Hospital Memorandum of Agreement

3010 Hospital Memorandum of Agreement (Rev.29, Issued: 10- 21-16, Effective: 10-21-16, Implementation 10-21-16) In accordance with 42 CFR 489.20(e), hospitals that provide inpatient hospital services paid under the Prospective Payment System (PPS) are required to maintain an agreement with a QIO to review the: • Validity of diagnostic information provided • Completeness, adequacy, and quality of care provided • Appropriateness of admissions and discharges • Appropriateness of care provided with respect to services for which payment may be made under Part A of Medicare The hospital MOA should include appropriate specifications listed in Section 3005 of this chapter. QIOs may follow the cover letter and model agreement (See Exhibits 3-1 and 3-2) when preparing the MOA. 3015 Home Health Agencies (HHAs) and Skilled Nursing Facilities (SNFs) Memoranda of Agreement (Rev.29, Issued: 10- 21-16, Effective: 10-21-16, Implementation 10-21-16) Under Section 1866(a)(1)(F) of the Act, QIOs must also enter into agreements with HHA and SNFs. The HHA and SNF MOAs should include appropriate specifications provided in Section 3005 of this chapter. QIOs may follow the cover letter and model agreement (See Exhibits 3-1 and 3-2) when preparing the MOA. QIOs may develop one MOA with a parent HHA operating in a state that has branches located in the same state as the parent agency. List the name and address of all branch office locations in the MOA with the parent agency. Separate MOAs are required for subunits of a parent HHA that serves patients in geographic areas different from that of the parent HHA because these subunits have their own agreement number. HHA subunits are semi-autonomous organizations and must independently meet the conditions of participation for HHAs (See 42 CFR 484.2). AGREEMENTS WITH MEDICARE ADMINISRATIVE CONTRACTORS (MACS)