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Transition of Responsibility for Medical Review From Quality Improvement Organizations (QIOs)

These claims processing instructions are being revised since there is a transition of responsibility for the majority of utilization review from QIOs to Medicare fiscal intermediaries and Medicare administrative contractors. Quality related and some other activities are remaining in the QIO SOW.

Download the Guidance Document

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: August 07, 2008

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.