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KEPRO is our new Medicare Quality Improvement Organization
June 6, 2019

This article is for acute care hospitals, home health agencies, rehabilitation facilities, and skilled nursing facilities.

The Centers for Medicare and Medicaid Services (CMS) has announced a change to the Quality Improvement Organization (QIO) serving our Medicare Advantage members. On June 8, 2019, KEPRO will replace Livanta for Medicare Advantage members’ appeals and quality of care reviews. Please send all materials required for appeals and quality of care reviews to KEPRO.

What does KEPRO do?
Each region has a designated QIO for Medicare beneficiaries. KEPRO will be the QIO for region 1, which includes Massachusetts.

Medicare Advantage members should contact KEPRO if they:

  • Have a complaint about the quality of care they received.
  • Think coverage for a hospital stay, home health care, skilled nursing facility care, or comprehensive outpatient rehabilitation facility (CORF) services are ending too soon.

Forms will be updated
We have updated the following forms with KEPRO’s information:

Questions?
If you have questions about a Medicare Advantage member’s appeal or quality of care review, please contact KEPRO:

Address Phone
KEPRO
5700 Lombardo Center Dr.
Suite 100
Seven Hills, OH 44131

1-888-319-8452
1-833-868-4055 (fax)
1-855-843-4776 TTY

 

MPC_052819-1N-1-ART

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