HMS Holdings Corp was incorporated on October 2, 2002 in the state of New York. It provides cost containment services to government & private healthcare payers & sponsors. The Company's program integrity services ensure that healthcare claims are paid correctly, and its coordination of benefits services ensure that it is paid by the responsible party. These services help clients recover amounts from liable third parties; prevent future improper payments; reduce fraud, waste and abuse; and ensure regulatory compliance. Its general services include Coordination of benefits services, Program integrity services, and Eligibility verification services. The Company's clients are the Centers for Medicare & Medicaid Services (CMS); state Medicaid agencies; commercial health plans, including Medicaid managed care, Medicare Advantage, and group health lines of business; government and private employers; Pharmacy Benefit Managers (PBMs); child support agencies; the Veterans Health Administration (VHA); and other healthcare payers and sponsors. The Company served CMS, the VHA, 46 state Medicaid agencies and the District of Columbia. It also provided services to approximately 160 commercial clients and supported their multiple lines of business, including Medicaid managed care, Medicare Advantage, and group health plans. It also acts as a subcontractor for certain business outsourcing and technology firms. The Company competes with business outsourcing and technology firms, claims processors (including pharmacy benefit managers), clearinghouses, consulting firms, and smaller regional vendors; these companies include Optum and Emdeon Inc. In addition, it frequently competes against clients who may elect to perform recovery and cost avoidance functions in-house.
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