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Contracting Reform - MAC Conversion
The Medicare Modernization Act (MMA) established a new administrative initiative that required CMS to use competitive procedures to replace its current fiscal intermediaries (FIs) and carriers with a new contracting authority, referred to as Medicare Administrative Contractors (MACs). CMS plans to award 19 MACs, including 15 A/B MACs and four DME MACs. The agency does not plan to set up specialty MACs to service home health and hospice providers. These functions will be included in the workload of four A/B MACs. Existing Medicare contracting authorities – FIs and carriers – will be phased out up through 2011, when all contracts will be recompeted and transitioned to MACs.
CMS decided to begin the transition by converting Durable Medical Equipment Regional Carriers (DMERCs) into DME MACs. All four DME MACs have assumed processing responsibilities previously handled by DMERCs.
CMS has now awarded contracts for seven A/B MAC administrators. Implementation of all 15 A/B MACs is to be completed by 2011. NASL Action NASL continues to monitor the implementation of this program and has followed up on reports of claims processing problems. |
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