Neil Hoosier & Associates
Transforming Knowledge into Innovative Solutions.
Neil Hoosier and Associates (NHA) is a nationally recognized federal healthcare management consulting firm delivering enterprise-level solutions to public- and private-sector clients for over 20 years. Best known for deep expertise working with CMS, the Medicare program, and insurers nationwide, NHA combines the expertise of a large company with the personalized responsiveness of a small business.
Main Office: Owings Mills, Maryland 21117 · HQ: Pomona, New York 10970
Phone: 443.213.8343 · Email: info@nhassociates.com
Website: nhassociates.com · Capabilities Statement: Download PDF
What Is Neil Hoosier and Associates (NHA)?
Quick Answer: Neil Hoosier and Associates (NHA) is a federal healthcare management consulting firm that has delivered high-quality solutions to public- and private-sector clients for over 20 years. NHA is best known for its deep expertise working with the Centers for Medicare and Medicaid Services (CMS) and the Medicare program. NHA's five core service areas are Program and Project Management, SDLC Integration and Support, Program Integrity, Audit and Compliance Oversight, and Training, Outreach, and Education.
Neil Hoosier and Associates occupies a unique position in the federal healthcare consulting market: a team of nationally recognized American industry experts with unrivaled experience working with CMS, the Medicare program, and insurers across the nation — delivering the enterprise-level solutions of a large company with the personalized attention and responsiveness of a small business.
For over two decades, NHA has built a proven track record protecting taxpayer dollars, modernizing critical government programs, and providing specialized knowledge in healthcare regulations and technology integration. Their work spans major CMS contracts including the MSPIC (Medicare Secondary Payer Integration Contractor), E&O (Evaluation & Oversight), PI ORC (Program Integrity Operational Review Contractor), and MDX/PULSE programs.
NHA at a Glance
🏢 Full Legal Name
Neil Hoosier and Associates — commonly referred to as NHA. The firm combines nationally recognized healthcare policy and regulatory expertise with advanced technology integration capabilities to modernize federal programs and protect program integrity.
🏛 Federal Healthcare Focus
NHA's primary client is the Centers for Medicare & Medicaid Services (CMS). NHA provides end-to-end support across program management, IT systems, integrity oversight, compliance auditing, and workforce training for Medicare and Medicaid programs.
📍 Two U.S. Offices
Main Office: Owings Mills, Maryland 21117
Headquarters: Pomona, New York 10970
Phone: 443.213.8343 · Email: info@nhassociates.com
⭐ Exceptional Performance
NHA has received Exceptional CPARS ratings from CMS — the highest available rating — for quality of deliverables, professionalism, flexibility, and responsiveness. Key personnel average 14+ years of Medicare experience and 6+ years on MSPIC-type contracts.
🎯 Mission
To deliver innovative solutions that transform knowledge into measurable outcomes for federal healthcare programs — protecting taxpayer dollars, modernizing government technology, and ensuring program integrity across the Medicare-Medicaid continuum.
🤝 Best of Both Worlds
NHA deliberately combines the expertise and experience of a large company with the personalized approach and responsiveness of a small business — offering clients the deep subject matter expertise they need with the dedicated attention they deserve.
NHA Core Services
Quick Answer: NHA offers five integrated service areas for federal healthcare programs: (1) Program and Project Management, (2) SDLC Integration and Support, (3) Program Integrity, (4) Audit and Compliance Oversight, and (5) Training, Outreach, and Education. Each service area is backed by 20+ years of proven performance on CMS and Medicare program contracts.
NHA's service capabilities span the full lifecycle of federal healthcare program management — from strategy and systems development through integrity oversight, compliance auditing, and workforce training. All five service areas draw from the same deep well of Medicare and CMS program expertise, enabling NHA to deliver integrated, cross-functional solutions for complex federal programs.
📋 Program and Project Management
NHA provides comprehensive program and project management solutions for complex, multi-contractor federal healthcare programs. NHA's approach combines rigorous deliverable tracking, contractor performance monitoring, risk assessment, and program health analysis to give federal clients clear visibility and control over their most critical programs.
Key Capabilities:
- Deliverable tracking and management for multi-contractor program environments
- Contractor performance monitoring and risk assessment
- SharePoint-based automation for program oversight workflows
- Scope management, schedule control, and budget monitoring
- Cross-functional stakeholder coordination for CMS and related agencies
- Program health dashboards and executive reporting
- Issue resolution and escalation management
Proven Result: As the MSPIC, NHA developed and implemented a SharePoint-based automated deliverable tracking system that transformed CMS's ability to manage deliverables and assess program health across five separate contractors in the COB&R program.
💻 SDLC Integration and Support
NHA provides end-to-end software development life cycle (SDLC) integration and support for federal healthcare IT programs — from requirements definition through system implementation, testing, and documentation. NHA's SDLC expertise ensures that complex government technology systems are built, tested, and deployed to meet CMS program goals with efficiency and reliability.
Key Capabilities:
- Scope definition and requirements facilitation for federal IT systems
- Systems development project leadership and oversight
- User acceptance testing (UAT) and regression testing management
- System documentation and technical writing
- JAVA Full Stack and MicroStrategy development support
- Data systems integration and consolidation
- Automated system testing and test engineering
- Legacy system modernization and migration
Proven Result: As the MSPIC, NHA led the development of the consolidated Benefits Coordination and Recovery System (BCRS) — replacing two duplicative legacy systems and establishing the new standard for both NGHP and GHP Medicare recoveries.
Wikipedia: Systems Development Life Cycle (SDLC)🔍 Program Integrity
NHA conducts comprehensive program integrity operational reviews and assessments for CMS and federal healthcare programs — providing the independent analysis, data evaluation, and actionable recommendations that agencies need to strengthen oversight, identify vulnerabilities, and implement best practices across the Medicare-Medicaid continuum.
Key Capabilities:
- On-site operational reviews and contractor site visits
- Employee interviews and process evaluations at federal contractor sites
- Data analysis and statistical review for program integrity assessment
- Document review and policy compliance analysis
- Universal recommendation development for program-wide improvements
- ZPIC and UPIC operational transition support
- Program integrity policy development and procurement support
- Vulnerability identification and risk mitigation recommendations
Proven Result: As the PI ORC, NHA conducted site visits at three ZPICs and produced seven universal recommendations that directly shaped CMS's UPIC procurement strategy and transition — informing the future of Medicare program integrity nationwide.
Wikipedia: Medicare Fraud and Abuse⚖ Audit and Compliance Oversight
NHA develops and implements CMS-approved auditing protocols to ensure the accuracy, timeliness, and quality of Medicare program decisions and contractor performance — protecting taxpayer dollars and improving consistency in decision-making across the Medicare appeals and administrative contractor system.
Key Capabilities:
- Auditing protocol development for Medicare appeals accuracy reviews
- QIC (Qualified Independent Contractor) performance auditing
- MAC (Medicare Administrative Contractor) appeals decision auditing
- CMS-approved audit methodology design and implementation
- Workload-specific protocol development for complex multi-type reviews
- Audit findings reporting and quality improvement recommendations
- Compliance monitoring and oversight program management
- Expandable auditing frameworks for new program workloads
Proven Result: As the E&O contractor, NHA developed CMS-approved auditing protocols for Medicare QIC appeals — then expanded the proven framework to MAC appeals, demonstrating the scalability and reliability that earned an Exceptional CPARS quality rating.
🎓 Training, Outreach and Education
NHA designs and develops custom training and education solutions for federal healthcare agencies, Medicare contractors, and insurers nationwide — ensuring that the people who administer the Medicare program have the knowledge, skills, and tools they need to perform accurately and consistently.
Key Capabilities:
- On-demand eLearning module development for federal healthcare programs
- Computer-based training (CBT) design and production
- Instructional systems design for Medicare/Medicaid programs
- Medicare cost report auditing training for MACs
- Federal mandatory reporting compliance training for insurers
- Standardized training programs for new and experienced contractor staff
- Medicare Advantage and Medicaid subject matter training
- Outreach and education program design for national audiences
Proven Result: NHA developed on-demand eLearning for Medicare Administrative Contractors on cost report auditing, and produced CBT modules that trained thousands of insurers nationwide on federal mandatory reporting requirements — programs still actively in use by CMS today.
NHA Success Stories & Featured Work
Quick Answer: NHA's success stories span over 20 years of federal healthcare contract performance. Key projects include the COB&R automated tracking system, the BCRS system consolidation, the ZPIC-to-UPIC program integrity transition, Medicare appeals auditing protocol development, and national eLearning programs for MACs and insurers still in use today.
📋 Managing Deliverables and Assessing COB&R Program Health
■ The Issue
With five different contractors working on the Coordination of Benefits & Recovery (COB&R) Program, CMS found it difficult to manage deliverables and assess the contributions and risks associated with each individual contractor. Program health visibility was limited, creating oversight gaps and accountability challenges.
■ The Result
As the Medicare Secondary Payer Integration Contractor (MSPIC), NHA developed and implemented a SharePoint-based automated deliverable tracking system — transforming CMS's ability to monitor contractor performance and assess program health efficiently. The system provided centralized visibility across all five contractors and became the standard tool for COB&R program oversight.
💻 Developing Systems to Improve COB&R Program Performance
■ The Issue
CMS previously relied on two separate systems for Non-Group Health Plan (NGHP) Medicare Secondary Payer recoveries, causing data duplication and significant inefficiencies in system maintenance. The fragmented architecture created operational overhead and increased the risk of data errors.
■ The Result
As the MSPIC, NHA led the development and implementation of a single, consolidated Benefits Coordination and Recovery System (BCRS). NHA managed scope definition, requirements facilitation, user acceptance and regression testing, and documentation. The new system reduced duplication, streamlined operations, and is now the standard for both NGHP and Group Health Plan (GHP) recoveries — advancing CMS's goals of efficiency and program integrity.
🔍 Helping Define the CMS Program Integrity Process
■ The Issue
When CMS was transitioning from Zone Program Integrity Contractors (ZPICs) to Unified Program Integrity Contractors (UPICs), it needed to know which ZPIC processes were most successful so it could apply them to the upcoming UPIC procurement. Without a systematic review, best practices risked being lost in the transition.
■ The Result
As the Program Integrity Operational Review Contractor (PI ORC), NHA conducted site visits at three different ZPICs — performing employee interviews, process evaluations, data analysis, and document reviews. NHA produced a comprehensive set of seven universal recommendations, enabling CMS to implement the best ZPIC practices across all ZPICs and incorporate them into the UPIC statement of work — directly shaping the future of Medicare program integrity.
⚖ Developing Auditing Protocols to Review Medicare Appeals Decisions
■ The Issue
CMS needed auditing protocols to evaluate the accuracy, timeliness, and quality of Medicare appeals decisions made by Qualified Independent Contractors (QICs). Without standardized protocols, there was no consistent framework for measuring QIC performance or ensuring taxpayer dollars were being used appropriately.
■ The Result
As the Evaluation & Oversight (E&O) contractor, NHA developed CMS-approved auditing protocols for each discrete QIC workload and implemented a consistent auditing approach. This strengthened oversight of Medicare appeals, improved consistency in decision-making, and ensured appropriate use of taxpayer dollars. When CMS later needed similar audits for Medicare Administrative Contractor (MAC) appeals decisions, they turned to NHA to apply the proven approach — a success that expanded NHA's scope and validated its reliability.
🎓 Instructing Medicare Administrative Contractors on Medicare Cost Reports
■ The Issue
CMS needed to train Medicare Administrative Contractors (MACs) on auditing annual cost reports and reimbursement processes. Ensuring consistent and accurate training for both new and existing MAC staff was essential to maintaining program integrity and effective cost report oversight across the Medicare system.
■ The Result
NHA partnered with CMS to develop on-demand eLearning modules for MACs — providing standardized, accessible training that strengthened audit accuracy and supported efficient reimbursement. The training resources benefit both new hires and experienced staff, ensuring consistent program administration regardless of staff turnover.
📚 Educating Insurers Across the Nation on Federal Reporting Requirements
■ The Issue
CMS needed to educate thousands of insurers nationwide on new mandatory federal reporting requirements under the Medicare Secondary Payer rules. Reaching a national audience of diverse insurers with consistent, accurate, and accessible training at scale presented a major logistical challenge.
■ The Result
NHA produced computer-based training (CBT) programs that instructed thousands of insurers on federal mandatory reporting requirements — providing standardized, scalable, on-demand education. The CBTs were so effective and well-designed that they are still in use by CMS today, continuing to support ongoing compliance and program success years after their initial development.
CPARS Performance Reviews & Client Testimonials
Quick Answer: NHA has received exceptional CPARS (Contractor Performance Assessment Reporting System) ratings from CMS across multiple contracts — including an explicit "Exceptional for Quality" rating on the E&O contract. Reviewers consistently highlight NHA's professional conduct, high staff retention, deep Medicare expertise, flexibility, and quality of deliverables.
The Contractor Performance Assessment Reporting System (CPARS) is the federal government's official system for evaluating contractor performance. NHA's CPARS record reflects over two decades of consistently strong performance across its CMS contracts.
NHA Domain Expertise
NHA's core team of nationally recognized experts brings unrivaled knowledge across the Medicare program, CMS operations, healthcare regulations, and government technology systems. This deep domain expertise — built over two decades of hands-on CMS contract performance — is what sets NHA apart from generalist federal IT contractors.
NHA's Core Knowledge Areas
- Medicare Secondary Payer (MSP) — Benefits Coordination and Recovery, COB&R program structure, NGHP and GHP recoveries
- CMS Program Operations — Medicare appeals, QIC/MAC performance, contractor oversight frameworks
- Program Integrity — ZPIC/UPIC operations, fraud and abuse prevention, audit methodology
- Healthcare IT Systems — BCRS, BCRS modernization, MDX, PULSE, legacy system migration
- Regulatory Compliance — Medicare mandatory reporting, MAO (Medicare Advantage Organization) compliance, federal contractor obligations
- eLearning & Instructional Design — On-demand CBT/eLearning for Medicare contractors and insurers
- SharePoint Automation — Workflow automation for federal program oversight and deliverable management
- Medicare Advantage & Medicaid — Cross-program expertise across Part A, B, C, and D and Medicaid intersections
Key Programs NHA Has Supported
🔗 COB&R Program (MSPIC)
The Coordination of Benefits & Recovery (COB&R) Program coordinates Medicare benefits when Medicare is not the primary payer. As the MSPIC, NHA provided program management, IT systems development, and integration support across this complex multi-contractor environment.
Wikipedia: Medicare Secondary Payer📊 BCRS System
The Benefits Coordination and Recovery System (BCRS) is the CMS system that processes Medicare Secondary Payer data and manages recovery activities for both NGHP and GHP cases. NHA led its development, consolidating two legacy systems into a single, efficient platform.
⚖ Medicare Appeals Oversight (E&O)
As the Evaluation & Oversight (E&O) contractor, NHA audits the quality and accuracy of Medicare appeals decisions made by QICs and MACs — ensuring the appeals process is fair, consistent, and aligned with CMS standards.
Wikipedia: Medicare Appeals🔍 Program Integrity (PI ORC)
As the Program Integrity Operational Review Contractor (PI ORC), NHA conducts independent operational reviews of CMS's program integrity contractors — providing the analysis and recommendations that shape how CMS prevents and detects fraud, waste, and abuse in the Medicare program.
💾 MDX & PULSE Programs
NHA supported the MDX and PULSE programs — CMS data and analytics platforms — providing technical operations support, stakeholder engagement, and process implementation to ensure reliable, repeatable data operations for CMS and its contractor ecosystem.
🎓 MAC Training Programs
NHA developed standardized eLearning and CBT training programs for Medicare Administrative Contractors — ensuring consistent knowledge of cost report auditing, reimbursement processes, and federal compliance requirements across all MAC staff, new and experienced.
Careers at NHA
Quick Answer: NHA is a growing federal healthcare consulting firm that actively recruits professionals with Medicare, Medicaid, CMS, coding, IT, project management, and instructional design expertise. NHA offers 15 days paid vacation upon hire, comprehensive health insurance, 401(k) with generous company match, flexible work arrangements, and a family-oriented culture.
NHA's team is its greatest asset. The high staff retention rates noted in NHA's CPARS reviews are a direct reflection of a workplace culture that values employees, invests in professional growth, and creates an environment where expertise can thrive. NHA is always seeking talented professionals — even when no specific opening is listed.
Roles NHA Seeks
📋 Project Management
Business Analysts, Systems Analysts, Quality Assurance Analysts, and Project Managers with federal healthcare or Medicare program experience.
🏥 Medicare / Medicaid SMEs
Medicare, Medicare Advantage, and Medicaid subject matter experts — including appeals specialists, coverage policy analysts, and Part A/B/C/D program experts.
💻 Software & Database Development
JAVA Full Stack developers, MicroStrategy developers, and database engineers with federal or healthcare IT experience.
🔒 Information Security
Information Security Specialists and IT Support professionals with federal security clearance experience or knowledge of CMS system security requirements.
✅ Coding & Appeals
Coding Specialists, Appeals Specialists, and Grievance Specialists with Medicare claims, coverage, or appeals process expertise.
🎓 Training & Education
Instructional Systems Designers, eLearning Developers, and Training Specialists with experience in outreach and education programs for healthcare or government audiences.
🧪 Automated Testing
Automated System Testers and Test Engineers for federal healthcare IT programs, including experience with UAT, regression testing, and SDLC support.
NHA Employee Benefits
💰 Compensation & Time Off
- 15 Days Paid Vacation Upon Hire (increases with tenure)
- 7 Days Paid Sick Leave
- Employer-Paid Holidays + Floating Holidays
- 401(k) with Generous Company Match
- HSA and FSA Programs
❤ Health & Wellness
- Comprehensive Health Insurance Options
- Employee Assistance Program (EAP)
- Discount Employee Programs & Services
- Voluntary Ancillary Benefits
- Travel Assistance, Will Prep & Power of Attorney Services
🤝 Culture & Work Life
- Flexible Work Location & Hours
- Casual, Family-Oriented Work Environment
- Engaged Managers and Low Staff Turnover
- Quarterly Employee Newsletter
- In-Person and Virtual Social Events
Don't see a current opening that matches your skills? NHA is always seeking experienced professionals. Submit your resume to the NHA Talent Community →
Frequently Asked Questions About NHA
What is Neil Hoosier and Associates (NHA)?
Neil Hoosier and Associates (NHA) is a federal healthcare management consulting firm based in Owings Mills, Maryland (main office) and Pomona, New York (headquarters). With over 20 years of experience, NHA delivers high-quality Program Management, SDLC Integration, Program Integrity, Audit and Compliance, and Training solutions to public- and private-sector clients. NHA is nationally recognized for its deep expertise in the Medicare program and its long-standing work with the Centers for Medicare and Medicaid Services (CMS).
What services does NHA offer?
NHA offers five core service areas: (1) Program and Project Management — deliverable tracking, contractor oversight, and program health monitoring; (2) SDLC Integration and Support — systems development, requirements facilitation, testing, and documentation; (3) Program Integrity — operational reviews, data analysis, and process evaluations for Medicare-Medicaid programs; (4) Audit and Compliance Oversight — auditing protocol development for Medicare appeals and contractor performance; (5) Training, Outreach and Education — eLearning modules, CBTs, and instructional design for federal agencies and contractors.
Who does NHA work with?
NHA primarily serves federal government agencies, with deep expertise working with the Centers for Medicare & Medicaid Services (CMS). NHA's clients span public-sector agencies administering the Medicare program and private-sector organizations including insurers, Medicare Administrative Contractors (MACs), Qualified Independent Contractors (QICs), Zone Program Integrity Contractors (ZPICs), Unified Program Integrity Contractors (UPICs), and other CMS program contractors across the nation.
What is the MSPIC and what did NHA do as the MSPIC?
The Medicare Secondary Payer Integration Contractor (MSPIC) is a CMS contract that manages the Coordination of Benefits and Recovery (COB&R) program. As the MSPIC, NHA: (1) Developed and implemented a SharePoint-based automated deliverable tracking system for the COB&R program's five-contractor environment; (2) Led the development of the Benefits Coordination and Recovery System (BCRS), consolidating two legacy systems into a single efficient platform now used as the standard for both NGHP and GHP Medicare recoveries; (3) Managed scope definition, requirements facilitation, user acceptance and regression testing, and documentation for the BCRS program.
How has NHA been rated on its federal contracts?
NHA has received exceptional CPARS ratings from CMS across multiple contracts. On the E&O contract, CMS rated NHA "exceptional for quality" — the highest available CPARS rating — citing the clarity, completeness, and continuous improvement of NHA's reports and deliverables. MSPIC CPARS reviews highlighted NHA's high staff retention, experienced personnel (14+ years Medicare experience, 6+ years on MSPIC), flexibility, and quick problem-solving. MDX/PULSE reviews praised NHA's technical expertise, proactive stakeholder engagement, and management team's reliability for unanticipated requirements.
What makes NHA different from other federal healthcare contractors?
Several factors distinguish NHA: (1) Unrivaled CMS expertise — a core team of nationally recognized experts with deep, specialized knowledge of the Medicare program, CMS operations, and healthcare regulations; (2) High staff retention — key personnel average 14+ years of Medicare experience, providing institutional knowledge that generalist contractors cannot replicate; (3) Proven track record — 20+ years of exceptional CPARS ratings for quality, flexibility, and responsiveness; (4) Best-of-both-worlds model — enterprise-level expertise and capabilities with the personalized attention and responsiveness of a small business; (5) End-to-end capabilities — spanning program management, IT systems, integrity, compliance, and training under one roof.
What is the Benefits Coordination and Recovery System (BCRS)?
The Benefits Coordination and Recovery System (BCRS) is a CMS data system for coordinating and recovering Medicare Secondary Payer payments. CMS previously relied on two separate systems for Non-Group Health Plan (NGHP) recoveries, causing data duplication and operational inefficiencies. As the MSPIC, NHA led the development of the consolidated BCRS — managing scope definition, requirements facilitation, UAT, regression testing, and documentation. The BCRS is now the standard platform for both NGHP and Group Health Plan (GHP) recoveries.
Does NHA work with private-sector clients?
Yes. While NHA is best known for its federal government work with CMS and the Medicare program, NHA also delivers solutions to private-sector clients — including insurers, healthcare organizations, and Medicare program contractors. NHA's training programs have directly served thousands of insurers nationwide on federal mandatory reporting requirements. NHA's website states: "For more than 20 years, we have delivered high-quality solutions to public- and private-sector clients, establishing a proven track record of success."
How do I contact NHA or request a capabilities statement?
You can contact NHA by phone at 443-213-8343, by email at info@nhassociates.com, or through the contact form at nhassociates.com/contact/. Main Office: Owings Mills, Maryland 21117. Headquarters: Pomona, New York 10970. NHA's Capabilities Statement is available for download at nhassociates.com (PDF). Connect with NHA on LinkedIn.
Is NHA currently hiring?
NHA is a growing firm that actively recruits experienced professionals even when no specific position is currently posted. NHA welcomes submissions from professionals with experience in: Coding, Appeals and Grievance; Project Management; Software and Database Development (JAVA Full Stack, MicroStrategy); Outreach and Education / Instructional Systems Design; Medicare/Medicare Advantage/Medicaid Subject Matter Expertise; Information Security; and Automated System Testing. Visit nhassociates.com/careers/ or submit your resume to the NHA Talent Community.
Partner with NHA for Federal Healthcare Solutions
Ready to learn how NHA's 20+ years of Medicare and CMS expertise can support your program? Get in touch with NHA today.
Contact Neil Hoosier and Associates
🏢 Main Office
Owings Mills, Maryland 21117
🏛 Headquarters
Pomona, New York 10970