Request for Information (RFI) Durable Medical Equipment (DME) Claims Processing System

The Centers for Medicare & Medicaid Services (CMS) issued a Request for Information (RFI) regarding a Durable Medical Equipment (DME) Claims Processing System. This RFI serves as a preliminary inquiry for information and planning purposes, without indicating a commitment to issue a Request for Proposal (RFP) or procure services. CMS aims to maintain and enhance the existing DME claims processing system, which processes over 1.2 billion Medicare Part B claims annually, in order to ensure a stable environment, modernize systems, and improve overall performance. The document outlines program objectives, including the need for contractors who have experience in managing extensive claims processing systems, integrating legacy with modern systems, and developing application programming interfaces (APIs). Interested vendors must respond with their qualifications and capabilities by May 30, 2025, to assist CMS in developing requirements for future procurement initiatives. The RFI highlights critical areas for potential vendors, including experience with HIPAA standards and the ability to scale teams efficiently. Overall, this RFI underscores CMS’s commitment to optimizing Medicare claims processing through modernization and effective management while inviting industry participation to enhance service delivery for beneficiaries.