OASIS Alert

Contractors:

New Medicare Contractor Takes Over Cahaba Region

HHAs and hospices from 15 states will see new Medicare contractor in 2011.

States in the Midwest, mid-Atlantic, and great plains areas of the country should expect a steep learning curve from a new Medicare payor some time this year.

"The Centers for Medicare & Medicaid Services ... has selected CIGNA Government Services as the new Medicare Administrative Contractor (MAC) for Part A/Part B Jurisdiction 15(J15)," regional home health intermediary Cahaba GBA says in a message to providers. "This jurisdiction includes the home health and hospice workload for which Cahaba currently serves as the Regional Home Health Intermediary (RHHI)."

No timeline: "At this time, we do not have a date/time period when the transition process will occur," Cahaba tells providers. Cahaba serves Iowa, Nebraska, Kansas, Missouri, South Dakota, North Dakota, Montana, Wyoming, Colorado, Utah, Delaware, Maryland, Pennsylvania, Virginia, West Virginia, and The District of Columbia.

"CIGNA Government Services will communicate with the J15 provider community throughout the implementation process and will post timely implementation news and information here on our new Jurisdiction 15 website," CIGNA says at www.cignagovernmentservices.com/j15/index.html.

"Cahaba will work closely with the incoming contractors throughout the transition process to ensure a smooth transfer of business functions for our current home health and hospice providers," the intermediary says. "Until the transition to MAC is complete, Cahaba will continue to serve as your Intermediary, maintaining the same level of service to our provider community."

Lack Of Home Care Experience Worrying

CIGNA currently holds the Durable Medical Equipment Administrative Contract (DME MAC) for Jurisdiction C, the contractor notes on its site.

But it doesn't have any home health agency or hospice experience, points out consultant Tom Boyd with Rohnert Park, Calif.-based Boyd & Nicholas. "Those HHAs and hospices that had Cahaba now will have someone unfamiliar with either," Boyd tells Eli.

BlueCross BlueShield of Tennessee's Medicare subsidiary, Riverbend Government Administrators, will partner with CIGNA on the J15 contract, reports the Chattanooga Times Free Press.

CMS originally awarded the J15 workload to Highmark Medicare Services. But after a protest, CMS switched to CIGNA.

Stay tuned: The contract for Jurisdiction 6, which includes home health and hospice states AK, AZ, CA, HI, ID, MI, MN, NV, NJ, NY, OR, WI, WA, is still under protest, according to CMS's contracting reform site. CMS had named Noridian Administrative Services as the incoming home health MAC, but whether that award will stand remains to be seen.

The transition for J14 (to NHIC) has been fully implemented, and the "transition" from Palmetto GBA to Palmetto GBA for J11 is in the contract phase, CMS reports.

Contracting information is at www.cms.gov/MedicareContractingReform " check the "Spotlight" link for the latest updates.

 

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