CHA News Article

CMS Announces Reorganization and Contracts for California
HSAG to be QIN and IPF support contractor; Livanta LLC to be QIO

The Centers for Medicare & Medicaid Services (CMS) has awarded Health Services Advisory Group, Inc. (HSAG) the new Quality Innovation Network (QIN) contract for California. HSAG is the current quality improvement organization (QIO) in California and was awarded the contract in conjunction with the CMS strategy to separate the QIN and QIO functions. According to CMS, QINs are responsible for working with providers, practitioners and the community on multiple data-driven quality initiatives to improve patient safety, reduce harm and improve clinical care at the local, regional and national levels.

Livanta, LLC, located in Annapolis Junction, MD, was named the QIO for California. QIOs now have primary responsibility for conducting case review functions such as complaint reviews, quality of care reviews, discharge appeals, higher weighted diagnostic related groups requests and EMTALA reviews. Known as Beneficiary and Family Centered Care QIOs, they have the potential to eliminate concerns regarding conflict of interest and conflict of role function. For more information about the QIO-QIN project, see the CMS press release.

CMS has also announced that Florida Medical Quality Assurance, Inc. (FMQAI)/HSAG will be the Hospital Inpatient Value, Incentives, and Quality Reporting outreach and education national support contractor for the inpatient psychiatric facility (IPF) quality reporting program. In addition to supporting IPFs, FMQAI/HSAG will support providers in these programs:

  • Hospital inpatient quality reporting
  • Electronic Health Record Incentive Program for Eligible Hospitals and Critical Access Hospitals
  • Hospital value-based purchasing
  • PPS-exempt cancer hospital quality reporting