HMS picks up Marketplace Management Compliance Reviews task

G2X TAKE: Leveraging Healthcare Management Solutions, LLC (HMS)’s prior experience working alongside CCIIO in support of their oversight and monitoring of Issuers who offer Qualified Health Plans in the Federally-Facilitated Marketplace, this woman-owned small business and CMS SPARC Prime, who carries a blend of clinical and IT expertise intended to touch the entire Healthcare delivery lifecycle of its primary customer, the Centers for Medicare & Medicaid Services (CMS), recently beat out two other bidders to be awarded a new 3-year task. This task was awarded using GSA Professional Services Schedule (PSS).

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  • HMS is a known incumbent on this effort, having been awarded a 3-year contract in 2016 for Marketplace Plan Management Compliance Review. They also bring a broad set of past performance in support of CMS ranging from providing Oversight of State Performance and Federal Oversight and Training in Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID), to support efforts to Survey Organ Transplants. 
  • HMS’ compliance related past performance with CMS includes reviewing the Qualified Health Plans (QHPs) offered on Healthcare.gov; performing clinical quality data validity and reliability testing; reviewing, editing, and remediating approximately 8,100 documents annually for section 508 compliance; and investigating and resolving automated system exceptions associated with Medicare beneficiary enrollments, direct billing, or third-party transactions on behalf of CMS. Source: HMS
  • Led by President, Leah Heimbach, late last year, HMS added William Turner as Chief Strategy Officer to assist with developing, communicating, executing, and sustaining corporate strategic initiatives in the areas of commercial, state and Federal Healthcare marketplaces, while expanding HMS into adjacent verticals and markets of Defense and Veterans Healthcare.
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