Noridian and RELI Group to Work Together to Detect and Prevent...

Noridian and RELI Group to Work Together to Detect and Prevent Fraud in Medicare

Healthcare Tech Outlook | Wednesday, June 22, 2022

Both Noridian and RELI Group will collaborate to verify information on provider ownership to detect and prevent fraud in medicare.

Fremont, CA: “One of Noridians' main goals is to enable access to health care through our work. However, its crucial the care is coming from trusted providers so people can feel confident their health is being put first,” comments Troy Aswege, senior vice president of operations at Noridian. “We’re honored to work with RELI Group to connect reliable providers with the millions of people who rely on Medicare for access to health care.” Noridian Healthcare Solutions, LLC (Noridian), a leader in designing solutions for federal, state, and commercial health care programs, has teamed with RELI Group, a management consulting firm, to evaluate and verify provider ownership information in Medicare programs. Noridian, as the subcontractor, is cooperating closely with RELI Group, the prime contractor, to build a procedure to verify the information is accurate and meets Center for Medicare & Medicaid (CMS) approval standards. The activities of Noridian and RELI Group will prevent and identify fraud and abuse, ensuring that beneficiaries utilize reputable service providers.

The contract covers all Medicare Part A, Part B, and the participating providers of durable medical equipment (DME). The primary goals of the agreement are to validate CMS-provided provider ownership information against the Secretary of State (SOS) website and to validate the results with the Provider Enrollment, Chain, and Ownership System (PECOS). Additionally, RELI Group will design, with Noridian's assistance, a standard operating method for each state to effectively validate ownership information on the CMS enrollment application.

“We place the highest value in supporting CMS in maintaining the dependability of overseeing national and state-based fraud, waste and abuse initiatives across payment programs,” comments Scott Bonney, Vice President of Health Information Technology at RELI Group. “Noridian is a valued partner for RELI on this project because they share in our passion for improving healthcare for the nation and they bring proven expertise in Medicare and Medicaid provider enrollment and management.”

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