Battle Continues Over MAC Award to Noridian

Two Medicare Administrative Contractors (MACs) are continuing their fight against the decision by the Centers for Medicare and Medicaid Services (CMS) to award a claims processing and payment contract for Jurisdiction E to Noridian Administrative Services (Fargo, N.D.) This jurisdiction covers California, Nevada, and Hawaii, as well as the U.S. territories of American Samoa, Guam, and the Northern Mariana Islands. It includes more than 3.5 million fee-for-service beneficiaries and serves some 500 hospitals and 86,500 physicians. The workload comprises approximately 8.9 percent of the national Medicare A and B fee-for-service claims volume. The probable cost for Noridian’s proposal was $373 million, while those from Palmetto and CGS came in at $371 million and $408 million, respectively. The GAO protest decision is at www.gao.gov/assets/660/652332.pdf. Protests filed by Palmetto GBA, which previously held the contract, and CGS Administrators LLC were denied by the Goverment Accountability Office, which concluded that Noridian’s noncost factors were superior and consistent with CMS’s evaluation scheme. Rebuffed by the GAO, Palmetto and CGS filed a complaint with the U.S. Court of Federal Claims, which is reviewing the case. Palmetto will continue to process benefit claims for Jurisdiction E until the review is completed.