Palmetto GBA loses protest for Medicare contract

January 22, 2013
Area(s) of Interest: Payor Contracting 

On January 18, the U.S. Government Accountability Office (GAO) announced that it had denied Palmetto GBA’s protest and awarded the Medicare contract for Jurisdiction E (previously referred to as J1) to Noridian Administrative Services.

The Centers for Medicare & Medicare Services (CMS) first announced in September 2012 that Noridian has been named the new Medicare Administrative Contractor for Medicare Parts A and B in California, Nevada and Hawaii, as well as the U.S. territories of American Samoa, Guam and the Northern Mariana Islands (Jurisdiction E, previously called Jurisdiction 1).

Jurisdiction E includes over 3.5 million Medicare fee-for-service beneficiaries, 500 Medicare hospitals and 86,500 physicians. MACs process Part A and Part B claims and perform other critical Medicare operational functions, including enrolling, educating and auditing Medicare providers.

Noridian and Palmetto are awaiting further direction from CMS on the transition plan, including a transition date. The California Medical Association (CMA) will work closely with the two companies to ensure a smooth transition. Until further direction is received, members should continue with business as usual.

Contact: CMA member service center, (800) 786-4262 or memberservice@cmadocs.org.

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