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CMS Again Extends InterQual Contract with McKesson to Support Medicare InitiativesJune 09, 2009 |
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Expanded Availability of InterQual Criteria Accommodates New Roles for Medicare Contractors 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 , the industry’s gold standard in evidence-based clinical decision support. 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. “With over 4,000 healthcare stakeholders, including government agencies, hospitals and health plans, using our InterQual Criteria, McKesson is uniquely positioned to foster alignment in an ever-changing industry,” said Tammie Phillips, vice president of InterQual for McKesson Health Solutions. “Our continuing relationship with CMS and other government entities benefits our hospital clients because it means they can access the same clinical knowledge bases being used by payors to make their decisions.” About the Centers for Medicare & Medicaid Services Formerly known as the Health Care Financing Administration (HCFA), CMS is the federal agency responsible for administering Medicare, Medicaid, State Children’s Health Insurance, Health Insurance Portability and Accountability Act, Clinical Laboratory Improvement Amendments and several other health-related programs. About IFMC For more than 35 years, IFMC has been dedicated to the delivery of innovative health management solutions. A full range of flexible and customized information, quality and care management services enables us to address all aspects of health care needs. About McKesson Corporation McKesson Corporation, currently ranked 15th on the FORTUNE 500, is a healthcare services and healthcare information technology company dedicated to helping its customers deliver high-quality healthcare by reducing costs, streamlining processes, and improving the quality and safety of patient care. McKesson is the longest-operating company in healthcare today, marking its 175th anniversary last year. Over the course of its history, McKesson has grown by providing pharmaceutical and medical-surgical supply management across the spectrum of care; healthcare information technology for hospitals, physicians, homecare and payors; hospital and retail pharmacy automation; and services for manufacturers and payors designed to improve outcomes for patients. For more information, visit http://www.mckesson.com .
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