Referral Reviews
QIOs are required to conduct quality reviews when complaints about Medicare beneficiaries' healthcare are received from sources other than the beneficiary. These referrals come from a variety of state and federal agencies and organizations, that include but are not limited to:- the Centers for Medicare & Medicaid Services (CMS)
- the Office of the Inspector General (OIG)
- Florida's Agency for Healthcare Administration (AHCA)
- the Federal Bureau of Investigation (FBI)
- the Centers for Health Dispute Resolution (CHDR)
- the Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
- and Medicare fiscal intermediaries




