Administrative Memos

200804

FROM: Theodore O. Will, Chief Executive Officer
DATE: Oct 27, 2008
SUBJECT: Implementation of Milliman Care Guidelines for Medicare Case Review
IPRO CONTACTS:

Andrea Goldstein, Vice President, Medicare/Federal Health Care Assessment, 516-209-5364

The purpose of this memorandum is to make you aware that effective January 1, 2009, IPRO will implement use of the Milliman Care Guidelines^® as the nurse screening tool for our Medicare medical record review process. As always, in accordance with the Medicare Quality Improvement Organization (QIO), should there be a question in regard to clinical issues such as medical necessity or quality of care, the case will be referred to a physician consultant for further review.

Additional information in regard to the Milliman Care Guidelines^® is available on their website at www.careguidelines.com. You may also contact Shaun Carey, Milliman Senior Account Executive at 866-402-2734.

Please feel free to contact Andrea Goldstein should you have any questions in regard to this memorandum or IPRO's planned implementation of the Milliman Care Guidelines^®.