Update on DME MAC Contractor Transition


Following up on a previous Smart Brief announcement, regarding upcoming changes in the contractors who will serve as the Durable Medical Equipment Medicare Administrative Contractors (DME MACs), AOPA has learned about additional details regarding the transition of DME MAC Jurisdiction A and Jurisdiction B responsibilities.

The denial of the NGS protest of the Jurisdiction B DME MAC contract award clears the way for CGS to begin transition work in preparation for its June 27, 2016 start date as the new Jurisdiction B DME MAC. CGS has announced that as of June 27, 2016, Jurisdiction B claims will be processed out of CGS existing operations center in Nashville, TN. CGS has announced that it intends to hire at least 150 staff members in Nashville to ensure that they have adequate capability to begin processing claims as of June 27th. In addition, CGS has announced that Doran Edwards, MD will serve as the Jurisdiction B DME MAC Medical Director once CGS takes over responsibility for Jurisdiction B. Dr. Edwards currently serves as an associate medical director for the Jurisdiction C DME MAC and has previously served as the medical director of the SADMERC. CGS has established a transition website where providers may learn more about the transition process. The transition website may be accessed by clicking on the following link: www.cgsmedicare.com/jb

In other news, Medicare NHIC has elected not to file a protest of the recent award of the Jurisdiction A DME MAC contract to Noridian Health Services, LLC, the current contractor responsible for Jurisdiction D and the PDAC. While this decision means that transition activities will begin shortly, Noridian has made no announcements as of yet. AOPA will continue to follow developments in both of these transitions closely.

Questions regarding this issue may be directed to Joe McTernan at jmcternan@aopanet.org or Devon Bernard at dbernard@aopanet.org