CIGNA Awarded A/B MAC J15
- By admin aapc
- In Billing
- July 30, 2010
- Comments Off on CIGNA Awarded A/B MAC J15
CIGNA Government Services, LLC (CGS) announced July 23 that it is the new Parts A and B Medicare administrative contractor (A/B MAC) for jurisdictions 15 and B. Effective July 8, CGS is responsible for the administration, processing, and paying of Medicare physician and hospital claims in Kentucky and Ohio (J15) as well as home health and hospice claim processing services in Colorado, Delaware, Iowa, Kansas, Maryland, Missouri, Montana, Nebraska, North Dakota, Pennsylvania, South Dakota, Utah, Virginia, West Virginia, Wyoming, and the District of Columbia (JB).
The combined service area includes more than 2.5 million Medicare beneficiaries, health care professionals and hospitals, according to a CGS press release. The Medicare Part A work will be subcontracted by Riverbend Government Benefit Administrators, LLC (RGBA).
The contract consists of a one-year base period with four one-year optional periods. CGS, headquartered in Nashville, Tenn., also is the carrier for North Carolina and Idaho.
Highmark Medicare Services, Inc. previously held the MAC contract for J15.
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Although CIGNA was awarded the contract, HIghmark and Palmetto contested the appointment. Palmetto is the current carrier for Ohio and previously Highmark was appointed the MAC for jurisdictions 15 and 16. The issue is supposed to be resolved October 31, 2010.
Maxine’s comment is not entirely accurate. NGS, Cahaba, and Highmark protested the J15 award to CIGNA. Check the GAO site to see a log of protests and the status of each: http://www.gao.gov/decision/docket?&openclosed=All&agency=60560&snumber=All&protestor=&filenum=&searched=1&order_by=date&Submit=Search&o=0
It’s a complicated issue but I think that Maxine is largely correct in that CIGNA is not taking over the J15 MAC right away and that Palmetto and NGS will continue their services as Carrier and FI respectively until later this year.
Regardless of who is contesting whom, Palmetto and NGS remain in place for the time being.
All remaining protests by Highmark Medicare Services and NGS have been denied by the Government Accountability Office as of October 29, 2010. Therefore, it appears that CIGNA will remain the new J15 contractor.