MACRA Section 509
- Summary of Section 509 of MACRA of 2015
- Implementation of Section 509 of MACRA of 2015
- Decisions Regarding Future MAC Procurements
Summary of Section 509 of MACRA of 2015
The Medicare Access and CHIP Reauthorization Act (MACRA) enacted on April 16, 2015, included language in Section 509 that extends Medicare Administrative Contractor (MAC) contract terms from five to ten years. The legislation also requires the Agency to publish performance information on each MAC, to the extent that such information does not interfere with contract procurements. The legislation applies to all contracts in effect at the time of enactment, meaning that current MAC contracts in place can be extended another five years to a maximum of ten. This also means that the Agency is required to immediately make public performance information on each MAC. Read the full text of this legislation at Public Law No: 114-10.
CMS is using the following strategy to implement this legislation.
- CMS published MAC performance information on its website in the summer of 2015. Learn more at MAC Performance Compliance.
- CMS conducted market research to gather industry feedback on performance information and various contract issues, including contract length and performance incentives. For more information, please see the Federal Register Notice at Medicare Program; Awarding and the Administration of Medicare Administrative Contractor Contracts [CMS-1653-NC].
- On August 5, 2016, CMS published a Request for Information (RFI) to provide industry with a draft Request for Proposal (RFP) for use in future Medicare Administrative Contractor (MAC) procurements. CMS is soliciting comments on this draft RFP (including the attachments), and the new MAC procurement schedule. For more information please see the posting at MAC RFI Special Notice –Draft request for proposal (RFP) – Request for information Part A/B Medicare Administrative Contracts (MAC).
Timeline for Future MAC Procurements - To comply with MACRA Section 509, CMS plans to execute the next round of MAC procurements (12 A/B MACs and 4 DME MACs) based upon a “first-in, first-out” timeline. The contracts with the oldest award dates will be re-competed first and the most recently-awarded contracts will be re-competed last. This schedule enables CMS to establish a “steady-state” level of MAC re-procurement activity by spacing re-procurements approximately five months apart. This approach also enables CMS and potential MAC contract Offerors to more predictably deploy acquisition resources and thereby avoid acquisition activity “stacking." For additional information regarding the schedule for future MAC procurements, please refer to Attachment 1 in the Request for Information that was released on August 5, 2016.