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CMS (Centers for Medicare & Medicaid Services) progresses claims processing scheme with overseer nominations:

This article was originally published in Clinica

Executive Summary

The US Centers for Medicare & Medicaid Services (CMS) has selected four specialty contractors via competitive bidding to handle the administration of $542m in combined claims from suppliers of durable medical equipment, prosthetics and orthotics. The winning contractors include: National Heritage Insurance, AdminaStar Federal, Palmetto Government Benefits Administrator and Noridian Administrative Services. Each contractor will assume full responsibility for claims processing work beginning on July 1, and will be able to renew their contracts in four one-year segments before being subject to competitive bidding again. To earn award fees from Medicare, the contractors will have to meet or exceed certain performance requirements that include enhanced provider customer service, increased payment accuracy, improved provider education and training, and cost savings resulting from efficiencies and innovation. CMS said it intends to issue 23 contracts by 2011 as required under the contracting reforms in the Medicare Prescription Drug Improvement and Modernization Act of 2003.

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