EDS Subsidiary Awarded $148 Million CMS Contract for Medicare Administrative Services to Northwest

HERNDON, Va. – EDS today announced that the U.S. Centers for Medicare & Medicaid Services (CMS) has awarded its subsidiary, NHIC, Corp., a $148 million contract to administer Part A and Part B Medicare claims payments to health care providers in four northwestern states. The contract is for one year with four 1-year options and will serve approximately 54,000 physicians and practitioners and 233 Medicare hospitals within Alaska, Idaho, Oregon and Washington.

NHIC will provide a variety of important Medicare administrative functions for hospitals, skilled nursing facilities and physicians in the regions and will be the providers’ first point of contact for the processing and payment of Medicare fee-for-service claims.

Additionally, NHIC will provide a wide range of additional administrative services, including: appeals, audit and reimbursement, provider enrollment, educational outreach, print and mail services, financial and accounting services, contact center, electronic data interchange, mailroom operations and medical and utilization review.

The contract will help CMS fulfill the contracting requirements of the 2003 Medicare Modernization Act, which requires the agency to transition Medicare fee-for-service claims from fiscal intermediaries and carriers to the Medicare Administrative Contractors.

“This is another step toward improving service to beneficiaries and health care providers as well as giving CMS greater oversight of the Medicare contractors that process and pay Medicare claims,” said CMS Acting Administrator Kerry Weems.

“The breadth of skills and experience from EDS’ subsidiary, NHIC, will help CMS achieve its goal of consolidating its benefits processing operations while saving money, promoting innovation and increasing operational excellence,” said Dennis Stolkey, vice president and general manager, EDS U.S. Government and Public Sector. “EDS has been a CMS Medicare partner since 1965, and we are pleased with this opportunity to provide technical support in order to serve the Medicare and Medicaid programs.”

NHIC is one of the largest Medicare Part B contractors in the country, already serving more than 150,000 health care providers in California, Maine, Massachusetts, New Hampshire and Vermont.