2020-01-29

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Submitted by FHNX on Tue, 12/17/2019 - 16:34
Date
2020-01-29
Event
Listening Session on MAC Opportunities to Enhance Provider Experience
Topic
Medicare Administrative Contractor

When: Wednesday, January 29, 2020, from 2 to 3 pm ET

Registration:  Register for Medicare Learning Network events.

Event Materials:

  • Presentation (PDF)
  • Audio recording and transcript: Available approximately 2 weeks after the event

Description:

As part of our 2020 priorities, we are holding a series of listening sessions to gather feedback and improve your experience with the Medicare Fee-For-Service (FFS) program. Through competitive cost-plus award-fee contract procurements, CMS encourages Medicare Administrative Contractors (MACs) to innovate and respond to provider, practitioner, and supplier expectations in their jurisdictions. 

We invite you to participate in one of three MAC listening sessions. CMS wants to hear your feedback to improve processes and enhance interactions with your MAC related to:

  • Operations
  • Technology
  • Business functions, including:
    • Claims processing
    • Electronic data interchange claims-based transactions
    • Telephone/written inquiries
    • Self-service (website/portal/interactive voice response unit)
    • Medical review
    • Outreach and education/educational resources
    • First level appeals or redeterminations
    • Provider enrollment
    • Debt collection
    • Cost report audit and reimbursement
    • Development of Local Coverage Determinations (LCDs)

We are particularly interested in hearing provider, practitioner, and supplier ideas about actions we could take to improve the overall beneficiary quality of care and customer service experience they may have with the MACsCMS Administrator, Seema Verma will open this call.

You can email comments or questions in advance of the listening session to CMSListens@cms.hhs.gov with “MAC Provider Experience in the subject line. We may address them during the listening session or use them to develop other resources following the session.

Background

Since Medicare’s inception in 1965, the Federal government has contracted with the private sector to process FFS Medicare beneficiary claims and perform related claims administration activities on behalf of Medicare.  Starting in 2006, MACs are the entities that administer the Medicare FFS program on behalf of CMS.  Currently, there are 12 MAC jurisdictions that administer a broad spectrum of Medicare Part A and Part B benefits (known as A/B MACs) and 4 MAC jurisdictions whose contracts focus on Durable Medical Equipment claims (called DME MACs).  The MACs are the backbone of the Medicare FFS program and directly perform a variety of key, specialized functions that are critical to FFS program operations. Collectively, in fiscal year 2018, MACs processed more than 1.22 billion Medicare FFS claims for about 39 million Medicare FFS beneficiaries--approximately two-thirds of the total Medicare population of 60.5 million beneficiaries--and served more than 2.1 million health care providers and suppliers enrolled in the Medicare FFS program paying out about $400 billion in benefit payments.

By design, MACs are intended to serve as the face of Medicare FFS to the Medicare provider, practitioner, and supplier community by delivering seamless customer service to those in each respective MAC jurisdiction.   This one-stop shopping approach is intended to minimize the burden that would exist if providers, practitioners, and suppliers had to coordinate piece-meal with different operational contractors for the various segments of the FFS Medicare program.

Target Audience: Medicare FFS providers, practitioners, suppliers, their representative associations, and any interested stakeholders.

Registration Assistance: