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Mike Mitka

JAMA. 2006;295:1635.

	Since this article does not have an abstract, we have provided the first 143 words of the full text and any section headings.

Citing a seeming lack of effectiveness and accountability by quality improvement organizations (QIOs) hired to investigate individual Medicare beneficiary complaints, Chuck Grassley (R, Iowa), chairman of the Senate Finance Committee, is asking administration officials to consider changing how these companies are paid to ensure that higher priority is given to activities that address patient complaints and improve quality of care.

In a March 3 letter to the Centers for Medicare & Medicaid Services, Grassley noted his committee's investigation into the Medicare QIO program that began in August of 2005 found questionable expenditures, potential conflicts of interest, and a lack of effectiveness.

The American Health Quality Association, a QIO trade association, said in a press release that it agreed the program needs changes but disputed some of Grassley's assertions. The association blamed any problems associated with the program on poorly written laws.