CMS taps EDS for anti-fraud support services

The Centers for Medicare and Medicaid Services inoculated itself against fraud and abuse with two task orders valued at up to $120 million that it awarded to Electronic Data Systems Corp. of Herndon, Va.

CMS, an agency of the Health and Human Services Department, awarded the work under its Medicare Prescription Drug Integrity Contractor indefinite-delivery, indefinite-quantity contract.

Each task order has a base year and four one-year options. The first task order is for the One Program Integrity program and has a potential value of $94 million. The second task order is for the Medicare Prescription Drug Integrity Contract North Region program and has a potential value of $26 million, said EDS spokesman Brad Bass.

Under the task order for the One Program Integrity, EDS will consolidate all data warehousing and analytics for contractors and perform other duties to detect fraud and abuse of CMS programs. The work includes:
  • Developing and implementing a data repository
  • Loading state Medicaid data into the repository
  • Implementing analytic solutions to present the data to users
  • Developing and implementing a Web portal to allow users convenient and secure access to data.

The majority of EDS’ work on the first task order will be deploying the Web portal, which will include existing and new applications. Thomson Medstat of Ann Arbor, Mich., will work with EDS to develop the data mapping and analytic software, and EDS will refine it to the needs of CMS. Program safeguard contractors, whom CMS has hired, will access the portals to ensure proper Medicaid payments are made to proper sources, Bass said.

The MEDIC North Region task order makes EDS responsible for audits, oversight, fraud and abuse of the prescription drug program. The north region spans 25 states, including Maryland, Massachusetts, New York and Pennsylvania among others, and stretches as far west as Montana, Bass said.

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