Resources for MACs
If you are a Medicare Administrative Contractor (MAC), here are some helpful resources. If you aren’t a MAC, you still might find these resources helpful to understand what MACs do and how they do it.
- Federal Acquisition Regulation (FAR): CMS follows the requirements of the FAR in procuring and managing the MAC contracts.
- HHS Acquisition Regulation (HHSAR): CMS follows the requirements of HHSAR in procuring and managing the MAC contracts.
- Cost Accounting Standards (CAS): The official codified Cost Accounting Standards appear at 48 CFR Chapter 99.
- A/B Enterprise Claims Processing Architecture (PDF): This document presents a detailed enterprise architecture view of the Fee-for-Service (FFS) business in April 2006, focusing on the functional and technical environments for processing FFS claims.
- MAC Transition Handbook (PDF): The A/B-DME Workload Transition Handbook was developed by the CMS Medicare Contractor Management Group for use by Medicare Administrative Contractors who are participating in a Medicare workload transition. The handbook provides information on the processes to transition from one MAC to another when a new contract is awarded.
- Compliance Program Guidance for FFS Contractors (PDF): All MACs shall have an effective compliance program in place. CMS has published its own guidance document, which MACs that are designing, implementing or evaluating their compliance programs may find useful
** Previous "Resources for MACs" postings can be found here: Resources for MACs Archive
A/B Enterprise Claims Processing Architecture (PDF)
Compliance Program Guidance for Fee-for-Service Contractors (PDF)
Medicare Administrative Contractor Workload Transition Handbook V.3.0_12112019 (PDF)