Liles Parker PLLC
(202) 298-8750 (800) 475-1906
Washington, DC | Houston, TX
San Antonio, TX | Baton Rouge, LA

We Defend Healthcare Providers Nationwide in Audits & Investigations

Highmark (MAC Jurisdiction H) Dates Released

(April 12, 2012): The Centers for Medicare & Medicaid Services (CMS) recently released the Medicare Administrative Contractor (MAC) transition dates for Jurisdictions 4, which covers Texas, Colorado, New Mexico and Oklahoma,  and 7, which covers Louisiana, Arkansas and Mississippi.  As previously reported, CMS is consolidating these two jurisdictions into a new Jurisdiction H, and has awarded the contract for administering all Medicare Part A and B operations to Highmark Medicare Services. After an unsuccessful appeal by TrailBlazer Health Enterprises and Pinnacle Business Solutions, the current MACs for these regions, implementation is moving forward.

I. What is Highmark?

Providers should note that Highmark was acquired earlier this year by Novitas Solutions, a wholly-owned subsidiary of BC/BS of Florida.  Novitas is currently the MAC for Delaware, New Jersey, Pennsylvania, Maryland, Washington, D.C. (Medicare Parts A & B) and for Arlington & Fairfax Counties and the City of Alexandria in Virginia (Part B only).

The recently released implementation schedule for Jurisdiction H is below.  Providers in these jurisdictions should be alert for information from their current MAC about specific implementation activities as these transition dates approach.

Jurisdiction H Transition to Novitas*

Medicare Part A (Institutional Providers, including any out of jurisdiction providers currently processed by PBSI or TrailBlazer)

States

Outgoing Fiscal Intermediary/ Outgoing MAC

Incoming MAC

Cutover/Transition Date

Arkansas, Louisiana, and Mississippi

PBSI

Novitas

8/20/2012

Colorado, New Mexico, Oklahoma, and Texas

TrailBlazer

Novitas

10/29/2012

Medicare Part B (Physicians, Practitioners & Suppliers)

States

Outgoing Carrier/ Outgoing MAC

Incoming MAC

Cutover/Transition Date

Arkansas and Louisiana

PBSI

Novitas

8/13/2012

Mississippi

Cahaba

Novitas

10/22/2012

Colorado, New Mexico, Oklahoma, and Texas

TrailBlazer

Novitas

11/19/2012

*This table is a direct copy of one appearing on the CMS website, available at http://cms.gov/Medicare/Medicare-Contracting/MedicareContractingReform/Downloads/JH_Implementation_Schedule.html

II. What are the new MAC Jurisdictions?

The map below, created by CMS, shows the new jurisdictions for MACs throughout the country.

Highmark Medicare

Jennifer Papapanagiotou Healthcare AttorneyLiles Parker is a full service health law firm, providing provider enrollment and change of ownership assistance, administrative appeal of overpayments, and legal analysis and assistance with Medicare reimbursement issues.  Should you have any questions, please contact Jennifer Papapanagiotou at 832-594-4376 for a free consultation.

  • Advertisement

Speak Your Mind

Tell us what you're thinking...
and oh, if you want a pic to show with your comment, go get a gravatar!

You must be logged in to post a comment.