CNSI Wins $35M Medicare Data Processing Contract

Adnan Ahmed, CNSI

Adnan Ahmed, CNSI

CNSI has been awarded a $35 million contract to develop a next-generation data processing system for Medicare claims.

The 4.5 year-long contract, awarded by the Centers for Medicare and Medicaid Services, will help the agency process “encounter data,” the records that contain clinical and diagnostic information generated by health care providers during visits by Medicare Advantage (Medicare Part C) beneficiaries.

CNSI has worked as a subcontractor maintaining the operations of the existing Encounter Data Processing System for five years, and has made significant investments in modernizing its claims processing platform to increase its accuracy and the number of encounters it can handle, the company said.

“In the last decade, CNSI has developed unparalleled experience in large-scale health IT projects,” said Vijay Mishra, CNSI senior vice president of federal programs. “From our implementation of several state Medicaid Management Information Systems to our experience operating the existing EDPS, we are perfectly suited to execute this project.”

CMS must process tens of millions of encounters weekly, analyzing the data to make appropriate adjustments to Medicare Advantage Organization reimbursements. Doing that work in a timely manner is a “monumental technological task,” which will be aided by the new EDPS, CNSI said.

Adnan Ahmed, CNSI co-founder and president, said he was pleased CMS allowed CNSI to expand on its previous work by developing the next generation of the EDPS system.

“The EDPS is a critical piece of public health infrastructure,” Ahmed said. “As a company, we have a long history of executing enterprise-level health IT projects. I’m excited to see CNSI meet – and exceed – CMS’ expectations for the next generation EDPS.”


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