Performant Healthcare Solutions Re-Awarded CMS Medicare Secondary Payer Commercial Repayment Center Contract
December 19 2022 - 7:30AM
Business Wire
Performant Healthcare Solutions (Nasdaq: PFMT), (“Performant”,
“the Company”), a leading provider of technology-enabled payment
integrity, eligibility and related analytics services, today
announced that the Centers for Medicare and Medicaid (CMS) awarded
Performant the Medicare Secondary Payer (MSP) Recovery Audit
contract also known as the Commercial Repayment Center (CRC) for a
6-year term consisting of one base year and five option years. The
is a contingency fee contract; CMS pays Performant a percentage of
overpayment recoveries returned to the Medicare Trust Fund.
Performant has been the incumbent MSP CRC contractor since
September 2017 and since then through the end of FY 2021 the
Company has increased recoveries to the Medicare Trust Fund by
nearly 340% per year.
“This contract win is an affirmation of our demonstrated history
of continuous improvement that has resulted in annually increasing
and record setting recoveries to the MSP CRC program,” stated
Simeon Kohl, President of Performant. “We are honored to serve CMS
as one of our longest healthcare partners. And we are excited to be
recognized by CMS as a best value contractor on multiple, national
programs. These programs afford Performant a unique view of the
national healthcare landscape and trends.”
Under the program, Performant is responsible for identifying and
recovering payments in situations where CMS should not be the
primary payer of healthcare claims because a beneficiary has other
forms of insurance coverage, such as through an employer Group
Health Plan or certain other payers.
In addition to the MSP CRC contract, Performant also serves as
the CMS Recover Audit Contractor (RAC) for Regions 1, 2 and the
nationwide Region 5 for Durable Medical Equipment, Prosthetics,
Orthotics and Supplies (DMEPOS) and Home Health and Hospice
(HH&H) claims. Further, Performant was recently selected as the
sole national medical reviewer for the Health and Humans Services
Office of the Inspector General.
ABOUT PERFORMANT Healthcare Solutions
Performant Healthcare Solutions is a leading provider of
technology-enabled audit, recovery, and analytics services in the
United States with a focus in the healthcare payment integrity
industry. Performant works with healthcare payers through claims
auditing and eligibility-based (also known as
coordination-of-benefits) services to identify improper payments.
The Company engages clients in both government and commercial
markets. The Company also has a call center which serves clients
with complex consumer engagement needs. Clients of the Company
typically operate in complex and highly regulated environments and
contract for their payment integrity needs in order to reduce
losses on improper healthcare payments.
Powered by a proprietary analytic platform and workflow
technology, Performant also provides professional services related
to the recovery effort, including reporting capabilities, support
services, customer care and stakeholder training programs meant to
mitigate future instances of improper payments. Founded in 1976,
Performant is headquartered in Livermore, California.
To learn more, please visit https://www.performanthealth.com
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Richard Zubek, Investor Relations Performant Financial
Corporation (925) 960-4988 investors@performantcorp.com
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