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MAC Contract for Jurisdiction E Goes to Noridian

by | Feb 25, 2015 | CMS-nir, Essential, National Lab Reporter

In a March 22 transmittal, the Centers for Medicare and Medicaid Services (CMS) said it will implement, as of July 1, a Part A and Part B claims processing and payment contract for Jurisdiction E to Noridian Administrative Services (Fargo, N.D.) The jurisdiction covered by the new Medicare Administrative Contractor (MAC) includes 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. Protests filed by Palmetto GBA, which previously held the contract, and CGS Administrators LLC were denied by the Government Accountability Office, which concluded that Noridian’s noncost factors were superior and consistent with CMS’s evaluation scheme. Both subsequently lost their appeal to the U.S. Court of Federal Claims. Palmetto will continue to process benefit claims for Jurisdiction E while CMS handles the transition of the contract to Noridian.

In a March 22 transmittal, the Centers for Medicare and Medicaid Services (CMS) said it will implement, as of July 1, a Part A and Part B claims processing and payment contract for Jurisdiction E to Noridian Administrative Services (Fargo, N.D.) The jurisdiction covered by the new Medicare Administrative Contractor (MAC) includes 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. Protests filed by Palmetto GBA, which previously held the contract, and CGS Administrators LLC were denied by the Government Accountability Office, which concluded that Noridian’s noncost factors were superior and consistent with CMS’s evaluation scheme. Both subsequently lost their appeal to the U.S. Court of Federal Claims. Palmetto will continue to process benefit claims for Jurisdiction E while CMS handles the transition of the contract to Noridian.

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