Beneficiary Complaint: New Concerns Raised by the Beneficiary

5050.1 – Beneficiary Complaint: New Concerns Raised by the Beneficiary (Rev. 28, Issued: 10-21-16, Effective: 10-21-16, Implementation: 10-21-16) As a result of the QIO’s broad focus in assessing the scope of the complaint, the QIO should rarely become aware of new Quality of Care Concerns after the complaint has entered the Quality of Care Review Stage. See Scope of Complaint, §5030.1. New issues/concerns may be added to the original complaint if the Interim Initial Determination step has not been completed. NOTE: In the rare event that a beneficiary raises a new issue/concern(s) after completion of the Interim Initial Determination (See §5050.4), the new issue/concern is processed as a separate/new complaint.