.

 

Resource

Livanta Provider Bulletin #21: https://www.livantaqio.cms.gov/assets/files/13-SOW-MD2024-QIOBFCC-PROV-1.pdf
Article Author: Beth Cobb, RN, BSN, ACM, CCDS
Beth Cobb, RN, BSN, ACM, CCDS, is the Manager of Clinical Analytics at Medical Management Plus, Inc. Beth has over twenty-five years of experience in healthcare including eleven years in Case Management at a large multi-facility health system. In her current position, Beth is a principle writer for MMP’s Wednesday@One weekly e-newsletter, an active member of our HIPAA Compliance Committee, MMP’s Education Department Program Director and co-developer of MMP’s proprietary Compliance Protection Assessment Tool.

This material was compiled to share information.  MMP, Inc. is not offering legal advice. Every reasonable effort has been taken to ensure the information is accurate and useful.