National Government Services, a subsidiary of WellPoint, has been selected by the Centers for Medicare & Medicaid Services to administer the Medicare administrative contract for jurisdiction 13, which includes the states of New York and Connecticut, US.
National Government Services (NGS) will perform key Medicare administrative functions for its contracts with hospitals, skilled nursing facilities and physicians, including – appeals, audit and reimbursement, claims processing, medical review and local coverage determinations.
The contract consists of one base year and four one-year options, and is worth up to $323 million over the five-year period. This Medicare administrative contract applies to part A and part B sections of Medicare, which include hospitals, skilled nursing facilities and physicians.
NGS will partner with MedUS Services, the upstate New York part B incumbent, for the administration of this contract. MedUS Services will process a portion of the jurisdiction 13 part B claims, appeals, medical review, provider enrollment, and provider outreach workloads.
Sandy Miller, senior vice president of WellPoint’s federal government solutions business, said: The jurisdiction 13 contract is the first for Medicare part A and B services awarded to NGS under new federal guidelines. We are committed to serving Centers for Medicare & Medicaid Services as a trusted partner, and we’re looking forward to competing for and winning additional contracts in the coming months.