Performant Financial Corporation Re-Awarded CMS RAC Region 1 Contract
Performant Financial Corporation (Nasdaq: PFMT) announced on March 26, 2021, that it has secured an 8.5-year contract from the Centers for Medicare and Medicaid (CMS) as the Region 1 Recovery Audit Contractor. This contract, acquired through competitive procurement, allows Performant to conduct post-payment reviews of Medicare claims across 11 states in the Northeast and eastern Midwest. The award reflects the firm's established partnership with CMS and its ongoing commitment to audit services, further solidifying its position in the healthcare payment integrity space.
- Awarded an 8.5-year contract by CMS, enhancing future revenue potential.
- Contract covers 11 states, increasing market presence in the Northeast and Midwest.
- Reflects a strong partnership with CMS, supporting business credibility.
- Potential revenue concentration risk due to reliance on federal government contracts.
- High competition in the market may affect future contract acquisitions.
Performant Financial Corporation (Nasdaq: PFMT), (“Performant”, “the Company”), a leading provider of technology-enabled payment integrity, eligibility and related analytics services, today announced that on March 26, 2021, the Centers for Medicare and Medicaid (CMS) awarded Performant an 8.5 year contract to serve as the Region 1 Recovery Audit Contractor (RAC). This contingency fee contract was awarded via a full-and-open competitive procurement.
Region 1 consists of 11 states across the Northeast and eastern-Midwest region. As the Region 1 RAC, Performant will perform post-payment reviews of Part A and B Medicare fee-for service claims to identify and support the recoupment of improperly paid claims. Any updates related to the contract will be posted on the Company’s CMS RAC Provider webpages.
“This award underscores our long-standing partnership with CMS and is a direct result of our team’s hard work and dedication since the contract was first awarded in 2016,” stated Simeon Kohl, SVP and GM Healthcare. “In addition to Region 1, Performant is also the nationwide Region 5 RAC for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) and Home Health and Hospice (HH&H) claims, and the exclusive contractor for the Medicare Secondary Payer (MSP) Commercial Repayment Center contract, Kohl highlighted. “It is always an honor to serve CMS and we are grateful to have the quality and value of our work affirmed through this award.
About Performant Financial Corporation
Performant helps government and commercial healthcare payors enhance revenue and contain costs by preventing, identifying, and recovering waste, improper payments and defaulted assets. Performant is a leading provider of these services in several markets, including Medicare, Medicaid, and Commercial healthcare. Performant has been providing recovery audit services for more than nine years to both commercial and government clients, including serving as a Recovery Auditor for the Centers for Medicare and Medicaid Services.
Powered by a proprietary analytic platform and workflow technology, Performant also provides professional services related to the recovery effort, including reporting capabilities, support services, customer care and stakeholder training programs meant to mitigate future instances of improper payments. Founded in 1976, Performant is headquartered in Livermore, California.
Forward Looking Statements
This press release contains certain forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995, including statements regarding our outlook for revenues, net income (loss), and adjusted EBITDA in 2020 and beyond. These forward-looking statements are based on current expectations, estimates, assumptions and projections that are subject to change and actual results may differ materially from the forward-looking statements. Factors that could cause actual results to differ materially include, but are not limited to, the material adverse impact of the COVID-19 pandemic on our business, results of operations and financial condition as well as on the business operations and financial performance of many of our customers, that the Company may not have sufficient cash flows from operations to fund ongoing operations and other liquidity needs, that the Company’s indebtedness could adversely affect its business and financial condition and could reduce the funds available for other purposes and the failure to comply with covenants contained in its credit agreement could result in an event of default that could adversely affect its results of operations, that the Company faces a long period to implement a new contract which may result in the incurring of expenses before the receipt of revenues from new client relationships, the high level of revenue concentration among the Company's largest customers and any termination in the Company’s relationship with any of our significant clients would result in a material decline in our revenues, that many of the Company's customer contracts are subject to periodic renewal, are not exclusive, do not provide for committed business volumes and may be changed or terminated unilaterally and on short notice, that the Company may not be able to manage its potential growth effectively, that the Company faces significant competition in all of its markets, that continuing limitations on the scope of our audit activity under our RAC contracts have significantly reduced our revenue opportunities with this client, that the U.S. federal government accounts for a significant portion of the Company's revenues, that future legislative and regulatory changes may have significant effects on the Company's business, that failure of the Company's or third parties' operating systems and technology infrastructure could disrupt the operation of the Company's business and the threat of breach of the Company's security measures or failure or unauthorized access to confidential data that the Company possesses. More information on potential factors that could affect the Company's financial condition and operating results is included from time to time in the "Risk Factors" and "Management's Discussion and Analysis of Financial Condition and Results of Operations" sections of the Company's annual report on Form 10-K for the year ended December 31, 2020 and subsequently filed reports on Forms 10-Q and 8-K. The forward-looking statements are made as of the date of this press release and the Company does not undertake to update any forward-looking statements to conform these statements to actual results or revised expectations.
View source version on businesswire.com: https://www.businesswire.com/news/home/20210413005818/en/
FAQ
What contract did Performant Financial Corporation win from CMS?
How many states does the new CMS contract cover for Performant?
What is the relevance of the CMS contract for Performant's future?
What challenges might Performant face with its new CMS contract?
