Description:
South Dakota Foundation for Medical Care (SDFMC) is a private, non-profit Quality Improvement Organization (QIO) authorized by Medicare to ensure that Medicare patients receive the highest quality health care. We are here to help Medicare patients if they think they are being discharged from the hospital too soon or if they are concerned about the care they received as a Medicare patient.
By law, the mission of the QIO Program is to improve the effectiveness, efficiency, economy and quality of services delivered to Medicare beneficiaries. Based on this statutory charge, and CMS Program experience, CMS identifies the core functions of the QIO Program as: improving quality of care for beneficiaries, protecting the integrity of the Medicare Trust Fund by ensuring that Medicare pays only for services and goods that are reasonable and necessary and that are provided in the most appropriate setting; and protecting beneficiaries by expeditiously addressing individual complaints, such as beneficiary complaints; provider-based notice appeals; violations of the Emergency Medical Treatment and Labor Act; and other related responsibilities as articulated in QIO-related law.