Seattle - Qualis Health announced today that it has been awarded a contract by South Carolina's Department of Health and Human Services to provide the state's 870,000 Medicaid enrollees with hospital utilization review services. The contract begins on July 1, 2007 and will be administered by staff located in Qualis Health's new office in Columbia, South Carolina.

Qualis Health, which has broad expertise evaluating and improving healthcare services for Medicaid clients in several other states, will provide utilization review services such as preadmission surgical justification review, retrospective review of inpatient hospital admissions, quality assurance reviews of children's behavioral health services, and quality of care reviews for Intermediate Care Facilities for the Mentally Retarded. In addition, Qualis Health will also complete project studies to identify patterns of care and positive outcomes that can be shared with physicians and the hospital community in order to facilitate systematic improvement.  

"This is a significant achievement for Qualis Health, allowing us to dramatically expand the geographic reach of our high quality, cost effective review services," said Qualis Health's President and CEO Jonathan R. Sugarman, MD, MPH. "We believe that our use of state-of-the-art technology and our adherence to the highest of national review standards will ensure that the Medicaid beneficiaries of South Carolina receive the medically necessary care that they need."

Qualis Health, which is accredited by URAC in health utilization management, case management, and independent review, has provided comprehensive care management services for more than 30 years to clients such as employers, health plans, trusts, third party administrators, workers' compensation organizations, and government agencies. Qualis Health currently covers approximately four million lives nationally with its suite of care management products.