About IPRO

The federal government requires each state to have a Quality Improvement Organization (QIO) to evaluate and improve the quality of health care services and to protect the rights of medical beneficiaries. IPRO, an independent, not-for-profit organization based in Lake Success, New York, is the QIO for the State of New York. It also has the responsibility to protect and improve the quality of health care services to those in the Medicaid program.

Who we are

IPRO has a staff of more than 400 doctors, registered nurses, public health specialists, research scientists and other professionals and an additional 300 board-certified physician consultants available to perform medical review.

What we do

• Partner with doctors, hospitals, nursing homes, home health agencies and other health care providers to look for the best way to treat common diseases that affect Medicare beneficiaries.
• Review Medicare services provided for medical necessity, appropriate setting and the quality of care.
• Collaborate with providers on projects to improve the quality of health care services.
• Protect beneficiaries by expeditiously addressing individual cases, such as beneficiary complaints, provider issued notices of noncoverage, and EMTALA (Emergency Medical Treatment and Active Labor Act) "dumping" violations.
• Educate physicians and providers on the review process and quality of care expectations.
• Educate and advise Medicare beneficiaries on their rights under the law.
• Provide a process to address quality of care concerns filed by medicare beneficiaries or family caregivers.

About this campaign

IPRO has been asked by the U.S. Centers for Medicare & Medicaid (CMS) to increase awareness of the Medicare quality of care review process. Although this review process is available to all of the almost 3 million Medicare beneficiaries in New York State, only a small fraction ever take advantage of it-simply because they aren't aware it exists.

The goal of the Special Study is to increase awareness among New York State seniors, their families and caregivers regarding the QIO quality of care complaint process. To that end, IPRO has developed a multi-media approach to the project, utilizing print, Web, radio, television and radio resources. Furthermore, Special Study Outreach Coordinators are presenting to beneficiaries, advocates and key stakeholder audiences across the state. In particular, efforts will be focused on delivering our message to the medically underserved in regions throughout New York State.

IPRO reviews concerns about the quality of medical care received in hospitals, nursing homes, home health agencies, hospices, outpatient facilities or physician's offices and works with providers to improve care for future patients. Medical experts at IPRO conduct impartial reviews to determine if care met professional standards and keeps the complainant or their representative updated on the progress of the case from start to finish. There is no cost for this service.

Why you would call IPRO?

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