Annual Medical Services Review Report

All Medicare Quality Improvement Organizations (QIOs) produce an Annual Medical Services Review Report, which includes the number of Medicare beneficiary complaints reviewed in their state. Acumentra Health is the Medicare Quality Improvement Organization for Oregon.

The Annual Medical Services Review Report includes

• reviews of all written quality-of-care complaints from a Medicare beneficiary or representative
• immediate reviews of Hospital-Issued Notices of Noncoverage (HINNs), if review is requested by a Medicare beneficiary or representative
• immediate reviews of hospital discharge notices in the inpatient setting, if review is requested by a Medicare beneficiary or representative
• fast-track reviews of Medicare Advantage plan-issued Notices of Medicare Non-Coverage (NOMNCs) issued by a skilled nursing facility or by a home health agency, if review is requested by a Medicare beneficiary or representative
• expedited reviews of Medicare fee-for-service Notices of Medicare Provider Non-Coverage (NOMPNCs) issued by a skilled nursing facility, home health agency, or hospice, if review is requested by a Medicare beneficiary or representative

From July 1, 2009, through June 30, 2010, Acumentra Health completed reviews on 22 quality complaint cases. For calendar year 2009, Oregon had 602,686 Part A Medicare beneficiaries, and at the time of this report, Acumentra Health reviewed less than 1 complaint case per 10,000 Part A Medicare beneficiaries.