Centers for Medicare & Medicaid Services Awards NCI $21M Prime Hearings and Applications Contract

July 13, 2021

Federal industry leader brings deep knowledge of Medicare appeal processing to support Office of Hearings and Inquiries

RESTON, Va., July 13, 2021NCI Information Systems, Inc. (NCI), a leading provider of advanced information technology solutions and professional services to U.S. federal government agencies, today announced it has won a $21 million prime contract with the Centers for Medicare & Medicaid Services (CMS). Under the contract, NCI will provide professional services to support the Office of Hearings and Inquiries in the review of the Risk Adjustment Data Validation (RADV) appeals and administrative management of Medicare Geographic Classification Review Board (MGCRB) applications and cases.

“We are honored that CMS has selected us to support this work that is critical to the agency mission in serving the health care needs of citizens across our nation,” said NCI President and CEO Paul Dillahay. “Our team is especially excited to continue our more than 20 years of service to HHS and CMS. By leveraging our deep understanding of the agency’s processes, together with our decades of success in developing effective data management solutions, we look forward to providing CMS with insights that are defensible, accurate and timely.”

Under the contract, which has one base year and four optional years, NCI will provide intake, preliminary review, support of hearing logistics, appeal adjudication recommendations and disposition support to the CMS Office of Hearings and Inquires for their processing of RADV appeals. Additionally, the company may provide support to the MGCRB regarding the managing, processing and verifying of applications, as well as processing post-decision actions.

NCI supports CMS on multiple mission-critical programs, including the Comprehensive Error Rate Testing (CERT) contract and the Payment Error Rate Measurement (PERM) contract. Both programs employ NCI’s artificial intelligence (AI) and intelligent automation capabilities to improve productivity and effectiveness of the program and payment integrity efforts. NCI will use that experience to make recommendations on the new contract, as well as its thorough understanding of second-level Medicare appeals derived from 20 years of experience working on CMS Center for Program Integrity and CMS Office of Financial Management contracts.