CMS to Extend Contracts for Region C and D DMERCs

WASHINGTON–CMS is extending the contracts for two DMERCs
because of a protest concerning its award of bids to the new DME
Medicare Administrative Contractors in Regions C and D.

At Wednesday’s Home Health, Hospice and DME Open Door Forum,
CMS’ Sue Lathroum announced that the two current
contracts–Palmetto GBA for Region C and Cigna Government Services
for Region D–will be extended to Sept. 30. The transition from the
Durable Medical Equipment Regional Carriers to the new MACs
originally was scheduled for July 1.

As part of CMS’ administrative contracting reform, the new MACs
will handle billing, customer service and other day-to-day
operations. Separate Program Safeguard Contractors (PSCs), which
assumed duties earlier this year, are handling benefit integrity,
medical review and medical policy for each region.

The protest that is holding up the transition was filed by
Cigna, which lost MAC contract bids on both Regions C and D in
January. Instead, CMS awarded Palmetto GBA the Region C contract,
and Noridian Administrative Services the Region D contract (see
HomeCare
Monday, Jan. 9).

According to Lathroum, the Government Accountability Office is
expected to rule on the protest on or before May 4.

The transition from DMERCs to the new MACs will still take place
as scheduled for Regions A (National Heritage Insurance Company,
replacing HealthNow) and B (AdminaStar Federal) on July 1. To help
providers with the transition in these jurisdictions, CMS is
developing fact sheets that should be released within the next two
weeks, Lathroum said.

For more information on CMS contracting reform, click
here.

In other news at the Open Door session, a CMS official announced
that the long-awaited rule on DME competitive bidding, mandated by
the Medicare Modernization Act to begin in 2007, should be released
“any day now.” The rule, which has been in clearance with the
Office of Management and Budget for months, is expected to name the
10 cities where CMS will roll out the bidding program.