Medicare J15 MAC Award Officially Protested
July 27, 2010:
CMS' Jurisdiction 15 (J15) Medicare Administrative Contractor (MAC) award to CIGNA Government Services is again on hold. Both National Government Services (NGS), the current Medicare FI for the region, and Hignmark Medicare Services filed protests last week, which means the US Government Accountability Office may not issue a decision until mid-fall.
CMS posted a brief overview of its decision to award the J15 MAC to CIGNA Government Services, LLC earlier this month. The MAC contract includes nearly all Medicare parts A and B, provider and beneficiary operations in Ohio and Kentucky, and was first awarded to Highmark in January 2009. Two firms protested, the award, one of them reportedly CIGNA, and CMS re-bid the contract. Following the re-bid, CMS announced it had reversed its initial decision and gave the job to CIGNA. Now that award has been officially protested, so the process is once again on hold.
The J15 MAC also includes home health and hospice claims administration for Colorado, Delaware, District of Columbia, Iowa, Kansas, Maryland, Missouri, Montana, Nebraska, North Dakota, Pennsylvania, South Dakota, Utah, Virginia, West Virginia and Wyoming.
NGS says it it is likely any MAC transition will run well into 2011, regardless, so it is Medicare business usual for Ohio hospitals and doctors. OHA will continue to monitor the situation and report again as details are released.
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