Enterprise Technology Solutions (ETS) LLC, a Service Disabled Veteran Owned Small Business (SDVOSB) and Health Net Federal Services LLC, the government operations division of Health Net, Inc., (NYSE:HNT) today announced they have been awarded a contract by the Department of Veterans Affairs Health Administration Center (VA HAC) to provide recovery audit services of VA payments made for non-VA hospital care to veterans. As the prime contractor for this agreement, ETS will provide program management, and Health Net Federal Services, the prime subcontractor, will provide technical and operational expertise.
The new contract with VA is effective for one year from August 5, 2009, through July 31, 2010, with four additional option years. The purpose of the contract is to perform a retrospective review of qualifying VA payments for hospital care provided by VA during fiscal years 2007 through 2011. The reviews include identifying and recovering any overpayments, reporting underpayments, and identifying any fraud and abuse trends in the qualifying programs.
Health Net’s partnership with ETS also includes serving as a prime subcontractor for repricing health care provider invoices for VA Medical Centers (VAMCs) nationwide. The Repricing Program reduces VA expenditures on claims for health care services provided to veterans in the private sector by utilizing contracted rates with nationwide provider networks. The collaborative partnership between ETS and Health Net has helped participating VAMCs save millions of dollars in claims costs, which are returned to VA to provide additional health care services to veterans.
“Working with VA, and Health Net, on the recovery audit services contract is an honor for ETS. ETS uses a team approach combining technical expertise with hands-on experience to deliver quality services to our clients. Our commitment and responsiveness to their needs is the cornerstone of our organizational and project management philosophy. We are excited about bringing this philosophy and expertise to the VA recovery audit program,” said Don Neilson, president of Enterprise Technology Solutions.
“We are excited to further our partnership with ETS to enhance our program expertise and increase our ability to support VA’s cost containment and reductions efforts,” said Health Net’s VA Programs Officer, Donna Hoffmeier. “For the past eight years, Health Net has successfully performed audit recovery services to VA as a subcontractor to small businesses. We look forward to collaborating with ETS to meet and exceed VA’s goals for cost savings.”
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