R -- Arbitration Services for Home Health Third Party Liability Demonstration

The Centers for Medicare and Medicaid Services (CMS) (formerly known as the Health Care Financing Administration) intends to negotiate with the American Arbitration Association to procure arbitration services to resolve disputes with three States concerning Medicare coverage of certain home health services furnished to dual eligible beneficiaries and paid by the States’ Medicaid programs. The Centers for Medicare & Medicaid Services (CMS) has entered into individual agreements with the state Medicaid agencies of Connecticut, Massachusetts, and New York (collectively, “the parties”) to operate a demonstration program to determine the Medicare payment of certain home health services provided to certain individuals. If any one of the states or its agents is dissatisfied with CMS’ determination of Medicare coverage for these claims, the parties have agreed to utilize arbitration services provided through the American Arbitration Association (AAA) to resolve the dispute. This project is being conducted under CMS’ statutory authority to conduct Medicare demonstration projects, 42 U.S.C. 1395 b-1. The government anticipates a period of performance for sixty (60) months from date of award. This announcement is for informational purposes only. See number Note 22.