CMS Awards Sparksoft with a 4-Year $118M Prime Contract to Maintain and Evolve the Advanced Provider Screening (APS) Program

News

Columbia, MD, July 5, 2024 – Sparksoft Corporation, an industry leader of innovative Digital Health solutions, has been awarded a 4-year, $118 Million prime contract by the Centers for Medicare & Medicaid Services (CMS), the largest task order award to-date on the GSA STARS III Governmentwide Acquisition Contract (GWAC), to maintain and evolve the Advanced Provider Screening (APS) program. APS continuously screens over 4 million active Medicare and Medicaid providers and suppliers, including physicians and non-physician practitioners, in all 50 states and 6 territories by automating data checks and maintaining screening profiles that enable proactive processes to identify ineligible healthcare providers as well as potential fraud, waste, and abuse (FWA) in claims. CMS' Center for Program Integrity (CPI) is tasked with preventing and detecting FWA for the National Medicare and State-wide Medicaid programs through provider audits and policy reviews, identifying and monitoring program vulnerabilities, and providing support and assistance to States. CPI collaborates with the Office of Legislation, U.S. Department of Justice, DHHS Office of Inspector General, State law enforcement agencies, other Federal entities, and CMS components on developing and advancing new legislative initiatives and improvements to detect, deter, monitor, reduce, and eliminate FWA, as well as taking legal action against bad actors that commit or participate in fraudulent or other unlawful activities.

APS is an interactive screening, monitoring and alerting system which serves as a central record of aggregated internal and external information on healthcare individuals and organizations. The system is used by Medicare Administrative Contractors (MACs), Unified Program Integrity Contractors (UPICs), and other stakeholders for verifying eligibility of providers, suppliers, owners, or other individuals that have submitted CMS-855 Medicare enrollment forms to the Provider Enrollment Chain and Ownership (PECOS) application. The goals and objectives of APS are to:

Maintain a centralized repository of all entity information collected from internal (CMS and other CMS provided government sources) and external data sources

Perform data aggregation from government and public data sources on new and existing entities

Further advance APS as a perpetual data engine to continually monitor and update data elements on entities in a timely manner

Continue to expand and support the use, interoperability, and sharing of aggregated entity data among the CMS enterprise, as well as with external and internal systems

Provide the ability for stakeholders to initiate entity creation and query entity data from APS

Support CPI mission to generate leads and alerts for potential FWA in support of CMS, the CMS enterprise and its Federal and State agency stakeholders

Under this contract, Sparksoft will provide management and technical expertise to achieve CMS' vision for the APS to provide an enhanced process that can address program needs across the enterprise and build a foundation for ongoing provider relationship management and enhancement of downstream business processes that rely on timely, accurate and accessible provider information. Sparksoft will perform Agile transformation and DevSecOps delivery of modern, cloud-based digital services that support the following APS capabilities:

Screen all entities submitted to APS and provide alerts when entities fail to meet the requirements established by CMS, or where other data checks create a risk of potential FWA

Provide an interface to receive information from and pass results of screening back to stakeholders and systems in an organized fashion that can be easily evaluated by program integrity analysts

Improve data quality from public and private sources, while supporting new and updated sources of data to improve the accuracy of entity resolution, aggregation, and screening and reduce the cost of operations

Provide data analytics for structured and ad hoc reports in near real time

Ensure system operations complies with all CMS IT policies and cybersecurity regulations

Support CMS program integrity ecosystem interoperability initiatives and sharing provider profile data with State Medicaid programs

Improve workflows and business processes for CMS staff and external stakeholders

"We are honored and humbled that the government continues to entrust us with support on some of the most mission-critical public health programs that impact our families and communities. It is truly a privilege to be such a trusted partner to our CMS clients, who are some of the most dedicated public servants leading transformational missions.” said Sparksoft’s CEO, Mr. Mike Finkel. Sparksoft’s COO, Mr. Venky Iyer stated that “With Sparksoft managing multiple agency-wide shared services like the Enterprise Portal and Data Services Hub, we take our responsibility to drive value and ROI for CMS very seriously. As taxpayers and effective fiscal stewards, it is our obligation to continue seeking out holistic synergies, meaningful efficiencies, and technological breakthroughs at an enterprise scale.”

This award expands Sparksoft’s industry leading expertise with healthcare provider data governance, such as delivering highly secure provider data and analytic products to dozens of Medicare, Medicaid, and Marketplace applications that supply life-saving information to over a hundred million beneficiaries and consumers on the CMS Enterprise Master Data Management (MDM) and the Enterprise Data Lake (EDL); providing Customer Service & Program Operations Center (CSPOC) support for the Health Resources and Services Administration (HRSA) National Practitioner Data Bank (NPDB), an alert system for federal and state licensing and certification authorities, hospitals, and other health care entities to use in evaluating the qualifications of health care practitioners they seek to license, hire, or contract with, or to whom they wish to grant clinical privileges; and leveraging our subcontracting experience on CMS PECOS, a national enrollment platform and repository of all Medicare provider and supplier enrollment data consumed across CMS stakeholders and Medicare claims processing systems.

About Sparksoft Corporation

Sparksoft is a Capability Maturity Model Integration (CMMI) Services and Development Maturity Level 3, ISO 9001:2015, ISO 20000-1:2018, ISO 27001:2013, and Federal Wide Assurance for the Protection of Human Subjects certified consulting organization with a proven record of successfully delivering modern digital health solutions for more than a dozen Federal, State, and Commercial customers. As evidenced by our 20+ active prime contracts and subcontracts, and further supported by our excellent Contractor Performance Assessment Reports (CPARs), Sparksoft is a highly mature and capable partner trusted by the government and industry. We bring to bear the essential institutional knowledge, contract vehicles, certifications, experienced personnel, and process maturity to deliver the requirements in compliance with Federal regulations, industry best practices, and agency governance needs.

Through our focused mission “to ignite innovation, inspire transformation, and implement digital solutions for a healthier nation” we specialize in DevOps Delivery, Data Science, Contact Center Operations, Life Sciences, and Test Automation. Since 2004, our exceptionally skilled people, proven leadership, and optimized processes all work together to relentlessly push for more efficient solutions for our HHS, Military Health, and Life Sciences clients. We have developed a support structure of Innovation Centers designed to collect our enterprise-wide lessons learned and identify project-specific opportunities for improvement. SparkLabs, where our Research & Development teams explore ideas and turn them into real-world solutions is an important impetus in our drive for innovation. We continually pull from our experience and combine this with forward-thinking technology from our certified partners like Red Hat, Microsoft, AWS, Okta, Google, Databricks, and ServiceNow to conceptualize novel and effective solutions such as our SparkLoader® RPA Data Pipeline, SparkGrid® Snowflake GUI, MockSpider® Virtual Sandbox, ScriptHive® for TDD/BDD automation, SparkMarker® Website Accessibility Platform, 508bee® Accessibility Validation, and many more.

Sparksoft’s website is updated regularly with news of product launches, contract awards, certification and vehicle changes, key hires, and corporate milestones. Visitors are encouraged to explore the website and also connect with us on Social Media