The Centers for Medicare & Medicaid Services (CMS) has awarded Pinnacle Business Solutions, Inc. (PBSI) a contract of up to five years for combined administration of Part A and Part B Medicare claims payments in Arkansas, Louisiana and Mississippi.
PBSI, headquartered in Little Rock, Ark., is the eighth new Part A/Part B Medicare Administrative Contractor to be named by CMS. By 2011, 15 Part A/Part B Medicare contractors will be assigned to cover every state and the District of Columbia.
"This is another step toward improving service to beneficiaries and health care providers, as well as giving CMS greater oversight of the Medicare contractors that process and pay Medicare claims," said Acting CMS Administrator Kerry Weems. "In awarding these contracts, CMS is ensuring that each Medicare contractor continues to provide the best overall value to the government and the American taxpayers, from both a cost and technical perspective."
PBSI will serve as the first point of contact for the processing and payment of Medicare fee-for-service claims from hospitals, skilled nursing facilities, physicians and other healthcare practitioners in the three states.
When contracting reform is fully implemented, all fiscal intermediaries and carriers will be replaced by MACs responsible for both Part A and Part B claims processing.
The contract, which has an approximate value of $178 million, will fulfill the requirements of the Medicare Modernization Act's contracting reform provisions. It includes a base period and four one-year options and provides PBSI with an opportunity to earn award fees based on ability to meet or exceed the performance requirements set by CMS.
According to reports, the requirements are rooted in CMS' key objectives for MACs, including enhanced provider customer service, increased payment accuracy, improved provider education and training leading to correct claims submissions, and realized cost savings resulting from efficiencies and innovation. In accordance with the MMA, MAC contracts will be recompeted at least every five years.
As the A/B MAC contractor, PBSI will assume full responsibility for the claims processing work no later than February 2009.
Are you happy with the new A/B MAC? Does it affect your practice/system? Send your comments to Associate Editor Chelsey Ledue at chelsey.ledue@medtechpublishing.com.