Medicare Managed Care Organizations (MCOs) Cost Reports

The Centers for Medicare and Medicaid Services is seeking contractors to conduct detailed examinations of cost reports submitted by cost-based Medicare Managed Care Organizations. The primary responsibility involves reviewing these reports to verify the accuracy and integrity of medical coding practices, ensuring that reimbursement claims align with established standards and regulatory requirements. This work is critical to safeguarding the financial integrity of the Medicare program by identifying potential overpayments, coding errors, or fraudulent submissions. The contract opportunity is forecasted with a NAICS code of 541211, indicating it falls under the accounting, auditing, and bookkeeping services category. The point of contact for the program is Frank Cisar, while Evan Seltzer serves as the contracting officer, reachable via email. The work is expected to be performed in alignment with CMS guidelines, though specific performance locations are not listed. This opportunity is intended for entities with expertise in healthcare financial analysis and medical coding validation, and all interested parties should monitor the official forecast listing for updates on the formal solicitation.