BFCC-QIO Transitions

Presenters/Authors
Stethoscope and laptop

On June 7, 2019, the current contracts between the Beneficiary and Family Centered Care-Quality Improvement Organizations (BFCC-QIO) and CMS came to an end. The BFCC-QIOs work under contract with CMS to provide services to people with Medicare, including reviewing appeals for the expedited determination. Livanta and KEPRO are still the two BFCC-QIOs under contract, but with recent contract renewal came a change to the BFCC-QIO services in 29 states. Effective June 8, 2019, the following BFCC-QIOs will service the listed states.

  • BFCC-QIO KEPRO will provide services to the following states: Alabama, Alaska, Arkansas, Colorado, Connecticut, Florida, Georgia, Idaho, Kentucky, Louisiana, Maine, Massachusetts, Mississippi, Montana, New Hampshire, New Mexico, North Carolina, North Dakota, Oklahoma, Oregon, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Washington and Wyoming. Please visit the KEPRO website for more information. 
  • BFCC-QIO Livanta will provide services to the following states: Arizona, California, Delaware, District of Columbia, Hawaii, Illinois, Indiana, Iowa, Kansas, Maryland, Michigan, Minnesota, Missouri, Nebraska, Nevada, New Jersey, New York, Ohio, Pennsylvania, Virginia, West Virginia and Wisconsin. Visit the Livanta website for more information.

How does this change affect providers?

If your facility is in one of the 29 states affected by the change, please take action on two important updates:

1.    Update Your Appeal Notices 

  • Post-acute care providers, including skilled nursing facilities (SNF), should update the Notice of Medicare Non-Coverage (NOMNC) Form with their new BFCC-QIO’s name and phone number.

2.    Complete a Memorandum of Agreement (MOA) and Provider Update Form

  • Federal law requires certain providers to have an MOA with a QIO, which outlines the QIO’s and provider’s responsibilities during the review process. All providers must submit a new MOA after June 7, 2019. Visit the QIO sites listed above to complete the MOA and Provider Update Form if you haven’t already done so.

BKD recommends all SNF providers review and update the NOMNC. If you have questions or concerns, contact your BKD trusted advisor or fill out the Contact Us form below. 


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