Recovery Audit Contractor DCS Licenses Milliman Care Guidelines®

SEATTLE, July 15 /PRNewswire/ -- DCS, a Recovery Audit Contractor (RAC) for the Centers for Medicare & Medicaid Services (CMS), has signed a five-year license agreement with Milliman Care Guidelines.  

DCS, A Performant Company, will use the Milliman Care Guidelines® content and software to review Medicare claims in 12 Northeastern and Mid-Atlantic states and districts -- Maine, Vermont, New Hampshire, Massachusetts, Connecticut, Rhode Island, New York, Pennsylvania, New Jersey, Delaware, Maryland, and the District of Columbia.  Under federal law, RACs review claims for compliance with CMS reimbursement policies, and identify both underpayments and overpayments.  

DCS will use six annually updated, evidence-based Care Guidelines products -- Ambulatory Care, Inpatient and Surgical Care, General Recovery Guidelines, Recovery Facility Care, Home Care, and Behavioral Health Guidelines.

"The breadth and detail of the Care Guidelines supports informed and consistent clinical decisions for the best possible care throughout the entire care continuum," said Kevin Daly, Milliman Care Guidelines Vice President of Sales.  "Having access to our evidence-based clinical tools enables quality and audit organizations to effectively manage their review processes and initiatives to improve the care provided for Medicare beneficiaries."

The Care Guidelines promote healthcare quality by providing clinical guidelines based on the best available clinical evidence.  The Care Guidelines also incorporate detailed quality measures from the Hospital Quality Alliance (CMS Core Measures) and other national standards-setting groups.  Each guideline topic outlines key issues, and provides details on clinical interventions to improve patient outcomes.

About DCS, A Performant Company

DCS is the premier provider of debt repayment services on behalf of state and federal government agencies, as well as many commercial organizations.  The company has unique expertise in recovering unpaid student loans, delinquent federal and state taxes, and even outstanding non-tax debt.  Building strong client relationships is a hallmark of DCS, as many of the company's customers have been valued partners for more than 20 years.  DCS has successfully recovered more than $4 billion for clients over the past 30 years.  For more information, visit www.performantcorp.com.

About Milliman Care Guidelines

Milliman Care Guidelines LLC, A Milliman Company, is located in Seattle, and independently develops and produces evidence-based clinical guidelines and software used by more than 1,700 clients, including more than 950 hospitals, seven of the eight largest US health plans, and 25 Centers for Medicare and Medicaid audit contractors.  Covering the continuum of care, the seven-product Care Guidelines series is updated annually by an experienced team of clinicians and is used to support the care management of a majority of Americans.  For more information, visit www.careguidelines.com

About Milliman

Milliman Care Guidelines is a wholly owned subsidiary of Milliman, Inc., which is among the world's largest independent actuarial and consulting firms.  Founded in Seattle in 1947 as Milliman & Robertson, the company now has 52 offices in key locations worldwide.  Milliman employs more than 2,400 people.  The firm has consulting practices in healthcare, employee benefits, property and casualty insurance, life insurance and financial services.  Milliman serves the full spectrum of business, financial, government, union, education and nonprofit organizations.  For further information, visit www.milliman.com

SOURCE Milliman Care Guidelines LLC