Spotlight

Status of Medicare Administrative Contractor (MAC) Contract Awards (as of April 26, 2013)

Protest Updates: On January 18, 2013, the Government Accountability Office (GAO) denied the two protests that had been pending against the Jurisdiction E A/B MAC contract award to Noridian Administrative Services (NAS) since October 2012.  As permitted by law, both protestors filed complaints challenging the Jurisdiction E MAC contract award with the U.S. Court of Federal Claims on February 1, 2013.  On April 17, 2013, the Court of Federal Claims denied both protests.   CMS and NAS will now move forward to implement the new contract and expects this process to complete by mid-September 2013. Access Jurisdiction E Implementation Schedule. While the new contract is being implemented, Medicare providers in California, Hawaii, Nevada, and the Pacific territories of American Samoa, Guam and the Northern Mariana Islands, will continue to file their Medicare claims with the incumbent A/B MAC (Palmetto GBA).  

On October 2, 2012, CMS was notified that a protest was  filed against the Jurisdiction L A/B MAC contract that was awarded to Novitas Solutions, Inc., on September 17.  In keeping with federal procurement law, CMS issued a stop work order for the Jurisdiction L contract, to allow the GAO to review the procurement record. Due to a second protest received on January 8, 2013, the contract remained under a stop work order through mid-April.  During the GAO review, Novitas continued to administer Medicare payments to providers in Jurisdiction L (the states of Delaware, Maryland, New Jersey, and Pennsylvania, as well as the District of Columbia) under an existing contract. On April 16, 2013, the GAO resolved the protest of the award. CMS will now move forward with Novitas to implement the new contract. Access Jurisdiction L Implementation Schedule. While the new contract is being implemented, Novitas will continue to administer Medicare payments in these states under an existing MAC contract. 

On October 9, 2012, CMS received notification that two protests had been filed against the Jurisdiction 6 A/B MAC contract that was awarded to National Government Services (NGS) on September 27.  GAO completed its review of the procurement record on January 16, 2013, and denied both protests.  CMS is presently implementing the Jurisdiction 6 MAC contract and expects the implementation process to be completed in September 2013.  Access  Jurisdiction 6 Implementation Schedule.  CMS and NGS will notify the affected Medicare providers concerning any actions that must be taken to support the implementation.  While the new Jurisdiction 6 MAC contract is being implemented, the current Medicare fiscal intermediaries and carriers will continue to administer Medicare payments to providers of Illinois, Minnesota, and Wisconsin.

On September 18, 2012, CMS received notification that a protest was filed against the DME MAC C contract award that was made to CGS Administrators, LLC (CGS), on August 31.  GAO completed its review of the procurement record and denied the protest on December 21, 2012.  CMS expects to complete the implementation of the new contract by April 30, 2013.  During this period, CGS will continue to administer Medicare payments to DME suppliers in Jurisdiction C under an existing contract.

Award Announcements:  On February 22, 2013, CMS made a contract award for the Jurisdiction K A/B MAC to National Government Services, Inc. (NGS).  The Jurisdiction K A/B MAC will administer Medicare Part A and Part B claims for covered services in the states of Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island and Vermont. The new A/B MAC contract replaces two separate A/B MAC contracts now in effect that were awarded in 2008.  NGS will be subcontracting several significant functions to NHIC Corp. (NHIC) under the new Jurisdiction K A/B MAC contract.  CMS issued the solicitation for the new Jurisdiction K A/B MAC contract in May 2012; inclusive of all options, the awarded contract has an estimated value of $493.2 million.  For more information about the Jurisdiction K contract award, use the following link: Jurisdiction K Award Fact Sheet.  The new contract will be implemented by October 31, 2013. To view the implementation schedule, use the following link: Jurisdiction K Implementation Schedule.

On September 27, 2012, CMS made a contract award for the Jurisdiction 6 A/B MAC to National Government Services, Inc. (NGS).  The Jurisdiction 6 A/B MAC administers Medicare Part A and Part B claims for covered services in the states of Illinois, Minnesota, and Wisconsin.  This contractor will also administer Medicare billings from home health and hospice providers in thirteen states and five U.S. territories.  The current Medicare fiscal intermediaries and carriers for these Medicare workloads (in addition to NGS, Wisconsin Physicians Service and Noridian Administrative Services currently service some of the Medicare claims to be transferred to the new contract) will continue in their responsibilities for several months while CMS and NGS implement the new contract. You may view the implementation schedule using the following link: Jurisdiction 6 Implementation Schedule. For more information about the Jurisdiction 6 MAC contract award, use the following link:  Jurisdiction 6 Award Fact Sheet.  All protests against the Jurisdiction 6 MAC contract award were resolved on January 16, 2013, and CMS and NGS will now implement the new contract in September 2013 (see Protest Updates above).

On September 20, 2012, CMS made a contract award for the Jurisdiction E A/B MAC contract to Noridian Administrative Services (NAS).  The Jurisdiction E A/B MAC administers Medicare Part A and Part B claims for covered services in the California, Hawaii, and Nevada, as well as the U.S. territories of American Samoa, Guam, and the Northern Mariana Islands.  The current A/B MAC for this geographic area, Palmetto GBA, will continue to administer provider claims until CMS completes the transfer of these Medicare contract responsibilities to NAS.  On April 17, the U. S. Court of Federal Claims denied all protests against the award. CMS and NAS will now move forward with the implementation. Use the following link to access the implementation schedule: Jurisdiction E Implementation Schedule. For more information about the Jurisdiction E award, use the following link:  Jurisdiction E Award Fact Sheet.  

On September 17, 2012, CMS made a contract award for the Jurisdiction L A/B MAC contract to Novitas Solutions, Inc.  The Jurisdiction L A/B MAC administers Medicare Part A and Part B claims for covered services in the states of Delaware, Maryland, New Jersey, and Pennsylvania, as well as the District of Columbia.  For more information about the Jurisdiction L award, use the following link:  Jurisdiction L Award Fact Sheet.  On April 16, 2013, the GAO resolved all protests against the award (See protest update above).  Use the following link to access the JL Implementation Schedule:Jurisdiction L Implementation Schedule.

On August 31, 2012, CMS made a contract award for the Jurisdiction C Durable Medical Equipment (DME) MAC contract to CGS Administrators, LLC.  The Jurisdiction C DME MAC administers Medicare supplier claims for DME furnished to program beneficiaries who reside in the states of Alabama, Arkansas, Colorado, Florida, Georgia, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia, and West Virginia, as well as Puerto Rico and the U.S. Virgin Islands.  The contract award was protested, but GAO has resolved the protest and CMS is now implementing the contract. (See Protest Updates, above). For more information about the Jurisdiction C award, use the following link:  Jurisdiction C Award Fact Sheet.