2024 proved to be a very successful year for Palmetto GBA’s business development program. Not only did we secure new contracts, but we also retained our contracts that were in recompete procurement. The awards, listed below, are a testament to our associates’ strong performance and customer service.

Jurisdiction J A/B Medicare Administrative Contractor (MAC)
Palmetto GBA’s was awarded the contract for Jurisdiction J A/B MAC covering Alabama, Georgia and Tennessee. Palmetto GBA performs all the Medicare Parts A and B administration for the jurisdiction including provider enrollment, outreach and education, claims processing, appeals, provider customer service, medical review, and audit and reimbursement.  The jurisdiction includes more than two million beneficiaries, 66 thousand physicians and 400 hospitals. Initially awarded by the Centers for Medicare & Medicaid Services (CMS) in 2018, this is our second-largest contract.

Railroad Retirement Board Specialty Medicare Administrative Contractor (SMAC)
Palmetto GBA secured a new ten-year contract to serve as the Railroad Retirement Board (RRB) SMAC. Palmetto GBA has held the RRB SMAC since 2000 and performs Medicare Part B administrative services for Railroad Retirement beneficiaries nationwide. These services include claims processing; appeals; provider enrollment; customer service and web technology services; medical review, benefit integrity, document control and mail services, banking services, overall financial management activities for more than 445,000 Railroad Medicare beneficiaries.

Customer Service Front End Systems (CSFES)
Palmetto GBA successfully retained the CSFES contract, which it has held since the inception of the Medicare +Choice (now Medicare Advantage) program. Palmetto GBA operates the Electronic Data Interchange (EDI) gateway and processes files within four front-end information technology systems and collects and processes risk adjustment, prescription drug event, encounter, Medicaid, and National Council for Prescription Drug Program data from trading partners.

End Stage Renal Disease (ESRD) Quality Improvement Program (QIP)
As a subcontractor to Broadway Ventures, LLC, Palmetto GBA was re-awarded the End Stage Renal Disease (ESRD) Quality Improvement Program (QIP) contract. This contract requires data validation from dialysis facilities under a Medicare quality improvement project to link reimbursement to patient outcomes. The results are used to provide feedback and set reimbursement rates for the next fiscal year.

South Carolina Department of Health and Human Services Third Party Liability
As a subcontractor to the Celerian Group’s Medicaid Division, Palmetto GBA was awarded the Third Party Liability Services contract to provide financial services including processing checks, managing ledger postings operations and call center functions of the Health Insurance Premium Program (HIPP).

Advanced Provider Screening (APS)
Palmetto GBA, as a subcontractor to Sparksoft, was awarded the Advanced Provider Screening contract to support the daily processing, rules assessment, reporting, and alerting of entity profiles to assure program eligibility and to prevent fraud, waste, and abuse.

Medicare Integrated Systems Testing (MIST)
Palmetto GBA, as a subcontractor to Sparksoft, was awarded the MIST contract. Palmetto GBA configures and provides use of the Multi-Carrier System (MCS) Desktop (MCSDT) applications. Along with all regular updates for the MCSDT server application, Palmetto GBA performs all server, security, operating system and database maintenance to support the application. 

General Services Administration’s (GSA) Special Item Number (SIN) and One Acquisition Solution for Integrated Services Plus
Palmetto GBA won seats on multiple GSA contract vehicles including the new SIN vehicle for cloud services and for the Third Party Administration of Insurance and Pension Funds (INS) SIN. As part of the joint venture, Techshed, Palmetto GBA was awarded a seat on the Highly Adaptive Cybersecurity Services (HACS) SIN within the GSA Multiple Award Schedule (MAS). With the Celerian Group’s JBS International as the prime contractor, Palmetto GBA gained a seat on the OASIS+ Best in Class (BIC) vehicle for management and advisory professional services. 

Navy Seaport Next Generation (NXG) On Ramp
As part of the TechShed joint venture, Palmetto GBA was awarded a seat on the Navy Searport NXG On Ramp. This indefinite delivery, indefinite quantity (IDIQ) vehicle is used for Navy and other U.S. defense departments information technology infrastructure programs.