The Commonwealth of Pennsylvania, Department of Public Welfare, has awarded CGI a contract renewal worth $44.9 million to help prevent, detect, deter and correct improper payments within Pennsylvania's Medicaid Medical Assistance program.
[See also: HHS aims to fund state efforts against Medicaid fraud .]
With enrollment in the program providing healthcare benefits to approximately 2.1 million people, the Department of Public Welfare requires constant, careful reviews to ensure that healthcare dollars are spent to provide quality medical services and not lost to improper payments, officials say.
Under the contract, which includes a four-year base and two two-year option periods, CGI will use its proprietary data mining software, the Customized Audit System (CAS), to conduct reviews of claims and records, identify over and underpayments for recovery, and provide support for appeals activities.
[See also: CGI delivers Medicaid EHR solution to Texas HHS.]
"We look forward to continuing our successful, 10-year partnership with the Department of Public Welfare," said Nazzic Turner, CGI's senior vice president and general manager, U.S. enterprise markets. "CGI brings a 20-year track record of claims review success to the partnership, recovering nearly $69 million dollars in improper payments for Pennsylvania."