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Transmittal 18-30: Quality Improvement Organization for the District of Columbia

Monday, October 29, 2018

The purpose of this transmittal is to inform you that the District of Columbia Department of Health Care Finance (DHCF) has renewed the Quality Improvement Organization (QIO) contract with Qualis Health (Qualis) to conduct utilization review and quality improvement activities for the District's fee-for- service (FSS) Medicaid program. Over the next five (5) years, Qualis will assist the District in ensuring that FFS beneficiaries receive appropriate and necessary care, including the level and quality of care administered, through prospective, concurrent and retrospective reviews of medical services. This transmittal summarizes and highlights the new and existing review activities that Qualis will conduct on behalf of DHCF.