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NMMRA QIO Uses Milliman Care Guidelines(R) for New Mexico Medicare and Medicaid Reviews
Date:3/24/2009

able standards of care, are medically necessary, and are delivered in the most appropriate setting," said Dan Jaco, NMMRA Chief Executive Officer. "Using the Care Guidelines helps us in that analysis. Competing for the CMS 9th Statement of Work was challenging, and we are pleased to be able to continue our work in helping New Mexico beneficiaries receive the best available medical care. We believe that using the Care Guidelines will enable us to meet our Medicare and Medicaid review requirements and will continue to make us competitive for future contracts," Jaco added.

Scott Harris, Milliman Care Guidelines Senior Vice President of Sales and Marketing, commented, "The Care Guidelines combine rigorously screened, evidence-based clinical information with key elements of quality programs such as HQA's hospital quality measures. These quality-focused measures, and other clinical tools included in the Care Guidelines, enable QIOs to effectively manage their review processes and quality initiatives."

About NMMRA

The not-for-profit New Mexico Medical Review Association (NMMRA) has been the state's premier independent health care consulting organization since 1984. NMMRA is the federally contracted Medicare QIO for New Mexico and state-contracted Medicaid External Quality Review Organization (EQRO). It is widely recognized for providing education and training, technical assistance, quality of care review, and project management expertise to a variety of audiences in a number of areas. In addition to its federal and state contracts, NMMRA also assists organizations outside of New Mexico in quality improvement initiatives, working with providers, beneficiaries, consumers, payors and others to improve care.

About Milliman Care Guidelines

Milliman Care Guidelines, LLC, A Milliman Company, is located in Seattle, and independently develops and
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SOURCE Milliman Care Guidelines
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