Congressman Tom Price, M.D. (R-GA) has introduced H.R. 805, the Quality Improvement Organization Program Restoration Act, to improve Medicare quality and efficiency by undoing the restructuring of the Quality Improvement Organizations (QIOs) imposed in 2011 as a part of a trade reform bill. This legislation -- co-sponsored by Rep. Ron Kind (D-WI) -- was previously introduced in the 112th Congress.
"As a physician, I understand how absolutely vital it is to maintain patient and doctor control over health care decisions. The actions that have been taken to restructure quality improvement organizations will do harm to the QIO program and ultimately threaten the quality of care for Medicare beneficiaries, other patients, families, and physicians," Congressman Price said. "Patients and physicians understand and appreciate the dangers associated with granting greater health care authority to Washington -- particularly when done at the expense of the knowledge and expertise of local physicians and health care providers. Our legislation is critical to restoring and maintaining local input into improving health care quality. It will empower patients and their doctors to make the best decisions."
QIOs are mostly private, not-for-profit organizations staffed by physicians and health care professionals who are trained to review medical care, help beneficiaries with complaints concerning their care and implement improvements in the quality of care. Local physicians are integral to the QIO process, providing key insights and feedback on the program.
H.R. 805 would:
Restore a requirement for state-based QIO contracts instead of giving the Secretary of Health and Human Services the opportunity to regionalize or nationalize QIOs.
Maintain local control and relationships within each state's health care community.
Continue the long-standing requirement for local physician involvement in peer review.
Avoid a fragmentation of QIO functions by requiring an integrated, collaborative approach among health care stakeholders to ensure continuum of quality care.