Starting October 1, 2020, the Centers for Medicare & Medicaid Services (CMS) regulations require providers (including short- and long-term acute care hospitals, inpatient rehabilitation facilities, skilled nursing facilities, home health agencies, physicians, and all other unnamed providers) to send medical records to Kepro electronically via a Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) approved method. Kepro will pay providers $3.00 for a complete patient record sent in an electronic format. For details, see the CMS FY2021 Inpatient Prospective Payment System (IPPS) Final Rule pp. 1693-1722, https://s3.amazonaws.com/public-inspection.federalregister.gov/2020-19637.pdf.
Kepro’s medical record request will provide details on how to securely submit the patient records electronically. This new requirement will affect all review types performed by the BFCC-QIO, including quality of care complaints and appeals. Providers that are unable to submit medical records electronically will need to obtain an approved waiver from Kepro. Without a waiver, Kepro cannot reimburse faxed or paper copy medical records. Please note that Kepro will continue to accept medical records via fax after October 1, 2020. However, these medical records will not be reimbursed until there is a signed waiver in place.
For more information about the electronic submission process, including waiver information and reimbursement rates, please visit www.keproqio.com/medicalrecords.
Livanta has issued a similar notices stating beginning October 1, 2020, they are prepared to receive medical records electronically through Direct Secure Messaging (appeals and quality cases), or via direct upload through their online e-LiFT portal (appeals cases only). If you are unable to use Direct Secure Messaging or the e-LiFT portal, please use faxed or mailed photocopies as a backup submission process. Livanta’s fax servers will remain online, and faxed submissions will not be rejected. Note that providers must have an approved waiver to be reimbursed for faxed or mailed hard copies.
For more information about the electronic submission process, including waiver information and reimbursement rates, please visit https://www.livantaqio.com/en/provider/Final_Rule