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QSSI Announces Award of CMS Point-of-Sale Facilitated Enrollment (POS FE) Eligibility Verification Contract

QSSI to support the facilitated enrollment of “dual eligible” Medicare and Medicaid beneficiaries and other low-income beneficiaries into the Medicare Part-D Prescription Drug Program.  The program helps ensure that the most vulnerable populations in our society receive their prescription drugs without interruption when they go to the pharmacy.

Columbia, MD – September, 27 2007 – QSSI has been awarded a prime contract with the Centers for Medicare and Medicaid Services (CMS) to provide beneficiary Eligibility Verification services to support the Medicare Part-D Prescription Drug Point-of-Sale Facilitated Enrollment (POS FE) program for low-income beneficiaries. In this program, QSSI will electronically query 51 State Medicaid Agencies, as well as the CMS Medicare Beneficiary Database (MBD) on behalf of CMS to determine the eligibility status of low-income beneficiaries who go to the pharmacy to receive drugs, but who are not enrolled in Medicare Part D prescription drug plan. In addition to performing the eligibility queries, QSSI creates a low-income subsidy (LIS) Deeming file that is fed into the CMS computer systems so that low-income beneficiaries are awarded the low-income subsidy.

"We are very pleased to be working with CMS and the State Medicaid Agencies to help ensure that the most vulnerable populations in our society receive the critical drugs that they need," said JR Glass, Director of QSSI Healthcare Programs.

"The CMS POS FE Eligibility Verification Contract award reflects our commitment in serving the CMS and the rest of the Federal Government on such key initiatives. We are very excited to be leading this effort on behalf of CMS", said Bikram Bakshi, CEO of QSSI.

About MMA

On December 8, 2003 the President signed The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA), authorizing a new Medicare Part D benefit that provides prescription drug insurance coverage to individuals who are entitled to Part A or enrolled in Part B.  Coverage began January 1, 2006.

The MMA included important changes on how Medicare/Medicaid ‘dual-eligibles’ receive prescription drug coverage.  Full-benefit dual eligibles are defined as individuals who are: 1) entitled to Part A or enrolled in Part B under Medicare; and 2) eligible for full Medicaid benefits.  Low-income subsidy eligibles are defined as those individuals who are deemed eligible by virtue of eligibility for Supplemental Security Income (SSI)-only (i.e., SSI and Medicare, but no Medicaid eligibility), or Medicare Savings Programs (MSPs, i.e. QMB-only, SLMB-only, or QI); as well as those who apply and are determined eligible by the Social Security Administration or their State Medicaid Agency.

Prior to the effective date of the MMA, Medicaid paid for most prescription drugs and Medicare paid for a very limited set of prescription drugs.  The MMA directed that Medicaid reimbursement for Part D covered prescription drugs end on December 31, 2005. 

To prevent a lapse between the end of Medicaid prescription drug coverage and beginning of Medicare Part D coverage, CMS drafted a policy that auto-enrollment of existing full-benefit dual eligible individuals in 2005 was to be effective January 1, 2006 and continue monthly thereafter.  CMS has conducted Auto-Enrollment of full-benefit dual eligibles into PDPs since October 2005, and Facilitated Enrollment of other LIS eligibles into PDPs since March 2006.  CMS continues to make every effort to identify and auto-enroll all full-benefit dual eligibles, and identify and facilitate the enrollment of other low-income subsidy (LIS) eligibles on a timely basis

About QSSI

Founded in 1997, QSSI is a rapidly growing SBA certified firm with a long track record of service to the Federal Government.  A SEI CMMI® Maturity Level 2 rated firm, QSSI provides   a range of Information Technology solutions with particular expertise in Enterprise Software Development, Security Services and Critical IT Infrastructure solutions. QSSI has successfully performed on over 100 Federal Contracts and manages over 200 IT professionals. QSSI is among only a handful of small businesses that are GSA approved to provide HSPD-12 services to the Federal Government on SIN 132-62. We are also a #GS-35F-0308L and GSA STARS awardee – #GS- 06F-0148Z

For additional information, please contact:

JR Glass, Director of Healthcare Programs

301-977-7884

lglass@qssinc.com

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