Maximus to process Medicare appeals

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Maximus will provide outsourcing services to the Centers for Medicare and Medicaid Studies.

Maximus Inc. will provide outsourcing services for the Centers for Medicare and Medicaid Studies to facilitate its appeals process under a three-year contract that could be worth as much as $13.1 million.

Under the contract, Maximus Federal Services will render binding and impartial determinations for disputed Medicare Part A claims and Provider Service Terminations, company officials said. The award encompasses all Medicare standard and expedited appeals for Medicare Fee for Services Part A in 24 western U.S. states, Guam, the Northern Mariana Islands and American Samoa.

As a qualified independent contractor to CMS, Maximus currently provides Medicare Part A appeals processing for the eastern half of the United States and nationwide for Medicare Part C and the prescription drug program, Part D.

The provider of health and human services program management and consulting services, based in Reston, Va., has partnered with CMS on Medicare projects since 1989.

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