More Medicare patients to learn about their rights to complain

Surgery centers, clinics, community health centers and other care settings would be required to refer patients to quality improvement organizations under a proposed CMS rule.

By David Glendinning — Posted Feb. 25, 2011

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More Medicare beneficiaries are set to receive information about where they can lodge quality-of-care complaints under a rule proposed recently by the Centers for Medicare & Medicaid Services.

Hospitals that provide inpatient care to Medicare enrollees are required to give written notice to those patients about their rights to complain about the care they receive. Those concerns are referred to Medicare quality improvement organizations, contractors that operate in every state.

Under the proposed expansion of this policy, more care settings would be subject to the QIO referral requirements. They are:

  • Ambulatory surgical centers.
  • Clinics, rehabilitation agencies and public health agencies that provide outpatient physical therapy and speech-language-pathology services.
  • Comprehensive outpatient rehabilitation facilities.
  • Critical access hospitals.
  • Federally qualified health centers.
  • Home health agencies.
  • Hospices.
  • Hospitals.
  • Long-term-care facilities.
  • Portable x-ray services.
  • Rural health clinics.

QIOs investigate complaints and use the data they compile to recommend broad actions that Medicare health professionals and suppliers can take to improve the quality of their care.

CMS will accept comments on the proposed rule until April 3 and expects to issue a final rule this year. Comments can be posted online (link).

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