A contract designed to modernize a provider enrollment system was publicly canceled, but has now been quietly removed from the Department of Government Efficiency’s ‘wall of receipts’ website.

The Centers for Medicare and Medicaid Services (CMS) promised to end the long-term project, which new health department leadership deemed a costly and ineffective failure. The contract was posted online after March 24 with limited information.

As previously reported by Fierce Healthcare, the contract for PECOS 2.0, or Provider Enrollment, Chain, and Ownership System, was carried out, at least in part, by contractor CGI Federal. The DOGE website listed a savings value of $0.

But by April 7, the wall of receipts posting for PECOS 2.0 appeared to have been scrubbed entirely. No similar listing for PECOS 2.0 by CGI Federal or any other contractor is listed on the website, and other termination notices listed with a value of $0 are still on the website. It’s the latest example of the DOGE website undergoing haphazard changes with no clear explanation.

Originally, the outbound link led to a federal procurement contract from July with a total value of nearly $104 million and $0 current obligation. That contract update can still be found in government databases but is not visible on the DOGE website at the time of publication.

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DOGE.gov/Noah Tong

Still, mentions of CGI Federal on PECOS pages on the CMS website vanished in recent weeks, with a warning message indicating a help desk portal would be moved by the end of March.

The PECOS contract can be dated back years underneath large parent contracts for CGI Federal, making it difficult to discern exactly what was spent, when and for which services, said Jenn Kerfoot, chief strategy and growth officer for digital health company DUOS.

“There’s not a lot of transparency in what’s getting cut because I think the goal of that website is to sensationalize big dollar amounts,” said Kerfoot, noting a lot of the contract has already been paid. “When I started looking into the other things DOGE has on there, we’ve already reaped the benefit out of it. There are some things in the subawards, or these tack-ons over time, that is maintenance of the specific product or service.”

For example. PECOS 1.0 falls under this contract, beginning 2012 and ending this month. More than $87 million was outlayed for systems support and development of PECOS 1.0 starting in 2016. The PECOS 2.0 modernization project was first awarded in 2016. This contract began implementation through a task order in 2020.

Notably, both parent contracts included COVID-19 spending, another target by the Trump administration. States sued the administration for rescinding more than $11 billion in funds awarded by the Department of Health and Human Services (HHS) to local health departments and nonprofits.

PECOS supports provider and supplier validation and enrollment, business relationship transparency and program integrity requirements. In recent years, CMS has enlisted CGI Federal to modernize the system, but after millions of dollars and the contract set to expire later this year, the government canceled the contract after “zero usable output was produced.”

“As part of overall efforts to reduce its reliance on contractors, CMS made the decision earlier this year to bring the PECOS work in-house,” a CMS spokesperson confirmed to Fierce Healthcare April 8.

‘Financial industrial complex’

Tracking the PECOS contracts is messy and convoluted, and drives at a larger theme surrounding procurement in the federal government.

“Looking at procurement, it was incredibly difficult to watch the changing of money,” Kerfoot explained. “It’s almost like a box, inside a box, inside a box. This is a very big financial industrial complex. This is a machine where the house always win. Lobbyists gonna lobby.”

For many government contractors, this traditionally reliable revenue stream is fundamentally disrupted under the Trump administration. All over the DOGE website, contracts with Deloitte, Accenture and other contractors are canceled across government agencies, leading to layoffs at these companies.

CGI Federal, the recipient of the PECOS contracts, is no stranger to lobbying. The company was also a primary contractor behind the rocky Healthcare.gov rollout, reported the Washington Post. An analysis from 2006 to 2013 showed the contractor lobbying on tax and appropriations bills to the tune of $800,000.

CGI Federal also had contracts canceled for APIs, or application programming interfaces, according to the DOGE website. APIs are connection points that help software components communicate with each other, said Stephanie Lambert, a provider enrollment project analyst for revenue cycle management company Zotec Partners.

In PECOS, APIs help providers revalidate with Medicare so they can earn reimbursement with services. If these APIs are no longer maintained and fall through the cracks in the future, providers may struggle to get reimbursed.

“It’s a little thing like that where it could have a big impact,” she said, adding that short-term disruptions would likely prompt CMS to find a long-term solution.