AWARD: Contract to support CMS PPFMG Audit Programs

Posted (Last updated )

G2X TAKE: This 3 year contact awarded out of the CMS’ Center for Consumer Information and Insurance Oversight is to utilize predictive modeling and other business intelligence tools to perform analysis for the Medicare Part C RADV Program, and to validate reports generated by the RADV Central Data Abstraction Tool (CDAT).

This $4M contract, awarded to SPARC awardee, Signature Consulting Group (SCG), is part of a larger effort to develop audit programs that will be used by PPFMG to audit entities that perform financial management functions for Healthcare Exchanges and to provide the analytic support needed to evaluate and monitor the financial management and oversight of ACA related programs. SCG will also provide comprehensive program support, expert risk adjustment, and medical record review (MRR) support for the Medicare Part C RADV audits and appeals process for the Medicare Plan Payment Group (MPPG).

This contract represents the second consecutive award that SCG has received to provide these services.

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