Federal requirement claims review Memorandum of Agreement (MOA) to Livanta

Posted on: 7/16/21

Medicare claim reviews have been on hold since 2019 but will soon be resuming. As a Medicare Beneficiary and Family Centered Care - Quality Improvement Organization (BFCC-QIO), Livanta is authorized to begin conducting this work for the Centers for Medicare & Medicaid Services (CMS). These audits by Livanta will include Short Stay Reviews, Higher Weighted Diagnosis Related Group Reviews (HWDRGs), and other reviews as directed by CMS. 
 
Please note that claim review by the BFCC-QIO is different from BFCC-QIO case review. Kepro will continue providing BFCC-QIO case review services for beneficiary appeals and quality of care complaints in our state, while Livanta will conduct claim review services. 
 
At this time, hospitals in our state must submit a Memorandum of Agreement (MOA) to Livanta. MOAs facilitate communication with the appropriate parties for the exchange of medical records and review findings.
 
Livanta is authorized to conduct claim review on a national scale, including in all 50 states, five U.S. territories, and Washington, D.C. Please click here, or the link below to read Livanta’s recently published Provider Bulletin for information about this important change and other critical updates. 
 
To complete your MOA, please visit the Livanta Claim Review website.