Medicare Administrative Contractors -- CMS -- What’s New

On November 19, 2008, CMS announced it had awarded the contract for Jurisdiction 14 (J14) to National Heritage Insurance Corporation (NHIC). NHIC will be responsible for the workload in Maine, Massachusetts, New Hampshire, Rhode Island and Vermont. NHIC's contract also includes the Regional Home Health and Hospice Intermediary (RHHI) workload in Jurisdiction A comprised of Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island and Vermont. As the J14 A/B MAC, NHIC will immediately begin implementation activities and will assume full responsibility for the work no later than September 2009.

On January 7, 2009, CMS announced it had awarded the remaining five contracts for the combined administration of Part A/Part B Medicare:

·  Noridian Administrative Services, LLC (NAS) has been awarded a contract for the combined administration of Part A/Part B Medicare claims payment in Jurisdiction 6 comprised of Illinois, Minnesota and Wisconsin. NAS will also be responsible for the home health and hospice processing workload in Alaska, American Samoa, Arizona, California, Guam, Hawaii, Idaho, Michigan, Minnesota, Nevada, New Jersey, New York, Northern Mariana Islands, Oregon, Puerto Rico, U.S. Virgin Islands, Wisconsin and Washington.

·  National Government Services, Inc (NGS) has been awarded a contract for the combined administration of Part A/Part B Medicare claims payment in Jurisdiction 8 comprised of Indiana and Michigan.

·  Cahaba Government Benefit Administrators, LLC (Cahaba GBA) has been awarded a contract for the combined administration of Part A/Part B Medicare claims payment in Jurisdiction 10 comprised of Alabama, Georgia and Tennessee.

·  Palmetto Government Benefits Administrator, LLC (Palmetto GBA) has been awarded a contract for the combined administration of Part A/Part B Medicare claims payment in Jurisdiction 11 comprised of North Carolina, South Carolina, Virginia and West Virginia. Palmetto GBA will also be responsible for the home health and hospice processing workload in Alabama, Arkansas, Florida, Georgia, Illinois, Indiana, Kentucky, Louisiana, Mississippi, New Mexico, North Carolina, Ohio, Oklahoma, South Carolina, Tennessee and Texas.

·  Highmark Medicare Services, Inc (HMS) has been awarded a contract for the combined administration of Part A/Part B Medicare claims payment in Jurisdiction 15 comprised of Kentucky and Ohio. HMS will also be responsible for the home health and hospice processing workload in Colorado, Delaware, District of Columbia, Iowa, Kansas, Maryland, Missouri, Montana, Nebraska, North Dakota, Pennsylvania, South Dakota, Utah, Virginia, West Virginia and Wyoming.

These contractors will immediately begin implementation activities and will assume full responsibility for the claims processing work in their respective jurisdictions no later than March 2010. Background sheets and Qs & As related to the awards are available at the A/B MACProcurement and Implementation link to the left.

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