WASHINGTON – Senate legislation introduced today calls for the overhaul of the $400 million-a-year program charged with providing technical assistance to boost the quality of Medicare services.

Sens. Chuck Grassley and Max Baucus sponsored the bill that calls for the remake of the Quality Improvement Organization Congress created 25 years ago to improve services delivered to Medicare beneficiaries.  

“It’s an oxymoron to have a quality improvement program that turns out to be poor quality,” Grassley said. “It needs a major overhaul. This program has evolved to have many different functions.  Some of them are at cross-purposes, and the QIOs aren’t performing any of the functions well.”

"We agree that it is time to modernize the nation's QIO program but it appears that we disagree on how that should look," said Marc Bennett,” president of The American Health Quality Association, which represents the QIOs. “We are still reviewing the Grassley/Baucus proposal to understand their strategy more fully.”

Just a year ago, Health and Human Services Secretary Michael Leavitt outlined plans to boost the program. Leavitt’s report to Congress responded then to criticisms and recommendations that had been leveled in a series of studies from the Institute of Medicine.

Leavitt noted the crucial role QIOs played in supporting one of the largest national efforts to provide help to physician offices in adoption of health information technology.

The Grassley-Baucus bill calls for a greater focus of QIO efforts on technical assistance for quality improvement and performance measurement. It would require transitioning other QIO responsibilities including complaint investigations to other entities.

In introducing the Senate bill today, Grassley said both Medicare beneficiaries and taxpayers would be better served by a revamped program that focuses on providing quality-improvement services in a competitive environment and holds QIOs accountable for results and tax dollars spent.  

“Improving the quality of healthcare services is an important job, and it needs to be done right,” Grassley said.

“Ensuring quality care helps us get more bang for our healthcare buck,” said Baucus. “Medicare pays the Quality Improvement Organizations so doctors and hospitals have a resource to help improve the quality of care they provide, and this bill puts QIOs in a better position to add value to the healthcare system,” he added.

The senators said the reform initiatives are based on a number of reports, including the findings and recommendations of a study by the Institute of Medicine of the National Academy of Sciences, which was required in the Medicare Prescription Drug, Improvement and Modernization Act of 2003.  Grassley and Baucus were the principal Senate authors of the 2003 legislation.

Grassley began investigating QIO expenditures and lack of transparency in 2005.  He exposed a QIO that was leasing residential properties and cars for board members and the CEO. QIOs have also paid for frequent conferences and some at lavish resorts.  Earlier this month, the Government Accountability Office released a report requested by Grassley about the failure of QIOs to help improve quality deficient nursing home care.