Maximus to process Medicare appeals

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.

About the Author

David Hubler is the former print managing editor for GCN and senior editor for Washington Technology. He is freelance writer living in Annandale, Va.

Reader Comments

Mon, Mar 9, 2009 billygriggs louisville,ky.

there was a waiver sent in sept.5 2008 concerning an accident 10/02/06 I would like to know if medicare is going to release more of the money they say they over paid.

Wed, Jan 28, 2009

I used to work on the Late Enrollment Penalties. This whole program is a joke. It is costing the American Taxpayer millions by paying Maximus to enforce a program that is completely senseless. The elderly and disabled are being charged a Late Enrollment Penalty when they couldn't afford to pay for a Part D prescription plan in the first place. How much sense does that make? Only the insurance companies and Maximus benefit by this program

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