MAXIMUS FEDERAL SERVICES, INC. - IGF::OT::IGF ELIGIBILITY APPEALS OPERATIONS SUPPORT
Key Details
Description
IGF::OT::IGF ELIGIBILITY APPEALS OPERATIONS SUPPORT
Context & Analysis
Department of Health and Human Services obligated $286,915,228.65 to MAXIMUS FEDERAL SERVICES, INC. for igf::ot::igf eligibility appeals operations support. The award is classified under NAICS 541611. Performance is located in VA. This award is one of several similar procurements from Department of Health and Human Services under NAICS 541611 — related awards are listed below.
Contractor Information
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IGF::OT::IGF THE CERT PROGRAM CALCULATES BI-ANNUAL IMPROPER PAYMENT RATES BASED ON THE RESULTS OF THE REVIEWS CONDUCTED. THESE RATES INCLUDE AN OVERALL NATIONAL MEDICARE FFS IMPROPER PAYMENT RATE AND IMPROPER PAYMENT RATES FOR EACH CLAIM TYPE [PART A INPATIENT HOSPITAL PROSPECTIVE PAYMENT SYSTEM (PPS); PART A EXCLUDING INPATIENT HOSPITAL PPS; PART B; AND DURABLE MEDICAL EQUIPMENT, PROSTHETICS, ORTHOTICS, AND SUPPLIES (DMEPOS)]. THE CERT PROGRAM ENSURES A STATISTICALLY VALID RANDOM SAMPLE; THEREFORE, THE IMPROPER PAYMENT RATE CALCULATED FROM THIS SAMPLE IS CONSIDERED TO BE REFLECTIVE OF ALL OF CLAIMS PROCESSED BY MEDICARE FFS PROGRAM DURING THE REPORT PERIOD. CMS ALSO USES THE CERT PROGRAM TO PERFORM SPECIAL STUDIES AND SUPPLEMENTAL MEASUREMENTS TO DETERMINE THE IMPROPER PAYMENT RATES OF PARTICULAR CLAIM TYPES. CALCULATIONS OF THESE RATES FACILITATE CMS ABILITY TO TAKE APPROPRIATE CORRECTIVE ACTIONS TO REDUCE IMPROPER PAYMENTS.
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