Thursday, April 27, 2006

Changes in Medicare Fiscal Intermediaries

From CMS:

The Centers for Medicare & Medicaid Services (CMS) is implementing significant changes to the Medicare fee-for-service program’s administrative structure. This Medicare Contracting Reform (MCR) will:

Integrate and simplify the administration of Medicare Parts A and B with primary A/B MACs which will process both Part A and Part B claims for the fee-for-service benefit;

Make contracting dynamic, competitive and performance-based, resulting in more accurate claims payments and greater consistency in payment decisions; and

Centralize information, creating a platform for advances in the delivery of comprehensive care.

Under MCR, there will be 23 Medicare Administrative Contractors (MACs) with no national MAC. These new MACs will include:

Fifteen primary A/B MACs to serve the majority of all types of providers for
Part A and Part B;

Four specialty MACs to serve home health and hospice providers; and

Four specialty MACs to serve durable medical equipment (DME) suppliers.


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