The Commonwealth of Virginia's Department of Medical Assistance Services has signed a deal with HMS for the New York firm to audit community mental health and other behavioral health providers that participate in the Virginia Medicaid program.
The contract is for three years, with three optional renewal years.
HMS will perform audits of in-state and out-of-state provider services, including outpatient psychotherapy and substance abuse, therapeutic day treatment, mental health support services and intensive in-home therapy.
DMAS may add additional provider classes as it deems necessary.
HMS will provide DMAS with information necessary to validate or substantiate erroneous claims or issues, notify providers of audit findings and support recovery of any overpayments.
As part of the process, HMS will work with DMAS to educate providers on billing and compliance issues so that providers and the program can reduce billing errors and avoid overpayments.
HMS coordinates benefits and program integrity services for government healthcare programs. The company's clients include health and human services programs in more than 40 states, 90 Medicaid managed care plans, the Centers for Medicare and Medicaid Services and Veterans Administration facilities.