Medicare Committees

Accountable Care Coalition of Southeast Wisconsin (ACCSW) Medicare Management Committee

The ACCSW Medicare Management Committee convenes quarterly to oversee Medicare administrative functions, including the provider integrity program and Office of Inspector General (OIG) sanction reviews. The Committee is also responsible for monitoring the financial operations of IPN’s Medicare agreements and the approval of all Medicare related policies and procedures to ensure all member physicians are in good standing. Currently, the Committee consists of eight member physicians, including the IPN VP of Medical Affairs (Chair), the IPN Medical Director, six additional IPN member physicians, the ACCSW Executive Director, an ACCSW Beneficiary, the IPN Director of Quality and Clinical Services (non-voting member), and the IPN CEO/Executive Director (non-voting member).

Together, the Medicare Management Committee develops and implements the ACCSW annual compliance plan, compliance monitoring tools, compliance reports, and compliance training. The Committee is responsible for maintaining necessary infrastructure to detect potential violations of the Medicare compliance program, investigating suspected violations, and developing corrective actions plans when violations are discovered.

ACCSW Medicare Care Coordination/Quality Committee

The ACCSW Medicare Care Coordination/Quality Committee convenes quarterly to review the overall quality performance of the ACCSW’s programs and address any potential quality of care issues. Currently, the Committee consists of seven member physicians, including the IPN Medical Director (Chair), the IPN VP of Medical Affairs, five additional IPN member physicians, the ACCSW Executive Director, the IPN Director of Quality and Clinical Services (non-voting member), and the IPN CEO/Executive Director (non-voting member).

The ACCSW Medicare Care Coordination/Quality Committee is responsible for creating programs to support Medicare quality measures and developing “best practices” by applying evidence-based protocols. To ensure all ACCSW member physicians are providing optimal care, the Committee analyzes and identifies opportunities to improve efficiencies in delivering care to ACCSW beneficiaries. The Committee also oversees the review and adoption process for the clinical practice guidelines for the specific disease categories and determines high-risk membership and develops applicable action plans.