Livanta, the new CMS Beneficiary and Family Centered Care-Quality Improvement Organizations (BFCC-QIOs) for multiple Medicare Regions, including CMS Region 3 has asked VHCA-VCAL to share information on the required Memorandum of Agreement (MOA) with members. Providers are required to sign the new MOA by June 8, 2019 as a condition of your organization’s participation in Medicare.

Previously signed versions of the MOA are invalid after June 7, 2019.  

Your organization will need to complete and sign a MOA for each CMS Certification Number (CCN) under which it operates. If your organization has multiple CCNs, but also has a central office that handles all record requests, appeals and QIO correspondence then you may list multiple CCNs on a single MOA. Otherwise, you must complete a separate MOA for each facility.

How to access and submit the MOA form:

• Download the MOA form from the Livanta website. If needed, please download Adobe Acrobat Reader DC using this link. The MOA form downloads as a fillable PDF file.
• Please read the entire MOA, complete the fillable form fields, and sign electronically where indicated. In addition to the signature of the Administrator on the MOA, Livanta requests information for four additional liaison(s)/contact(s) departments in your organization. Non-user specific emails are preferred if available, such as “medicalrecords@…” rather than individual emails which may change
  with personnel.
• Save the file to your computer. When submitting the MOA, please ensure that all required fields are completed before sending.
• E-mail the completed MOA and contact lists as an attachment to: ProviderUpdate@Livanta.com. Submitting the fillable PDF form via email is the fastest and preferred way to complete the process and have your information updated.
• Instead of emailing, you may fax your MOA to (443) 973-7124. Note that faxing your MOA may result in delayed processing.

If you have any questions or concerns, including concerns about the MOA language, please email ProviderUpdate@Livanta.com. If you are unable to e-mail or fax your organization’s MOA, please call (240) 712-4300, ext. 2125.