Does CMS have any plans for combining the current claims processing systems?

Question: Does CMS have any plans for combining the current claims processing systems?

Answer :
The MediSAM initiative replaces the Medicare Claims Processing Redesign (MCPR) effort. MediSAM is a long-range initiative that will incrementally transform and modernize the independent contractor systems, Shared Systems, and the Common Working File (CWF).
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For Medicare FFS claims processing systems, the new approach will combine newer technologies with existing system components to make incremental improvements rather than completely replacing the existing systems all at once. A unified, modernized FFS claims processing system will evolve from this incremental modernization approach. Key characteristics of the approach include:

· Eliminating duplicate functions and data among the current systems.

· Modernizing and renovating existing system components and data.

· Strategically injecting new technology to allow for greater flexibility and interoperability.

· Modernizing auxiliary systems and utilities that support claims adjudication (e.g., back end print).

The long-term MediSAM vision and concept of operations calls for Medicare FFS operations to be hosted in a geographically-dispersed EDC environment. A unified claim processing system, operating at multiple EDCs, will replace the existing Shared Systems and CWF; and interact with front-end and back-end services as well as related CMS systems (e.g., Health Integrated General Ledger Accounting System (HIGLAS)).