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On August 8, 2008, CMS publicly announced the award of 53 contracts for the QIO Program 9th Statement of Work (SOW) with an effective date of August 1, 2008. Of the 53 contracts for the core 9th SOW, 13 were competitively awarded and 40 were negotiated renewals. On August 12 and 13, 2008 respectively, CMS received notification that a protest to the award of WVMI Quality Insights for the state of North Carolina and a protest to the award of Health Services Advisory Group (HSAG) for the state of California had been filed with the Government Accountability Office (GAO). As both protests were filed timely, an automatic stay of performance went into effect for both the NC and CA 9th SOW awards. The following provides an update to the status of the protests and the stay of performance for the states of NC and CA. **UPDATE: November 21, 2008** Status of QIO Contract for North Carolina CMS is currently making a new award decision for this contract. At this time, the original awardee, West Virginia Medical Institute is under a stop work order and there is a protest filed with the Government Accountability Office on this procurement. Until further notice, North Carolina beneficiaries who wish to file complaints or appeals about the quality of their care under Medicare should contact the existing QIO in North Carolina, the Carolina Center for Medical Excellence at 1-800-922-3089. Status of QIO Contract for California The Court of Federal Claims found in CMS' favor, denying the bid protest filed. CMS was able to continue transitioning work to the new California QIO for the 9th SOW, HSAG. At this time HSAG has assumed beneficiary protection responsibilities in California, and is the only entity serving as the California QIO. California beneficiaries who wish to file complaints or appeals about the quality of their care under Medicare should contact HSAG at 1-800-841-1602 (or 1-800-881-5980 for TDD-hearing impaired callers). **UPDATE: AUGUST 5, 2008** In August 2008, QIOs began work on their 9th Statement of Work with CMS. To learn more, read our Fact Sheet on the 9th SOW page. In August 2008, work began on the QIO Program's 9th Statement of Work (SOW), which extends through July 31, 2011. The 9th SOW builds on the Administration's health care initiatives and a growing evidence base about how to improve the quality and efficiency of the health care sector. The 9th SOW has 6 six main sections. Three of them are required of all 53 QIO contractors, while 3 will be competed among the QIOs to be conducted sub-nationally. For All QIOs: - Beneficiary Protection
- Patient Safety
- Core Prevention
"Sub-national" Tasks for Some QIOs: - Chronic Kidney Disease (CKD) Project
- Care Transitions Project
- Prevention: Efforts to Reduce Health Disparities among Diabetes Patients
What's New Under the 9th SOW?
Part of CMS' new emphasis under the 9th SOW is to use management information tools (such as milestone and project tracking) to ensure that QIOs' services make positive contributions to beneficiary care, and that the Agency receives the best value for the resources it expends on the Program. The new SOW represents a significant shift in the way CMS approaches its quality responsibilities. In response to these recommendations, we have used the 9th SOW as a way to: - Develop a robust framework of quality measures that provides accountability to the QIOs for making changes at all levels of the health care system; and
- Implement a management information system that helps CMS keep its fingers on the pulse of the Program through monitoring how well QIOs stack up on programmatic and administrative metrics.
In addition, QIOs will focus their intervention projects across the spectrum of care, rather than in "silos" based on settings of care, as we have with previous scopes of work. This will allow the QIOs to have a sector-wide impact on the provision of care to Medicare beneficiaries. Furthermore, QIOs will focus their interventions on those providers/practitioners who are most in need of quality assistance. QIOs will provide intensive, one-on-one support with low-performing providers rather than casting their net of limited resources in less strategic ways, as may have been done in the past. Learn More about the 9th SOW CMS' announcement of the 9th SOW contract award is available in the "Downloads" section at the bottom of this page. As part of the transition to the 9th SOW, CMS conducted contract competition in several areas of the country. Please refer to the "Downloads" section at the bottom of this page to learn more about the Request for Proposals that CMS solicited as part of this competition.
Page Last Modified: 01/07/2009 3:26:58 PM
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