Medicare Secondary Payer Integration Contractor

Added: Dec 06, 2016 4:08 pm ************ Request for Information (RFI): *************

Regarding the Medicare Secondary Payer Integration Contractor Procurement

I. Background
In an effort to comply with the legislative mandate included in Public Law 112-242 [Strengthening Medicare and Repaying Taxpayers Act (SMART Act) of 2012] the Centers for Medicare & Medicaid Services (CMS) will issue a request for proposal from offerors who will assist it in meeting its responsibility to oversee and manage the Medicare Secondary Payer operations.

Currently that oversight and management is performed by the Medicare Secondary Payer Integration Contractor (MSPIC). CMS requires the MSPIC contractor to work in concert with the Coordination of Benefits & Recovery (COB&R) contractors to enable CMS to facilitate, track and develop processes which ensure that Medicare beneficiary claims are paid first by the primary payer (whether Medicare, employer insurance or other insurance). The MSPIC contractor will work with the other COB&R contractors to collect, monitor and coordinate the individual work of each contractor into one information base. This information will include but is not limited to, program wide management, business analysis, outreach and education, associated change control processes for all COB&R contracts. The performance of the MSPIC contract coordination requirements will allow CMS to more efficiently identify and recover claims paid conditionally or improperly by Medicare as the primary payer in the most cost effective and efficient manner.

II. Purpose of this Request for Information
The purpose of this RFI is to solicit industry and public comment with respect to the draft Statement of Work (SOW). CMS is interested in industry feedback regarding any area in the SOW that in the respondent’s opinion might require clarification or additional details. It is important that CMS obtain feedback related to the SOW in advance of the upcoming MSPIC procurement so that CMS is able to capture and consider concerns, and suggestions, if any, that might provide potential Offerors the ability to more fully respond to the up-coming request for proposal.

III. Instructions:
• In the event the reviewer desires to make a comment to the SOW that comment or comments should be emailed to Lauren Holsey at Lauren.holsey@cms.hhs.gov.

• Each comment should be reflected on the attached spreadsheet and should specify the exact SOW section (and subsection) as well as the paragraph within the SOW section to which the comment applies so as to allow CMS to fully understand the context, meaning and impact of the comment.

• All comments should be received not later than Friday December 16, 2016. Comments received later than 5pm on Friday December 16, 2016 will not be considered.


Attachments:
Attachment 1 - DRAFT Statement of Work
Attachment 2 - RFI Comment Sheet