Progress | Growth

Perpetual advancement

Growth Initiative

In 2017, Palmetto GBA continued developing the expertise and infrastructure to provide data analytics services and technology to targeted federal agencies. This strategic initiative will enhance our IT offerings, diversify customers and broaden federal government contract vehicle access. We can then offer even more comprehensive technology and business management services to both the public and private sectors.


Last year, we developed and executed an acquisition strategy that has resulted in growth for our company. We refined and focused the initiative’s strategic direction, as well as continued to build our team of talented professionals. The initiative’s ongoing objectives include:

  • Obtain additional contract vehicles
  • Align with companies that have outstanding performance and growth potential
  • Build capabilities and synergies

New Business

Strategic Partner Acquisition of Resources Contract (SPARC)

SPARC is a multiple-award, Indefinite Delivery/Indefinite Quantity (IDIQ), performance-based contract available to all components within CMS and all Health and Human Services Operating Divisions. Through it, partners procure IT System development services, from end to end. Its purpose is to provide strategic, technical, and program management guidance and support services, and to facilitate the modernization of CMS business processes and supporting systems and their operations.

Palmetto GBA participated on several SPARC teams, and as a sub-contractor our teams were awarded four SPARC contracts — one full and open unrestricted seat and three reserved for small business participation.

Jurisdiction J A/B MAC

Palmetto GBA was awarded the Jurisdiction J A/B MAC contract. Under this contract Palmetto GBA will perform all the Medicare Parts A and B administration for the jurisdiction, including provider enrollment, outreach and education, Medicare claims processing, appeals, provider customer service, medical review, and audit and reimbursement. This jurisdiction includes the states of Alabama, Georgia and Tennessee, and represents 6.9 percent of the national Part A/Part B claim-volume workload. Read more


Renewed Contracts

Year after year Palmetto GBA is rehired to continue delivering innovations and efficiencies for its contract clients. As a sought-after partner by the federal government, we are proud of every renewed contract and see each as an opportunity to better ourselves. Each win is a huge accomplishment. We’re proud of them all.

    Continuing Education (CE) Support & Medicare Learning Network (MLN) Product Development

    Retaining the contract since 2002, Palmetto GBA again was awarded the CE-MLN Contract formerly known as the Provider Education and Support Services Contract. The contract supports and develops Medicare educational materials for healthcare professionals.

    In 2017, Palmetto GBA’s CE-MLN contract:

    • Produced 97 web-based training courses for the Medicare Learning Network™, including content development, programming, testing and 508 compliance
    • Produced 89 provider education publications for the Medicare Learning Network™, including fact sheets, booklets and education tools

    • Processed, maintained and reported on evaluation, post-activity survey, and certificate data for 136,948 participants

    • Wrote and designed two successful reaccreditation application portfolios for:

      • the Accreditation for Continuing Medical Education’s (ACCME) prestigious Accreditation with Commendation
      • the International Association for Continuing Education and Training (IACET) Authorized Provider status
    • Facilitated the Centers for Medicare and Medicaid Services Continuing Education’s (CMSCE) national leadership role in the Alliance for Continuing Education in the Healthcare Professions Federal Educators (ACEHP) member section


    Third Party Liability (TPL) with SC Medicaid

    As a subcontractor to the Celerian Group Medicaid division, Palmetto GBA again was awarded the Third-Party Liability contract in August 2017. Its purpose is to provide financial and IT services in support of the Medicaid Third Party Liability (TPL) for South Carolina. Successfully rehired for this work since May 2011, Palmetto GBA has traditionally handled the disposition of all solicited Medicaid TPL checks received, including initiating debit and credit adjustments. Additionally, Palmetto GBA administers the Health Insurance Premium Program and processes quarterly credit balance reports submitted by institutional providers. When the new contract begins later in 2018, Palmetto GBA will continue to maintain all previous responsibilities and assume added case management responsibilities for casualty, estate recovery, class action suits, and special needs trusts.  

    Front-End System (FES)

    For nearly 20 years, Palmetto GBA has successfully retained the Front-End System (FES) contract (previously the CSFES). The contract’s purpose is to collect and process all Medicare Part C and Part D program data records around the clock. As the FES contractor, Palmetto GBA is responsible for the design, development, testing, implementation, operation, and maintenance of these four front-end systems.

    In 2017, the national contract processed more than 3.8 billion encounter claims, risk adjustment transactions, prescription drug events and Medicare/Medicaid dual eligible claims, serving 728 Medicare Advantage plans with more than 44 million enrolled beneficiaries.



    West Virginia Medicaid Audit

    Palmetto GBA once again was awarded the contract for the West Virginia Medicaid Audit to provide cost report desk review, field audit, and other necessary services to assist the West Virginia Department of Health and Human Resources, Office of Accountability and Management Reporting, in meeting its Title V (Maternal and Child Health) and Title XIX (Medicaid) cost report settlement requirements. This is done in conjunction with the provider’s annual Title XVIII (Medicare) cost report settlement, if applicable.

    As needed, Palmetto GBA performs additional tasks for the department to analyze its provider payment methodologies, or other necessary tasks for the efficient operation and management of its Title V and Title XIX Programs.



    Daily efficiencies propel near-perfect contract ratings.

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    Precision & ingenuity drive uncommon results.

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    Extraordinary potential through new contracts & year-over-year renewals.

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    Competitive advantage through enterprise-level innovations.

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