CMS is changing the MAC bidding/award process to compress the original 15 MACs down to 10. The current Jurisdictions 1, 9, 10, 11, and 12, will remain as is. Jurisdictions 2 and 3; 4 and 7; 5 and 6; 8 and 15; 13 and 14; will be combined into 5 bids/awards. For the details on this change, see the link below, or go to www.hfssoft.com, and click on the News Tab.
DME Re-compete:
In 2006, the Centers for Medicare and Medicaid Services (CMS) awarded the first MAC contracts to administer Medicare claims for DME benefits in jurisdictions A and B. Under the Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA) the Secretary of Health and Human Services must re-compete its Medicare Administrative Contractors contracts every five (5) years. Therefore, on Thursday, December 30, 2009, CMS issued a solicitation for the first “second generation” MAC contractors for DME Jurisdictions A and B. Currently, National Heritage Insurance Company (NHIC) is serving as the DME MAC in Jurisdiction A, and National Government Services (formerly doing business as AdminaStar Federal Inc.) is serving as the DME MAC in Jurisdiction B. CMS anticipates awarding these contracts and fully transitioning the workloads to new MAC contracts by no later than December 2010.
CMS recently pulished updated info about MAC Jurisdiction J-7 (AR, LA, MS). CMS said “In taking corrective action CMS plans to issue a new solicitation to procure the A/B Medicare Administrative Contractor Jurisdiction 7 workload previously solicited under RFP-CMS-2007-0002. CMS anticipates initiating the new procurement action in calendar year 2010.” In essence, CMS is re-bidding J-7, so who knows when we will see a final award!
This completes all 15 MAC awards. HFS is the vendor for 11 of the 15. There are still some protests/appeals to be resolved, so the following list is subject to change.
The list is:
MAC Jurisdiction #1 (CA, HI, NV) awarded to Palmetto GBA.
MAC Jurisdiction #2 (AK, ID, OR, WA) awarded to NHIC.
MAC Jurisdiction #3 (AZ, ND, MT, SD, UT, WY) awarded to Noridian.
MAC Jurisdiction #4 (CO, NM, OK, TX) awarded to Trailblazer.
MAC Jurisdiction #5 (IA, KS, NE, MO) awarded to WPS.
MAC Jurisdiction #6 (IL, MN, WI) awarded to Noridian. Also includes HHA.
MAC Jurisdiction #7 (AR, LA, MS) awarded to Pinnacle.
MAC Jurisdiction #8 (IN, MI) awarded to NGS.
MAC Jurisdiction #9 (FL, PR) awarded to FCSO.
MAC Jurisdiction #10 (AL, GA, TN) awarded to CAHABA GBA.
MAC Jurisdiction #11 (NC, SC, VA, WV) awarded to Palmetto GBA. Also includes HHA.
MAC Jurisdiction #12 (DE, DC, MD, NJ, PA) awarded to Highmark.
MAC Jurisdiction #13 (CT, NY) awarded to NGS.
MAC Jurisdiction #14 (ME, MA, NH, RI, VT) awarded to NHIC. Also includes HHA.
MAC Jurisdiction #15 (OH, KY) awarded to Highmark. Also includes HHA.
The four DME jurisdictions (A, B, C, D) are:
A = CT, DE, DC, ME, MD, MA, NH, NJ, NY, PA, RI, VT.
B = IL, IN, KY, MI, MN, OH, WI.
C = AL, AR, CO, FL, GA, LA, MS, NM, NC, OK, PR, SC, TN, TX, U.S. Virgin Is., VA, WV.
D = AK, Amer. Samoa, AZ, CA, Guam, HI, ID, IA, KS, MO, MT, NE, NV, ND, Northern Mariana Is., OR, SD, UT, WA, WY.