Dr. Oleck jumps from Region B to Region C

Sunday, December 11, 2005

WASHINGTON - On March 1, as part of CMS's reorganization of the DMERCs, Region B Medical Director Dr. Adrian Oleck will move to Region C.

CMS decided early last year to reorganize the DMERCs into two components, each overseen by a specialist contractor. One organization, the Medicare Affiliated Contractor or MAC, will handle a region's billing, customer service and other day-to-day operations. Each region will also have a Program Safeguard Contractor or PSC, overseen by a medical director, that handles fraud and abuse, medical review and crafts policy.

In early October, CMS awarded Region B's program safeguard duties to TriCenturion, which performs similar duties for Region A. Dr. Paul Hughes serves as medical director for TriCenturion, and in March, he will assume Oleck's job in Region B and continue his duties in Region A.

In November, TrustSolutions won the bid to become Region C's Program Safeguard Contractor and hired Oleck to be its medical director. On March 1, Oleck will replace Dr. Stacey Brennan, who will assume new duties related to provider hearings.

EDS won the bid to become Region D's program safeguard contractor and subcontracted the medical review functions to IntegriGuard. The new Region D medical director is Dr. Mark Pilley. Dr. Robert Hoover, the former Region D medical director, left that job last summer.

Industry watchers expect CMS to award MAC contracts by the end of December. Most likely, they say, the current DMERC administrators will retain those duties. With the new MACs scheduled to assume administrative duties July 1, awarding the bids to the current contractors in regions A, B, C and D is the "path of least resistance" given the short transition period, said a well placed source.

For a more in-depth explanation of the DMERC transition, see "Ask the DMERC MDs" in the December issue of HME News.