Section 198.545, RSMo requires the department of health and senior services to contract with the federally designated Medicare Quality Improvement Organization (QIO) in this state to conduct IDR conferences. To comply with this requirement, the department contracted with TMF Health Quality Institute (the federally designated Medicare QIO) who subcontracted with Primaris Healthcare Solutions to conduct IDR conferences.
Effective November 8, 2019, CMS awarded the federally designated Medicare Quality Improvement Organization contract for Missouri to Health Quality Innovators (HQI). Because of this change, the department’s contract with TMF automatically terminated. The department is discussing a possible contract with HQI, but at this point there is no contract for IDR services. Should a facility request an IDR during this time, two options are available: 1) The department will conduct the IDR conference, or 2) The facility can delay the conference until a permanent solution is determined.
If you have any questions regarding this change in process, please contact Shelly Williamson at Shelly.Williamson@health.mo.gov or at 573-526-4872.