Home Beneficiary Helpline Careers About Us Contact Us
Kepro - Beneficiary and Family Centered Quality Improvement Organization (BFCC-QIO)
Sign Up For Kepro’s Email List
healthcare professionals Other Reviews
We are the Medicare Quality Improvement Organization, working to improve the quality of care for Medicare beneficiaries. Our site offers beneficiary and family-centered care information for providers, patients, and families. Welcome!

related links

Kepro is responsible for other mandatory reviews as part of its a Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) contract with the Centers for Medicare & Medicaid Services (CMS).

These other reviews include 


Kepro conducts a five-day medical advisory review upon request from the appropriate CMS regional office. Kepro’s physician conducts a medical assessment of a potential Emergency Medical Treatment and Active Labor Act (EMTALA) violation case as specified in Part 9 of the QIO Manual (Attachment J-4). The five-day review is not mandated by the federal statute and regulations. However, the regional office may use this review as a resource in making a compliance determination, rather than simply determining the merits of the complaint.

Under sections 1867(d)(3) of the Act and 42 CFR §489.24(g), Kepro is required to conduct a 60-day review upon receipt of a completed EMTALA case sent to the Office of the Inspector General for possible civil monetary penalty or exclusion sanction as outlined in Part 9 of the QIO Manual.

referral reviews

BFCC-QIOs are required to conduct quality reviews when complaints about Medicare beneficiaries' healthcare are received from sources other than the beneficiary. These referrals come from a variety of state and federal agencies and organizations that include, but are not limited to:

  • CMS;
  • the Office of the Inspector General (OIG);
  • the Federal Bureau of Investigation (FBI);
  • the Centers for Health Dispute Resolution (CHDR);
  • the Joint Commission; and
  • Medicare Administrative Contractors (MAC).

Disclaimer/Privacy Policy Accessibility Site Map IT Log In
Follow QIO Program on Twitter Watch Kepro BFCC-QIO videos on YouTube Download screen reader for the Visually Impaired Get Adobe Acrobat Reader