Discovery Health Partners Announces $78 Million in Restored Medicare Premiums

LOTHIAN, Md. (April 16, 2015)—Discovery Health Partners, a division of LaunchPoint, today announced it has restored $78 million in Medicare premiums for 12 health plans using Discovery’s Medicare Secondary Payer (MSP) Validation solution over the past 18 months. As part of the work, Discovery restored $8.5 million for a 32,000-member Northeastern community Medicare Advantage (MA) plan and $13.4 million for a 38,000-member Midwestern community MA plan. Both plans partnered with Discovery for a full-service reexamination of their MSP programs and enjoyed restorations within an initial validation process that typically lasts 4 months.

“Restored premiums of this level are very significant, as they show that even when plans are very focused on restoring underpaid premiums due to MSP, they may not be catching all opportunities, which can add up to millions of dollars for plans of any size,” said Laura Cohen, vice president of operations at Discovery Health Partners. “Our success has been due to our expert MSP validation team; a series of best practices in validation, CMS communications, and results tracking; and Discovery Health Partners’ new proprietary MSP Validation software solution.”

Over the last 18 months, Discovery has dedicated a growing practice to helping MA plans become more focused and diligent about restoring premiums reduced incorrectly for MSP, with substantial results. In addition, Discovery is offering its new MSP Validation software solution on a subscription basis for its health insurance customers, adding to its suite of Discovery Eligibility solutions. Developed by experts in information management, MSP validation, and CMS communication, the new proprietary Discovery software solution helps automate the MSP validation process. By enabling payers to speed up the identification and validation of open records and track CMS communications, the system automatically calculates expected adjustments and delivers complete visibility of progress throughout the entire process. The software solution can be used to supplement a plan’s current in-house MSP efforts or used as a part of an ongoing relationship with Discovery’s MSP validation experts. In either case, the software helps improve efficiency and speed of validation and foster best practices, which can lead to increased premium restorations.