HHS Launches Medicare Accounting Systems Integration Project
HHS Secretary Tommy Thompson on Sept. 27 announced the launch of a "long term" project that will integrate Medicare's accounting systems and replace the current "mainframe-based" system with a "modern, Web-based" accounting system. The Healthcare Integrated General Accounting System, or HIGLAS, will combine the 53 separate, "outdated" systems currently used by the "private insurance companies that process and pay" 3 million Medicare claims daily. Independent audits, conducted by the General Accounting Office and HHS' Office of the Inspector General, "revealed weaknesses in the accounting of Medicare claims" and following a Centers for Medicare and Medicaid Services evaluation, CMS decided to replace the old system with a "commercial off-the-shelf" program for both Medicare contractors and CMS "administrative accounting functions."
Implementation
Under the initiative started by the Clinton administration, CMS is teaming with PricewaterhouseCoopers, Oracle Corp. and Electronic Data Systems to implement the program. The project will start with a "pilot" program at Palmetto Government Benefit Administrators, a contractor that processes "primarily" hospital and other institution claims, and with Empire Blue Cross and Blue Shield, which mostly processes physician and supplier claims. Following extensive testing of the system, "full implementation" is expected in the end of fiscal year 2006. The contract is "potential[ly]" worth $328.4 million over its entire period (HHS release, 9/27).
