The Commonwealth of Pennsylvania, Department of Public Welfare, has awarded CGI (Fairfax, Va.) a contract renewal worth $44.9 million, including a four-year base and two, two-year option periods, to help prevent, detect, deter, and correct provider improper payments within Pennsylvania's Medicaid Medical Assistance (MA) program.
With enrollment in Pennsylvania's MA program providing healthcare benefits to approximately 2.1 million people, the Department of Public Welfare requires constant, careful reviews to ensure that healthcare dollars are spent to provide quality medical services and not lost to improper payments. Under the contract, CGI will use its proprietary data mining software, the Customized Audit System (CAS), to conduct reviews of claims and records, identify over and underpayments for recovery, and provide support for appeals activities.