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Welcome! The South Dakota Foundation for Medical Care serves the health care community and the Medicare population as the Physician Peer Review and a Quality Improvement Organization (QIO) for South Dakota. As a member of the health care community, you will have access to the latest regulations, guidelines and health care quality improvement studies. If you are a Medicare recipient, see our Medicare Enrollee News section to explore your resources, rights and how we can help you make informed health care decisions.
What do QIOs do?
By law, the mission of the QIO Program is to improve the effectiveness, efficiency, economy, and quality of services delivered to Medicare beneficiaries. Based on this statutory charge, and CMS' Program experience, CMS identifies the core functions of the QIO Program as:
Improving quality of care for beneficiaries;
Protecting the integrity of the Medicare Trust Fund by ensuring that Medicare pays only for services and goods that are reasonable and necessary and that are provided in the most appropriate setting; and
Protecting beneficiaries by expeditiously addressing individual complaints, such as beneficiary complaints; provider-based notice appeals; violations of the Emergency Medical Treatment and Labor Act (EMTALA); and other related responsibilities as articulated in QIO-related law.
Medicare beneficiaries can click on the link to find information on lodging beneficiary complaints,or here for their Medicare Rights.
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All information on this site is provided as a public service only and should not be relied upon as medical or legal advice. Some of the information included in this site was obtained through work performed under a contract with the Centers for Medicare & Medicaid Services, Department of Health and Human Services. SDFMC shall not be held liable for any damages arising from the use of or reliance upon information supplied herein. Any links to other organizations contained on this site are for informational purposes only and do not imply endorsement by SDFMC.
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© 2012 South Dakota Foundation for Medical Care, All Rights Reserved |
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