June 10, 2009 - For the tenth consecutive year, IFMC (Iowa Foundation for Medical Care) will administer a contract with McKesson on behalf of the Centers for Medicare & Medicaid Services (CMS) for the use of InterQual Criteria, an evidence-based clinical decision support solution.
Through this agreement, Medicare fiscal intermediaries (FIs), Medicare administrative contractors (MACs) and quality improvement organizations (QIOs) contracted by IFMC now have access to the entire spectrum of InterQual Criteria products plus historical criteria to support their newly defined utilization review and quality oversight functions.
To improve the efficiency and quality of healthcare delivered to Medicare beneficiaries, CMS is shifting responsibilities for measuring and preventing improper payments to inpatient hospitals from the QIOs to the FIs and MACs, thus allowing QIOs to focus on improving patient quality of care and provider assistance efforts. To support these contractors in making consistent level-of-care decisions while accommodating their shifting roles, McKesson is making available additional criteria sets, including rehabilitation, skilled care and the newly released molecular diagnostic testing product.
The criteria will be delivered via InterQual Online Anonymous Review, a McKesson-hosted solution that allows users access to InterQual Criteria without exposing patient-identifying information. Users will also be able to use the hosted solution to review historical criteria, facilitating date-sensitive reviews for programs that look at medical necessity information retrospectively.
Additional information regarding CMS and its programs is available at http://cms.hhs.gov/about/default.asp and www.ifmc.org.
For more information: http://www.mckesson.com