Notice ID: 231291
The Center for Clinical Standards and Quality (CCSQ), in collaboration with our Centers for Medicare and Medicaid partners (CMS), seeks contract support to provide expert technical, analytical, and subject matter support to align quality goals and priorities across CCSQ and in the Quality Improvement Organization (QIO) contracting approach.
CMS, an agency of the U.S. Department of Health and Human Services (HHS), implements the QIO Program per Part B of Title XI of the Social Security Act (hereinafter referred to as the Act), as amended by the Peer Review Improvement Act of 1982 and Section 261 of the Trade Adjustment Assistance Extension Act of 2011.
The QIO Program is one of the largest federal programs dedicated to improving health quality for Medicare beneficiaries, with its central mission to improve the effectiveness, efficiency, economy, and quality of services delivered to Medicare beneficiaries. QIOs work under the programmatic framework that CCSQ establishes for day-to-day operations and are managed by (CCSQ its iQuality Improvement and Innovation Group (iQIIG)). Importantly, QIOs are a critical lever for CCSQ to drive quality improvement, innovation, and systems change in support of its goals for healthcare transformation. The core functions of the QIO Program are:
- Improving the quality of care for beneficiaries;
- Protecting the integrity of the Medicare Trust Fund by ensuring that Medicare pays only for services and goods that are reasonable and necessary and that are provided in the most appropriate setting; and
- Protecting beneficiaries by expeditiously addressing individual complaints, such as beneficiary complaints; provider-based notice appeals; violations of the Emergency Medical Treatment and Labor Act (EMTALA); and other related responsibilities as articulated in QIO-related law.