The Centers for Medicare & Medicaid Services has announced the final five contractors that will process and pay Medicare claims for healthcare services under the Medicare fee-for-service program.
"With these last awards, CMS completes a major step in its effort to improve the way in which the government contracts for claims administration for the largest part of Medicare across the United States," said Acting CMS Administrator Kerry Weems.
The new contracts that will be administered for up to five years will process and pay 36 percent of the national volume of Medicare Part A and Part B claims payments in 14 states, mostly in the South and Midwest. These are services furnished by hospitals, physicians and other healthcare providers to people with Medicare.
CMS now has met its goal of awarding all 15 Medicare Administrative Contractor (MAC) contracts.
"CMS will receive the best value for the critical function of processing and paying Medicare claims," said Weems. "This is another step toward ensuring that we have a highly functioning processing and payment system that helps to improve services to beneficiaries and healthcare providers in the Medicare fee-for-service benefit plan."
The final five Part A and Part B MAC contractors will immediately begin their implementation activities and assume full responsibility no later than March 2010. The new contractors will take over the claims payment work now performed by numerous fiscal intermediaries and carriers.
The MAC contracts, which have an approximate value of $1.4 billion over five years, will fulfill the requirements of the Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA) contracting reform provisions.
The five new MACs are:
• Noridian Administrative Services, LLC, based in Fargo, N.D., will serve Jurisdiction 6, comprised of Illinois, Minnesota and Wisconsin;
• National Government Services, based in Indianapolis, Ind., will serve Jurisdiction 8, comprised of Indiana and Michigan.
• Cahaba Government Benefit Administrators, LLC, based in Birmingham, Ala., will serve Jurisdiction 10, comprised of Alabama, Georgia and Tennessee.
• Palmetto Government Benefits Administrators, based in Columbia, S.C., will serve Jurisdiction 11, comprised of North Carolina, South Carolina, Virginia and West Virginia, with some operations performed in Columbus, Ohio.
• Highmark Medicare Services, headquartered in Camp Hill, Pa., will serve Jurisdiction 15, comprised of Kentucky and Ohio.