Unwillingness to Cooperate

5125.2.1 – Unwillingness to Cooperate (Rev. 28, Issued: 10-21-16, Effective: 10-21-16, Implementation: 10-21-16) In some instances, the practitioner(s) and/or provider(s) may clearly express intent not to cooperate with the QIO for Quality Improvement Initiatives. In these situations, the Quality Innovation Network-QIO should advise the practitioner(s) and/or provider(s) that the matter may be referred to the CMS COR (or to a State survey agency through the regional office). In addition, a QIO may refer the matter to other CMS contractors (e.g., Medicare Administrative Contractors), with appropriate review authority over the practitioner’s and/or provider’s activities or to the State Board of Licensing. The practitioner and/or provider(s) may also be subject to additional reviews focusing on identified areas of concern in appropriate situations. NOTE: Failure to agree to or participate in a Quality Improvement Initiative is not justification for referral to the Office of Inspector General (OIG) for possible sanction action.