HP Awarded $200 Million Medicare Contract

The Centers for Medicare & Medicaid Services (CMS) has awarded Hewlett-Packard Enterprise Services a contract worth up to $200 million to provide application services that improve Medicare Part B claims processing, as well as the delivery of healthcare services to beneficiaries.

The Medicare Part B Shared System Maintainer contract is for one base year with seven one-year renewal options. Medicare's Multi-Carrier System (MCS) is utilized by CMS carriers and Medicare administrative contractors (MACs) to process approximately 750 million Medicare Part B claims annually.

Medicare Part B is medical insurance that helps cover doctors' services and outpatient care. It also covers some other medical services that Part A doesn't cover, such as physical and occupational therapy and some home health care. Part B helps pay for these covered services and supplies when they are medically necessary.

HP announced Monday that the contract calls for the company to provide applications support and maintenance services, including full development lifecycle support for system maintenance and enhancements. HP services will deliver production and user support for the processing of an ever-increasing volume of Medicare Part B claims, as well as MAC transition support.

HP will also deliver related system maintenance and transition support to the Healthcare Integrated General Ledger Accounting System. This system exchanges data with the MCS for the processing of claim billing information, provider profile information, beneficiary profile information, check reconciliation, payment information, and other claim-related data.

"As the Medicare population grows, CMS continues to modernize to be able to manage and deliver transformative technology that will improve Medicare services for beneficiaries and healthcare providers alike," Dennis Stolkey, senior VP, U.S. public sector at HP Enterprise Services, said in a statement.

In support of CMS's Medicare Modernization and Affordable Care Act initiatives, HP will:

-- Implement large-scale legislative mandates such as Health Insurance Portability and Accountability Act (HIPAA) 5010 transactions and International Classification of Diseases, 10th edition (ICD-10), code sets.

-- Consolidate processing cycles or establish new MACs system environments within the CMS enterprise data centers.

-- Develop new MCS system interfaces in support of the CMS National Level Repository, which is associated with determining provider incentives for implementing electronic heath records.

To best meet the needs of CMS, HP is teaming with four small businesses to provide valuable insight and innovative IT solutions.

HP was awarded the initial Part B Shared System Maintainer contract in 1997 and has been using CMMI Level 5, the highest system and software process maturity rating, since June 2007.

In addition, HP has provided support services to Medicare and Medicaid clients since the inception of the programs, handling 35% of all Medicare and Medicaid claims in the United States, and processing 2.4 billion healthcare transactions annually -- including 1 billion in healthcare claims. HP 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.

The Medicare Part B Shared System contract was made under the Enterprise System Development indefinite-delivery-indefinite-quantity contract vehicle awarded to HP Enterprise Services by CMS in 2007.