Payment Development, Implementation, and Monitoring for Disease Management Demonstrations

The purpose of this task order is to provide support to the Centers for Medicare & Medicaid Services (CMS) in implementing and monitoring demonstration projects that provide disease management services to Medicare beneficiaries. These demonstrations include the LifeMasters Disease Management demonstration for dually-eligible Medicare beneficiaries, and several other disease management demonstrations that are in the planning stages. Under this task order, the major tasks are: 1. Providing general technical support to CMS in the analysis of rate proposals and assistance in calculating the appropriate payment rates (both initial and annual updates) for the selected projects; 2. Educating demonstration sites regarding payment calculations, billing processes and requirements, and budget neutrality requirements; 3. Monitoring payments and Medicare expenditures to assure budget neutrality, including designing data collection processes for use in collecting and warehousing necessary data elements from sites and CMS administrative records for assessing performance; and 4. Performing financial analysis to assist in the financial settlement and reconciliation.