Minimum Data Set Quality Control Tool (MDS QCT)

CMS is seeking to continue use of a Minimum Data Set Quality Control Tool (MDS QCT) by engaging a qualified, experienced, and financially sound contractor to manage, maintain, enhance and test the current software required by Medicare contractors to adjust skilled nursing facility (SNF) and hospital swing bed (SB) claims and make payments correctly. The software is also used by the Comprehensive Error Rate Testing (CERT) Contractor as part of the payment error rate calculation for SNFs and the Recovery Audit Contractors (RACs) in the recovery of overpayments. CMS Center for Program Integrity (CPI) is responsible for managing certain information systems that provide the data necessary to support Medicare claims adjustment, provider records auditing, and error rate monitoring programs. CMS requires a qualified, experienced, and financially solvent contractor to continue providing services in support of the management, enhancement, maintenance, and testing of the MDS QCT. The MDS QCT is a key application used by Medicare contractors to perform the critical functions mentioned above, and to assist the Agency in its efforts to achieve a fifty (50) percent error rate reduction in payment of Medicare claims. The services obtained under this task order are severable.