G2X TAKE: RELI Group, a very fast growing 8(a) HUBZone small business and a major partner to CMS, recently added a new 3-year contract to provide Quality Assurance Monitoring (QAM) at Medicare Administrative Contractor (MAC) Provider Contact Centers (PCCS). The contract was awarded as an 8(a) sole source action.
“This is a CMS mission critical requirement – quality assurance is an extremely important part of CMS’ oversight of MAC PCCs and of the provider’s experience with Medicare.”
“The contractor shall support CMS with the QAM process, used to determine the accuracy, completeness, professionalism, and adherence to the Privacy Act of CSR responses to telephone inquiries at Medicare PCCs. To perform QAM, the independent monitoring contractor is required to access and maintain a secure connection (via CMSNet) to the MAC quality monitoring systems, thus enabling access to the MAC audio call recordings while viewing the video file of the CSR screen navigation. Each MAC owns and maintains its own system. These systems vary, but in general, they are from one of the leading industry vendors in the marketplace (i.e., Call Copy, NICE, Qfiniti, and Verint). The contractor shall work with CMS and the MACs to ensure that the MAC systems permit proper access.”
“In addition, QAM requires the Contractor to provide a team of Quality Monitors (QM) with expertise in quality assurance, Medicare policy, and the ability to interpret visual recorded CSR screen navigation (i.e. FISS, MCS, HIMR, CWF, HETS, and VMS), claims, and various systems while listening to the audio of inbound provider calls received in MAC PCCs nationwide.” See an early sources sought and Draft SOW released late last year here.
- When you win a lot, you hire a lot and RELI Group has done plenty of that, adding several strategic hires thus far in 2020, to include Senior Proposal Manager Gaurav Madaan and Suzanne (Blazar) Pasternak to drive Strategic Growth and proposals and industry leader Mike Sacca to serve as Vice President of Healthcare and Data Analytics. These hires come on the heels of adding another established industry veteran, Frank Gorton, as VP late last year.
- Just some of the recent wins at CMS for RELI Group include a 2-year CMS PCG Initiatives Data Analysis and Error Rate Reduction Contract; a 4-year contract to support the CMS Audit Correspondence Tracking System (ACTS) program; a task to provide Marketplace Integrated Data Collaboration and Analytics Platform (MIDCAP) Management; an Electronic Submission of Medical Documentation (ESMD) Development Applications and Technical Support (DATS) task; a 5-year Administrative Simplification Enforcement and Testing Tool (ASETT) support task; a $23.6M Medical Review Accuracy Contract Award; a 3-year contract to deliver mission-critical support to two websites owned and managed by CMS, Medicaid.gov and InsureKidsNow.gov; two Risk Adjustment Data Validation Medical Record Review Contractor A support tasks; a task award to support end-stage renal disease quality incentive program data validity and reliability; a 5-year award to provide support to CMS for Comparative Billing Reports (CBR); a $25M CMS Medical Record Review Contractors (MRRC)-A Support contract; and a 2-year task to provide CMS Audit Administrative Tracking Tool Support.
- RELI Group maintains a Prime position on nearly every key contract vehicle at CMS, to include CMS SPARC, the $5B CMS RMADA II IDIQ, $25B CMS Network of Quality Improvement and Innovation Contractors (NQIIC) IDIQ, $1.6 Billion CMS Measure and Instrument Development and Support (MIDS) IDIQ, GSA 8(A) STARS II, and CIO-SP3 SB.
- Led by President and CEO, Sam Elias, RELI Group was recently named one of the NXT UP firms poised to make big waves in the Federal sector in 2020 and for years to come.
Included below is a snapshot of Prime Obligations for RELI at CMS by fiscal year and NAICS.