Examples of NDHCRI’s contracts
Health Care Financing Administration
	NDHCRI has contracted with the Centers for Medicaid & Medicare Services (CMS) since 1974 to serve as the Medicare Peer Review/Quality Improvement Organization for North Dakota. In this role, NDHCRI:
	Serves as a quality improvement organization, working with hospitals and clinics to identify process improvement opportunities.  Conducts case review of Medicare claims, validation of codes, quality review, preauthorizations, and medical necessity determinations.  Manages a beneficiary hotline and serves as an educational resource to Medicare beneficiaries.
North Dakota Department of Human Services (NDDHS)
	NDHCRI contracts with the NDDHS to perform review of Medicaid claims, which includes validation of codes, quality review, preauthorizations, and medical necessity determinations. In addition, NDHCRI is currently partnering with NDDHS to work on special projects targeting asthma and pneumonia care in the Medicaid managed care setting.