EDS, an HP company, today announced that the Centers for Medicare & Medicaid Services (CMS) awarded EDS subsidiary NHIC Corp. a contract to administer Part A and Part B Medicare claims payments for health care providers in five northeastern states.
The contract is worth $176 million if all options are exercised for the next five years.
The Medicare Administrative Contractor (MAC) Jurisdiction 14 contract will help streamline Part A and Part B Medicare claims processing work done in Maine, Massachusetts, New Hampshire, Rhode Island and Vermont (Jurisdiction 14). The contract will serve approximately 1.7 million Medicare fee-for-service beneficiaries, almost 80,000 physicians and practitioners, and 220 Medicare hospitals in Jurisdiction 14.
NHIC will serve as the first point of contact for the processing and payment of Medicare fee-for-service claims from hospitals, skilled nursing facilities, physicians and other health care providers within Jurisdiction 14. NHIC will assume full responsibility for the claims processing work that is currently performed by three fiscal intermediaries and two carriers.
NHIC also will administer Medicare claims filed by home health and hospice providers in the five Jurisdiction 14 states, as well as Connecticut. Additionally, NHIC will provide educational services to providers and state medical associations about claims transfers.
National Government Services, Inc. was selected as a subcontractor to deliver home health claims and institutional provider payment processing support and expertise.
The contract will help CMS fulfill the contracting requirements of the 2003 Medicare Modernization Act, which requires the agency to transition Medicare fee-for-service claims from fiscal intermediaries and carriers to Medicare Administrative Contractors.
NHIC will provide education and information regarding the transition to Medicare providers and provider associations in Jurisdiction 14 via mailings, email distribution and website publications. NHIC will host webinars and conference calls and provide a toll free hotline to support various transition activities.
“The breadth of skills and experience from EDS subsidiary NHIC will help CMS achieve its goal of consolidating its benefits processing operations while saving money, promoting innovation and realizing operational efficiencies,” said Dennis Stolkey, senior vice president of U.S. Public Sector at EDS, an HP company. “EDS has been a CMS Medicare partner since 1965, and this opportunity allows us to provide additional technical support for Medicare.”
NHIC currently supports CMS as a Durable Medical Equipment Medicare Administrative Contractor in 11 northeastern states and the District of Columbia, and it administers Medicare Part B claim payments as a Medicare contractor in New England.
With more than 7,000 health care experts supporting clients in 30 countries, EDS has provided support services to Medicare and Medicaid clients for more than 40 years. It now processes more than 270 million Medicare claims and about 1 billion Medicaid claims per year. EDS provides an array of technology services for CMS and Medicare contractors, including data center services, maintenance of the Medicare Part B system, and non-base system support.
