DMERC shuffle may result in lost jobs

Sunday, January 15, 2006

BALTIMORE - CMS's decision to re-shuffle the DMERCs may result in more than 250 lost jobs at the Buffalo, N.Y.-based HealthNow.

In early January, CMS named the Medicare Affiliated Contractors (MACs) that will handle each region's billing, customer service and other day-to-day operations. (Last fall, the agency named the Program Safeguard Contractors, overseen by medical directors, that will handle fraud and abuse, and craft policy.)

For Region A, CMS replaced HealthNow with National Heritage Insurance Co., which has offices in Los Angeles; Marysville, Calif.; and Hingham, Mass.

HealthNow's failure to renew its contract has put about 255 jobs at facilities in Town of Union, N.Y., and Dallas, Pa., at risk, reported the Press & Bulletin (Greater Binghamton, N.Y.) on Friday, Jan. 13.

A company spokeswoman told the newspaper that HealthNow has processed Medicare Part A and B claims for five years.

The new MACs have already begun transition activities and will assume full responsibilities for the claims processing work currently performed by the DMERCs July 1, 2006.

Each MAC contract includes a base period and four, one-year options. The MACs will have the opportunity to earn fees based on their ability to meet or exceed the performance requirements set by CMS.

The remaining MACs are: AdminaStar Federal (Region B); Palmetto GBA (Region C); and Noridian Administrative Services, which replaced Cigna (Region D).