HMS Expands Work with World Trade Center Health Program to Support Member Coverage through Cost Containment Services

HMS (NASDAQ: HMSY), the leading provider of payment accuracy and population health management solutions, has expanded its partnership with the World Trade Center (WTC) Health Program for payment accuracy services.

Having helped the WTC Health Program recover more than $31 million by ensuring workers' compensation pays eligible medical claims first, HMS’ proven success supporting the Program led the company to secure a new contract award to continue to support it through July 2026. As of July 2020, the expanded scope of work includes HMS’ payment accuracy services to ensure all members impacted by the tragic 9/11 events continue getting the support they need.

The WTC Health Program provides medical monitoring and treatment for more than 105,000 responders and survivors whose health was affected at the World Trade Center and related sites in New York City, the Pentagon and Shanksville, Pennsylvania. Since 2001, the WTC Health Program has helped thousands of those affected on or after 9/11 get the care they need and deserve. HMS’ payment accuracy solutions will ensure the sustainability of the Program and its mission to care for our heroes and survivors.

This WTC Health Program contract award supports the establishment of a comprehensive cost avoidance, coordination of benefit, and recovery program, including both pre- and post-payment processes to improve efficiency and cost control. HMS’ suite of payment accuracy and cost containment solutions will facilitate more accurate and efficient payment processes.

“Controlling costs without compromising care quality is crucial to continue providing coverage for those whose health was forever changed by the attack on 9/11,” said Bill Lucia, chairman and CEO for HMS. “This patient population is uniquely complex, and HMS’ solutions will help ensure the Program operates efficiently to ensure those suffering from chronic health issues like respiratory disease and cancer are taken care of.”

HMS’ suite of payment accuracy solutions includes Coordination of Benefits for Commercial Insurance Billing, Workers’ Compensation Recovery, and Identification of Deceased Members, as well as, Payment Integrity for Clinical Claims Review, Payment Analytics and FraudCapture™ to meet the objectives of its comprehensive cost avoidance program.

The objectives for long-term success include identifying primary health insurance, managing coordination of benefits, recouping incorrectly paid claims from private insurance and New York State (NYS) Workers’ Compensation Board (WCB) insurers through its Health Insurance Matching Program (HIMP), identifying deceased members, and providing quality assurance payment integrity services.

About HMSHMS advances healthcare by helping organizations reduce costs and improve health outcomes. Through our industry-leading technology, analytics and engagement solutions, we save billions of dollars annually while helping consumers lead healthier lives. HMS provides a broad range of payment accuracy and population health management solutions that help move the healthcare system forward. Visit us at www.hms.com or follow us on LinkedIn and Twitter.

Media Contact Lacey Hautzinger Senior Director, Corporate Marketing [e-mail]