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Medicare Contracting Reform
What it means to you as a healthcare provider

The effects of Medicare Contracting Reform are wide-reaching, and at some point will affect nearly every healthcare provider that submits claims to Medicare.
Do you know everything you should about contracting reform and the possible effects it can have on how you submit claims or receive remittance advice?

A short, animated video has been created to give you an overview of Medicare Contracting Reform and how reform will benefit providers and beneficiaries. It also explains the effect contracting reform can have on your Medicare claim reimbursement workflow.

In addition, the video provides information on new technologies and services that are now available to providers – new options that can help streamline the Medicare reimbursement process and decrease your costs.

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Be sure to turn up the volume on your computer to hear the audio portion.

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New Jurisdictions for Part A
and Part B Providers

Using a competitive process, CMS will establish Medicare Administrative Contractors (MACs) that will serve as the single point of contact for providers and suppliers for all claims-related business. Requiring MACs to focus on financial management is expected to result in more accurate claims payments and greater consistency in payment decisions.

Read the article, “Preparing for a Transition from an FI/Carrier to a Medicare Administrative Contractor (MAC)” from MLN Matters.

For more information on Medicare Contracting Reform:

• Centers for Medicare & Medicaid Services (CMS) Web Site

Or click on one of these links for more information on Medicare Contracting Reform transition events in these jurisdictions:

• J2 MAC (includes Part A/B workload for AK, ID, OR, WA) Awarded to NHIC – award has been protested

• J6 (includes Part A/B workload for IL, MN, WI; Home Health/Hospice workload for JD) Awarded to Noridian Administrative Services – award has been protested

• J7 MAC (includes Part A/B workload for AR, LA, MS) Award has been protested

• J8 MAC (includes Part A/B workload for IN, MI) Awarded to National Government – award has been protested

• J11 MAC (includes Part A/B workload for NC, SC, WV, VA; Home Health/Hospice workload for JC) Awarded to Palmetto GBA – award has been protested

• J15 MAC (includes Part A/B workload for KY, OH; Home Health/Hospice workload for JB) Awarded to Highmark Medicare Services – award has been protested