Annual Report

Introduction

Livanta LLC is the Centers for Medicare & Medicaid Services (CMS) designated Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) in Area 1 and Area 5. Medicare beneficiaries who receive health care services in the states listed above, or their representatives, can contact Livanta to:
Appeal a decision to discharge a beneficiary from the hospital when there is a concern that the discharge is happening too soon
File a complaint or concern about the quality of health care they received in the past, or are undergoing now
Appeal a decision to end a course of treatment, such as rehabilitation, nursing home, home health, or hospice care, when there is a concern that the beneficiary still needs skilled care

In addition to the roles described above, Livanta reviews medical records to verify that the coding is accurate, that the care provided was medically necessary, and that the care provided was delivered in the most appropriate setting. More detail about Livanta’s coding validation, utilization review, and Emergency Medical Treatment & Labor Act (EMTALA) review work can be found in this report.

QIOs serve as the largest federal program dedicated specifically to improving health care quality at the community level. The program focuses on work with patients, caregivers, health care providers, and partners to support the development of healthy people in healthy communities, resulting in better care and lower costs. This report underscores our commitment to transparency by providing key performance metrics from the first year of Livanta’s work with Medicare beneficiaries. Livanta understands and respects beneficiaries’ rights and concerns, and we are dedicated to protecting patients by reviewing appeals and quality complaints in an effective and efficient patient-centered manner.

This annual report provides data regarding case reviews that were completed on behalf of Medicare beneficiaries and their representatives, health care providers, and CMS.