CMS tries again for Region C MAC

Sunday, June 11, 2006

WASHINGTON - CMS has put the Medicare Administrative Contractor (MAC) award for Region C back out to bid, giving companies another shot at beating out Palmetto GBA for it.

CMS awarded the contract to Palmetto in January, as part of its transition from DMERCs to MACs. Soon after the award, however, Cigna Government Services, which also bid on the contract, filed a protest, sending it to the General Accountability Office (GAO) for a ruling. The GAO approved the protest May 4.

"In response to the recommendations of the GAO, on May 10 CMS reopened discussions with the offerors within the competitive range in this procurement for Jurisdiction C," the agency states on its Web site. "CMS requested that the competitive range offerors submit Final Proposal Revisions which will be evaluated consistent with the provision for the solicitation."

CMS didn't state when it expects to award the MAC for Region C.

Because CMS has put the award back out to bid, the companies that are still interested, including Palmetto and Cigna, "probably have to go back to square one and revamp their bids," said Michael Watson, vice president of government affairs for American Medical Technologies.

"I hope this isn't just an exercise in futility," he said. "I hope (CMS) is actually going to look at other contractors."

Due to the protest, CMS delayed the transition from DMERC to MAC for Region C from July 1 to Oct. 1. It plans to make the transition in regions A, B and D on schedule.

Another lesser-known impact of Cigna's protest: CMS might also have to delay its transition to a single company to handle all claims for all regions, also planned for July 1. The agency awarded the Medicare Electronic Interchange System (MEDIS) contract to Palmetto, but one of its requirements is that the winner be a MAC.

"The MEDIS contract has been the sleeper of all the contracts," said Andrea Stark, a Medicare consultant with MiraVista. "At this point, we're mostly just getting that information out there. Providers have questions already, and when they hear about the MEDIS contract, they have more questions."