Thursday, May 31, 2012

Colorado taps HMS for insurance buy-in program

DENVER – HMS, which develops coordination of benefits and program integrity technology for payers, has been awarded a contract to administer Colorado's Health Insurance Buy-In (HIBI) Program and its Medicare Buy-In project.

Under the terms of the contract, awarded by Colorado's Department of Health Care Policy and Financing, New York-based HMS will perform outreach and enrollment services for Medicaid beneficiaries who may be eligible for HIBI – a health insurance premium payment (HIPP) program – or Medicare. The contract is renewable for additional one-year periods for a maximum term of five years.

"HIPP programs are designed to save taxpayers money by assisting qualifying Medical Assistance beneficiaries in taking advantage of employer sponsored health insurance, which in many cases may be more cost effective and offer broader benefit coverage than traditional Medicaid agency options," said Maria Perrin, HMS chief business officer. "HIPP furthers states' efforts to help citizens access the most comprehensive healthcare coverage available via flexible enrollment programs."

As states begin to implement health insurance exchanges (HIX) in accordance with the Affordable Care Act, she added, "it will be increasingly important to ensure that the multiple coverage options available to consumers are effectively coordinated between public and private sources and that private insurance coverage options are retained as alternatives for as many individuals as possible."

HMS has provided third party liability and cost avoidance services to Colorado since 2001. During that time, officials say, HMS has recovered more than $230 million on behalf of the state and helped achieve millions more in cost avoidance savings.

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