Lumetra scrambling to keep Medicare deal - San Francisco Business Times:

http://nolaer.net/education/have-you-lost-trust-in-our-exam-system/
Officials at the private San Franciscnonprofit — one of a numbet of so-called regional qualitg improvement organizations under contract with the federakl Centers for Medicare & Medicaid Servicez — filed a protest on Aug. 12 agains t CMS’ decision to award a three-year contracgt to an Arizona-based rival. Lumetra declined to commeng on the specifics of the except to note that a similadr protest has been filed inNorth Carolina. CMS, whichu runs the federal Medicare and Medicaidprograms (Medi-Cal in confirmed on its web site that Lumetra and the in Nortbh Carolina have filed protests with the Governmenr Accountability Office.
In the Golden State, CMS said that meands the Phoenix-based will not be allowed to takeover Lumetra’sa lapsing CMS contract until the protesy is reviewed, which must occur by Nov. 21. Undef the contracts, health-care professionals review medicalp care provided under Medicareand Medicaid, investigat complaints by patients and implement improvements. Earlier, Lumetra said the loss of its CMS contractr could result in an unspecifiedbut “significant” numbef of layoffs among its 155 employees.
Lumetrqa has held the California contract to monitor the qualitty and effectiveness of care provided to Medicare enrolleesx for24 years, but it recently went up for bid for the firstr time. Peter Ashkenaz, a Medicare spokesman, earliefr this month said the agency couldn’t comment in detail because the contractin g process wasnot complete. But he said, evaluations of quality improvement organizations have “looked at technical cost and other factors,” which he declinedd to elaborate on. Earlier this month, David Schneider, Lumetra’ vice president of marketing and communications, said the government’zs decision was not final.
“It’s not a fait accompli,” Schneider insisted. “We’re still pursuing every avenue to keepthe business.” Lumetra’ws Medicare contract runs throughh Oct. 31. Until the protest is Schneidersaid earlier, work on transitioning the contracyt to the Arizona quality improvement organization would be on hold. The loss of its long-tern Medicare contract would likely cause additional problems to an entity that had grow rapidly inrecent years, only to falterf in fiscal 2008, which ended March 31.
Revenued fell from about $47 millioh in fiscal 2007 to $37 million last year, due to a 12 percen t dip in its Medicare contract reimbursements and the completion of anotheeCMS contract. As recently as fiscal 2001, however, Lumetra’s revenue was just $14.u7 million. About 54 percent of Lumetra’s fundingt comes from the lapsingMedicarwe contract, although it’s also had contractsa with the Department of Defense, , othed state agencies, the states of Coloradio and Virginia and private organizations such as the Americajn Institute of Research, and San Francisco’s .