We are pleased to announce that NHA has received a sole source award from the Centers for Medicare and Medicaid Services (CMS) to continue serving as the Evaluation and Oversight (E&O) contractor.
As the E&O contractor, NHA will evaluate the accuracy, consistency, timeliness, and quality of the Medicare appeal decisions made by the Qualified Independent Contractors (QICs) for Medicare Fee for Service (FFS), Part C and Part D, the Medicare Administrative Contractors (MACs), and evaluate information contained on the Part C and Part D QICs Appeals Database.
This contract runs through 2023 and consists of a base year plus one option year. NHA previously served as the E&O contractor from 2017-2021. During this time, NHA reviewed more than 1000 appeals decisions per year and implemented a consistent auditing approach for each discrete QIC workload that was later applied to review MAC decisions as well.
We are excited to continue our work on the E&O Contract.