Livanta National Medicare Claim Review Contractor

Memorandum Of Agreement

The MOA is a legal document that facilitates the exchange of information between the provider and Livanta. An MOA outlines the BFCC-QIO’s and the provider’s responsibilities in accomplishing Medicare-required reviews. The requirement for Medicare providers is described in the Social Security Act Section 1866 paragraph (a)(1)(E). Additional information can be found online at: https://www.ssa.gov/OP_Home/ssact/title18/1866.htm.

Livanta is contractually obligated to provide CMS with a list of providers that do not submit a signed MOA if CMS requests it. To maintain compliance with Medicare rules, it is critical that Livanta receives your organization’s MOA. Please review the following guidance to ensure compliance with the MOA requirement

Acute Care Facilities, including acute care inpatient hospitals, inpatient psychiatric hospitals, and long-term acute care (LTAC) hospitals:

• Located in CMS Regions 1, 4, 6, 8, or 10:
• An MOA is now required with Livanta.
• Livanta’s MOA for claim review in CMS Regions 1, 4, 6, 8, and 10 can be found below.
• After an MOA has been submitted, should you need to update your contact information for Livanta, please do so using the Contact Update Form. See below.
• Located in CMS Regions 2, 3, 5, 7, or 9:
• If your organization has NOT already submitted an MOA with Livanta, you must do so now.
• Livanta’s MOA for acute care organizations in CMS Regions 2, 3, 5, 7, and 9, which covers case review and claim review activities, can be found at https://livantaqio.cms.gov/en/Provider/MOA.
• If your organization has already submitted an MOA with Livanta, no further action is required at this time. Optionally, you may wish to update your contact information for Livanta using the Contact Update Form, which is also available at https://livantaqio.cms.gov/en/Provider/MOA

MOA Online Forms

Contact Update Form

	CMS Region / States and Territories
1	Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont
2	New Jersey, New York, Puerto Rico, U.S. Virgin Islands
3	Delaware, Maryland, Pennsylvania, Virginia, West Virginia, Washington, D.C.
4	Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee
5	Illinois, Indiana, Michigan, Minnesota, Ohio, Wisconsin
6	Arkansas, Louisiana, New Mexico, Oklahoma, Texas
7	Iowa, Kansas, Missouri, Nebraska
8	Colorado, Montana, North Dakota, South Dakota, Utah, Wyoming
9	Arizona, California, Hawaii, Nevada, American Samoa, Guam, Northern Mariana Islands
10	Alaska, Idaho, Oregon, Washington