CMS awards $5.5M deal for incentive payment services

By Mary Mosquera
10:01 AM

The Centers for Medicare and Medicaid Services is readying a set of electronic accounting and processing tools that will help authenticate, track and manage payments to healthcare providers participating in the federal <a href="/directory/meaningful-use" target="_blank" class="directory-item-link">meaningful use financial incentive program.

To support its efforts, CMS recently awarded a $5.5 million five-year contract to National Government Services Inc., a large Medicare contractor in 20 states, to assist in preparing and processing incentive payments beginning in fiscal 2011.

The services will help ensure the proper accounting of the payments to eligible physicians and hospitals under the HITECH Act, according to CMS.

The agency has estimated that up to 50,000 physicians and more than 2,000 hospitals will participate in the first year of the meaningful use program.

Indianapolis-based National Government Services will develop software to create provider incentive payment files, prepare the files to prompt payment and track the payments.

Data will flow into this system from CMS's National Level Repository (NLR), which will contain healthcare providers' registration for incentive payments, documents verifying their eligibility and banking information for each recipient.

An NLR rules engine will calculate the provider payment amounts, verify meaningful use, check for duplicate payments and maintain the incentive payment history files.

Other CMS Medicare administrative contractors will supply supporting information about participating Medicare providers, such as their identification numbers, banking information and medical claims payments history.  
National Government Services will develop the technical format for the incentive payment files that the contractor will download monthly from the database to support that month's batch of payments.

The company will transmit through a CMS secure network standard payment files to the Medicare bank for provider payments. The company will also process paper check payments for providers who don't have electronic funds information available.