SMRC: Noridian is in, StrategicHealthSolutions is out

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Friday, May 11, 2018

FARGO, N.D. – Noridian Healthcare Solutions has taken over yet another CMS contract.

The company, which is already the Medicare Administrative Contractor for jurisdictions A and D, and the Pricing Data Analysis and Coding contractor, among other things, has been awarded a $227 million contract to be the new Supplemental Medical Review Contractor.

“Noridian has extensive DME experience in the field, so this is definitely in their wheelhouse,” said Andrea Stark, a reimbursement consultant with MiraVista. “I think this is a good thing for the HME industry going forward.”

CMS previously contracted with Omaha, Neb.-based StrategicHealthSolutions to conduct post-pay review audits as the SMRC.

Reimbursement consultant Mary Stoner also believes Noridian is a good pick to be the SMRC. She has worked closely with the company in her work on the DMERC Advisory Committee for Jurisdiction D.

“They’re a go-to for us on that committee,” said Stoner, president of Electric Billing Service Inc. “When we’ve had questions for the SMRC that we’ve sent over and over and over, and never received a response. We already have a relationship with Noridian, so we know they’re going to be taking and answering those questions.”

There are some, however, that take pause with giving Noridian the power to conduct not only pre-pay reviews as a MAC but also post-pay reviews as the SMRC.

“People are a little uneasy with that,” said Ronda Buhrmester, a reimbursement specialist with The VGM Group. “So they’re not sure about it yet.”

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