MAXIMUS receives contract to review reconsiderations of Medicare Part D program

MAXIMUS (NYSE:MMS), a leading provider of government services worldwide, announced today that its Federal Services subsidiary has been awarded a one-year contract by the Centers for Medicare & Medicaid Services (CMS) to continue to serve as an independent review entity for reconsiderations of beneficiary appeals for the Medicare Part D program.

The Company has performed this work since the Medicare prescription drug program was implemented in January 2006. The one-year contract is valued at approximately $14.3 million and includes a nine-month option period, which brings the total contract value to $25.0 million if this option is exercised.

“MAXIMUS Federal has been the sole provider of Part D appeal reconsiderations since the inception of the Medicare Part D program. This latest contract award from CMS underscores our role as a leading QIC and allows us the opportunity to process Medicare Part D reconsiderations across the entire country.”

As the Part D Qualified Independent Contractor (QIC), MAXIMUS Federal acts as the independent review entity responsible for conducting reconsiderations of adverse coverage determinations and redeterminations made by Part D plans in the Medicare Prescription Drug Program. Under the current contract, MAXIMUS Federal also conducts reconsiderations of adverse determinations related to prior creditable prescription drug coverage and imposition of a late enrollment penalty under the Medicare Part D program. In addition to Medicare Part D, MAXIMUS Federal also performs reconsiderations nationally as Part A and Part C QICs.

“MAXIMUS is committed to providing unrivaled service in the administration of government health and human services programs as we seek to expand our client relationships,” commented MAXIMUS CEO Richard Montoni. “MAXIMUS Federal has been the sole provider of Part D appeal reconsiderations since the inception of the Medicare Part D program. This latest contract award from CMS underscores our role as a leading QIC and allows us the opportunity to process Medicare Part D reconsiderations across the entire country.”

In addition, MAXIMUS Federal is also recognized as the industry leader for government-sponsored health reconsideration and appeals programs at the state level, and operates clinical review projects for 30 state regulatory agencies. With over 200 health reconsideration experts across the Company, MAXIMUS delivers experience and thought leadership to the critical process of health appeals reconsiderations. MAXIMUS Federal provides specialized services through a blend of professionals, including physicians, pharmacists, and attorneys, who are able to navigate the challenging and often complex regulations encompassing health reconsiderations and appeals.

MAXIMUS Federal Services is fully accredited by the Utilization Review Accreditation Commission as an independent review organization. Many of the Company’s independent review programs are also ISO 9001:2008 certified. Since 1989, MAXIMUS has completed more than 750,000 reconsiderations.