“Finally Friday!” Review of KEPRO Webinar on QIO Short Stay Review Program

FRIDAY October 2, 2015:

“KEPRO Kicks It.

We review their webinar wherein
they try to sound as if they are
reasonable and wear white Stetsons.

Get the Handouts

High-functioning sociopaths are not exactly good candidates to be a Physician Advisor. Here's a one word list of characteristics to avoid: House.

This was actually a picture from last week’s show, but I think it still applies, this week, as I am imagining this fellow may now work for a QIO.

[Warning… Rant follows… Intended for mature audiences… reader discretion is advised.]

I guess I’m just tired of hearing CMS contractors try to spin their work as if they are on the providers’ side of the table.

(Gee Ernie, why do you say that?)

The attitude of CMS and their contractors — contractors are guilty by association and by accepting the CMS contracts and CMS’ conditions, directions, and disingenuous totally abusive jerrymandering-like selection of regulations CMS chooses to enforce or ignore — is obvious by inspection: providers are guilty by default, and we can do whatever suits our agenda (which is “reducing reimbursements, period, and no we don’t really have beneficiaries health in mind, which even the U.S. Senate saw as obvious since we never study the effect of our policies on anything except how much we have avoided paying out, do I have to go on?”), AND, due to the wisdom of Congress, we and our policies, programs and procedures are beyond judicial review, thank you very much.

The latest proof of this attitude is actually enshrined in at least two of the slides from the KEPRO webinar of September 29.

Get the slides from the KEPRO webinar and view our recording of it, in our blog.

Exhibit 1 for the Prosecution: KEPRO Slide 16

Exhibit 1 for the Prosecution: KEPRO Slide 16

Slide 16 from their deck, and their expanded explanation of their process, shows the first step in this, the latest insidious chapter in the sad saga of the 2 Midnight Rule: they will use a single commercial tool to judge medical necessity, with caveats for claims that fail, including subjective judgement of signs and symptoms, risk, and about a dozen other reasons to justify their subsequent denial. (Enter, House…)

Exhibit 2 for the Prosecution: KEPRO Slide 18

Exhibit 2 for the Prosecution: KEPRO Slide 18

Slide 18 form their deck includes proof that all providers are guilty and worthy of at least Minor Concern. There is no “level” for providers who have no errors in the reviewed cases. Even if they now add a level for that, their attitude and thinking is revealed. All providers are guilty from the get-go.

ANYWAY… we will discuss all that today… and many more of their slides.

 

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REPLAY of This Week's Show

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