CMS Issues RFI on Potential Consolidation of MAC Jurisdictions
The Centers for Medicare and Medicaid Services (CMS) issued a recent request for information (RFI) concerning the potential jurisdiction consolidation of 4 Medicare administrative Contractor (MAC) jurisdictions into 2 jurisdictions, and potential extension of MAC contracts to 10 years:
- Consolidation of A/B Medicare Administrative Contractors (MACs) for Jurisdiction 5 (Iowa, Kansas, Missouri and Nebraska) and A/B Home Health and Hospice (HH+H) MAC Jurisdiction 6 (Illinois, Minnesota, and Wisconsin plus HH+H claims for Alaska, American Samoa, Arizona, California, Guam, Hawaii, Idaho, Michigan, Minnesota, Nevada, New Jersey, New York, Northern Mariana Islands, Oregon, Puerto Rico, US Virgin Islands, Wisconsin and Washington) into “Jurisdiction G”;
- Consolidation of A/B MAC Jurisdiction 8 (Indiana and Michigan) and A/B HH+H MAC Jurisdiction 15 (Kentucky and Ohio plus HH+H claims for Colorado, Delaware, District of Columbia, Iowa, Kansas, Maryland, Missouri, Montana, Nebraska, North Dakota, Pennsylvania, South Dakota, Utah, Virginia, West Virginia and Wyoming) into “Jurisdiction Q”; and
- Extension of 5-year MAC contract awards to 10 years.
According to CMS, the purpose of this RFI is to assist in identifying the benefits and challenges of jurisdiction consolidation and awarding MAC contract awards for 10 years based on “experience and industry best practices”. For jurisdiction consolidation, topics include analysis for development and implementation, communication issues, potential system and non-system impacts, and workflow impacts over time. For awarding future MAC contracts, topics include recommendations for incentivizing and rewarding exceptional MAC performance, specific metrics or criteria to measure MAC performance and relationships with providers, and impacts of possible re-negotiation with each MAC contract each option year. CMS clarified it will use this information obtained from this RFI “at its discretion and will not provide comments to any vendor’s submission. However, responses to the RFI may be reflected in future MAC procurements.”
