Serco Inc. has won a $109 million, 7-year contract with the Centers for Medicare & Medicaid Services to support the agency’s Comprehensive Error Rate Testing program, serving as the CERT Review Contractor.
The award extends Serco’s 12-year history supporting CMS. Under the contract, Serco will manage the medical review process for a stratified random sample of claims, deploying independent medical reviewers supported by intelligent document processing and AI to validate compliance with Medicare coverage, coding and billing rules. The CERT program measures and reports the improper payment rate for the Medicare Fee-for-Service program, which processes over $1 trillion in medical expenditures annually for nearly 70 million Americans.
“Serco provides actionable insights to CMS to help educate providers, enhance oversight, and strengthen program integrity,” said Michael LaRouche, CEO of Serco Inc. “Our decade-long partnership with CMS and our proven ability to leverage technology to improve efficiency, making us a vital partner in ensuring the sustainability of critical health programs for the American people.”
Work will be performed virtually and at Serco facilities in the Richmond, Virginia, area.