Signature Consulting Group (SCG) will support the Centers for Medicare & Medicaid Services (CMS) eligibility determinations for the Patient Protection and Affordable Care Act (PPACA or ACA) Health Insurance Exchanges.

Signature Consulting Group (SCG) will continue its support from the 2024 payment notice to manage and analyze the policy impact of the public comment for CMS’s 2025 Payment Notice. The Department of Health and Human Services (HHS), Centers for Medicare & Medicaid Services (CMS) 2025 Payment Notice defines the benefit and payment parameters and standards for the ACA Marketplace that all agents, brokers, web-brokers, and issuers assisting consumers are required to follow.

Signature Consulting Group (SCG) will support the Department of Health and Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), providing support for the Health Equity Executive Order to Advance Racial Equity and Support for Underserved Communities.

Signature Consulting Group (SCG) will manage and analyze the policy impact of the public comment to CMS 2024 Payment Notice. The Department of Health and Human Services (HHS), Centers for Medicare & Medicaid Services (CMS) 2024 Payment Notice defines the benefit and payment parameters for the finalized standards for issuers and Marketplaces, and all requirements for agents, brokers, web-brokers, and issuers assisting consumers with enrollment through Marketplaces that use the federal platform. In 2023, the final rule strengthened the coverage offered by qualified health plans (QHPs) on the federal Marketplace to ensure consumers will more easily find the right level of health quality and affordable coverage for their circumstances.

Signature Consulting Group (SCG) has been developing for CMS Robotic Process Automation (RPA) solutions for various departments within the Office of Human Capital’s (OHC) enterprise systems and workflows. SCG works closely with OHC stakeholders surveying and performing analysis to identify areas of opportunity to improve the user experience and automate ongoing manual processes using RPA. Implementing RPA has greatly reduced redundant manual data entry into multiple systems, eliminated risk of human errors across business processes, improved data integrity and quality, streamlined operational processes, reduce agency operational cost, and improves overall efficiency and performance.

Signature Consulting Group (SCG) will continue to apply Independent Coding Consultant (ICC) for expert coding support for the medical record reviews (MRR) for the Contract-Level Risk Adjustment Data Validation (RADV) Program to the Centers for Medicare and Medicaid Services (CMS), Center for Program Integrity (CPI). The purpose of the RADV Program is to measure the extent to which inaccurate diagnosis codes affect associated payment for MA beneficiaries by estimate Contract-Level risk-adjustment payment-error for payment adjustment and payment recovery efforts. SCG will provide our coding subject matter expertise in supporting of training, guidance to validate and clarify the RADV and MRR process.

Signature Consulting Group (SCG) is working on the Palmetto GBA team’s Data Analytics Group which works across their Medicare Administrative Contractor (MAC) Jurisdiction M (JM) MAC jurisdictions and National Provider Enrollment DEMPOS West Programs. MACs are multi-state, regional contractors responsible for administering both Medicare Part A and Medicare Part B claims. Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) are responsible for issuing or revoking Medicare supplier billing privileges for DMEPOS suppliers. SCG’s Statistical Analyst will support data analytics providing sophisticated data interpretation, compilation, and verification to guide improvements and efficiencies across the MAC and DEMPOS programs.

BALTIMORE, Md.—The Centers for Medicare (CM), under the Centers for Medicare and Medicaid Services (CMS), awarded a prime contract to Signature Consulting Group (SCG) to serve as the Independent Verification & Validation (IV&V) contractor for the Risk Adjustment Data Validation (RADV) program. SCG will be ensuring the quality and assisting in the auditing of medical record review to validate the accuracy of risk adjustment data for Part C payments and the payment errors audits related to the Part D payment accuracy of sampled Prescription Drug Event (PDE) records. SCG has developed a set of rapid agile test automation tools that will be used to expand testing capacity and verification effectiveness to the RADV Audits.

Signature Consulting Group (SCG) will continue to apply digital and data analytics services and system integration in support of the Centers for Medicare & Medicaid Services’ (CMS) Office of Human Capital (OHC) modernization of HR business system workflows and data management.

As part of an expansion into more Health IT sectors, Signature Consulting Group (SCG) has partnered as a sub-contractor with Liberty IT Solutions to support the Veterans Affairs Administration (VA) on two awarded contracts: the Health Integration and Modernization (HI&M), $434 million; and Product and Technology Ecosystem and Management Services (PTEMS), $974 million.

As part of this Information Technology (IT) and Health IT services IDIQ, SCG will continue to extend its support and services into the Veterans Affairs (VA) Department.

Centers for Medicare and Medicaid (CMS) selects Signature Consulting Group (SCG) for the award of the Provider Customer Service Program (PCSP).