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Written by: Darlene D'Altorio-Jones (1959-2015) on Wednesday, June 22, 2011 Posted in: Inpatient Rehab

CMS initially planned to award a total of 19 MAC contracts through three procurement cycles. Currently, there are 15 A/B MAC jurisdictions that have served as the foundation for CMS’s initial series of A/B MAC procurements. CMS will consolidate the 15 A/B MAC jurisdictions into 10 A/B MAC jurisdictions. See detail on this initiative by going to www.cms.gov/MedicareContractingReform.

What are the benefits that CMS feel are possible?  They state that, “through the implementation of Medicare Contracting Reform, CMS will establish a premier health plan that allows for comprehensive, quality care and world-class beneficiary and provider service.”

Under the new Medicare Administrative Contractor (MAC) contracting authority, CMS has 6 years-between 2005 and 2011-to complete the transition of Medicare Fee-for-Service (FFS) claims processing activities from the FIs and carriers to the MACs. Modernization Act (MMA) of 2003, section 911 authorized these changes. The provisions contained under section 911 are collectively referred to as Medicare Contracting Reform.

ConsolidatedMAC1

ABMacspic

  • In Summary:
      • A/B  MAC:  15 are transitioning to 10 jurisdictions (Noted in map as E – N Jurisdictions)
        • E = 1
        • F = 2 & 3
        • G = 5 & 6
        • H = 4 & 7
        • I   = 8 & 15
        • J  = 10
        • K = 13 & 14
        • L = 12
        • M  = 11
        • N   =  9

        A-D Jurisdictions are reserved to describe two different allocation maps as noted.  (Dependent on whether DME , Home Health or Hospice, enlarged versions can be found on cms.gov under MAC)

        jurisdictionatod3

    Remain aware of your current MAC provider. The website Codemap.com has a beneficial state by state listing of A/B providers. This site allows you to link to the MAC provider  for your state  at the A / B level and provides listings that can be sorted by LCD, effective and revision dates, title and codes covered in the  various listed policies.
    ** Mediware blogs often cover topics that can vary by jurisdiction. Please use these references to determine your individual jurisdiction & circumstances for A/B service oversight.