CMS is seeking a contractor to build and maintain a website to streamline information from Medicare review programs on enforcement actions against Medicare providers.
Currently, CMS uses a number of private companies to review claims and medical documentation and ensure Medicare providers are compliant. These review contractors send claim review information and reports to CMS via email, and the information is then uploaded into a data warehouse. Each review contractor posts the results on their own websites for providers to view.
The current system lacks a way for review contractors to make sure they are not reviewing the same topic for the same provider at the same time. It also lacks a way for providers to view all their education activities and Medicare review information in one convenient location.
The new website will allow both CMS and its review contractors to view provider profiles, which will contain information on when the provider received one-on-one education, which claims were reviewed by which review contractor and if it was referred for other reviews. Providers will also be able to view their profiles on a single website, the future ProviderMedicare.gov.
Applicants must submit proposals by June 18. CMS plans to award the contract Sept. 30 and the performance period will run through Sept. 29, 2017.
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