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TMF Health Quality Institute Awarded Highly Sought After CMS Contract.

AUSTIN, Texas -- TMF Health Quality Institute (TMF), one of the nation's leading Medicare quality improvement organizations (QIOs), has been awarded the Beneficiary Protection Program (BPP) QIO Support Center (QIOSC) contract by the Centers for Medicare & Medicaid Services (CMS).

"Under a contract with CMS, QIOs work with consumers, physicians, hospitals, nursing homes, home health agencies and other caregivers to improve the quality of health care delivered to patients," said William G. Gamel, MD, CEO of TMF. "The role of QIOs also is to protect the integrity of the Medicare trust fund by ensuring payment is made only for medically necessary services."

Each QIO must meet challenging goals established by CMS. Various QIOSCs support the QIOs in achieving CMS specific goals in the different task areas.

As the BPP QIOSC, TMF's role is to support CMS and all QIOs nationwide in meeting their CMS Beneficiary Protection Program goals related to Medicare case review activities. Case review activities ensure that services provided to Medicare beneficiaries are of a quality that meets professionally recognized standards of care, are medically appropriate, and are cost effective. A Medicare beneficiary is anyone entitled to Medicare benefits based on the designation by the Social Security Administration.

"We're very pleased that CMS awarded TMF this contract," said Gamel. "It clearly shows that CMS thinks highly of our ability to accomplish this challenging task." The BPP QIOSC contract was sought after by many QIOs in the nation.

"TMF was founded more than 30 years ago, and we've continuously demonstrated to CMS that we are leaders in many areas of case review and quality improvement activities," said Gamel. "As the Medicare QIO for Texas, we have demonstrated our expertise through the development of a solid case review program that integrates case review with quality improvement, resulting in improved care to Medicare beneficiaries."

This isn't the first QIOSC contract that TMF has been awarded. "For the last six years, we've gained valuable experience as the Hospital Payment Monitoring Program QIOSC," said Gamel. "The goal of that contract is to support CMS and all QIOs nationwide in identifying and preventing Medicare payment errors in short-term and long-term acute care prospective payment system hospitals."

Gamel said that TMF's success is due to the support it receives from the health care community. "We can't improve quality of health care without the support and partnership of the providers, the trade associations and other QIOs," said Gamel. "Their commitment and passion to improving quality of health care is evident by their ongoing efforts to deliver the right care, for every patient, every time."
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Publication:Business Wire
Date:Nov 9, 2005
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