tci Medicare Compliance & Reimbursement - 2003 Issue 29

Quality: Quality Reviews Just Got Less Private

QIOs to disclose more to patients. Health care providers should be aware that patients will now be able to extract potentially damaging information from QIOs. If a patient ever complains to a quality improvement organization, the Medicare QIO must tell her, at a minimum, whether the QIO believes the beneficiary's treatment met "professionally recognized standards of health care," the U.S. Court of Appeals for the D.C. Circuit ruled June 23 in Public Citizen Inc. v. Dep't of Health and Human Services (No. 01-5294). The appellate panel was construing a provision of the Social Security Act stating...

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