CMS Approval Process – Referrals to the QIO from Any Source

9210.1 – CMS Approval Process – Referrals to the QIO from Any Source Other than CMS (Rev. 24, Issued: 02-12-16, Effective: 03-14-16, Implementation: 03-14-16) Every request should be in writing, offer clear and cogent rationale, and be submitted through the COR for the QIO contract. After receiving such a request, the QIO should, consistent with the contract: • Analyze the request to determine the appropriate staff hours and associated budget the QIO will require; and • Submit both the request and the QIO cost analysis to the QIO COR. • In the event that the QIO receives a fraud or abuse review referral from any source other than CMS, it should notify the CMS COR before the QIO conducts the review.