CMS Renews Contract with Quest Analytics for Medicare Advantage Network Oversight

Quest Analytics has secured a five-year contract renewal with the Centers for Medicare & Medicaid Services (CMS), extending a partnership that began in 2007. The company provides essential software and analytical tools for Medicare Advantage network adequacy reviews, supporting CMS in evaluating provider networks against regulatory standards. Quest Analytics’ solutions facilitate the assessment of network adequacy across over 40 specialties and facilities, incorporating population density and time-distance metrics to ensure compliance with CMS requirements. These tools are integral to CMS’ triennial network reviews, service area expansions, and the Health Plan Management System (HPMS) Network Management Module. The partnership highlights the ongoing regulatory focus on maintaining sufficient provider networks to guarantee access to covered services for Medicare Advantage enrollees. Quest Analytics’ platform processes extensive provider data, supporting numerous healthcare organizations and regulatory agencies nationwide. Their technology aids not only CMS but also health plans and provider groups in managing and monitoring over 7,000 provider networks and more than 700,000 healthcare professionals. This renewal signifies the sustained reliance on advanced data analytics and geospatial technology to improve network design, compliance oversight, and ultimately access to quality care under federally regulated health plans.