If you thought Highmark Medicare Services (HMS) was taking over as your new Medicare Administrative Contractor (MAC) next year, not so fast.
TrailBlazer Health Enterprises, which was set to lose its four-state Southwest jurisdiction to HMS, protested the MAC Jurisdiction H transition to the Government Accountability Office (GAO), leading the GAO to issue a stop work order to HMS on Nov. 28.
What this means for you: If you reside in Jurisdiction 4 or 7 – both set to transition over to HMS – you will continue to bill your current MACs until the GAO issues a ruling on the protest. The GAO must rule by March 1, 2012 at the latest.
The impacted territory, in terms of Part B billing, is comprised of TrailBlazer’s Jurisdiction 4 – Colorado, New Mexico, Oklahoma and Texas – and Pinnacle Business Solutions’ Jurisdiction 7 – Arkansas and Louisiana (plus Mississippi for Part A). Even though TrailBlazer filed the protest, practices in Pinnacle’s jurisdiction will also see their transition to HMS placed in limbo as a result of the stop work order.
As part of the GAO order, HMS was directed to “cease any work in support of the MAC JH contract and implementation activities,” according to a statement on HMS’ website.
For background info on the transition and a link to bookmark for future updates, go to https://www.highmarkmedicareservices.com/transition/jh/index.html.