CMS Publishes New DME MAC Information
Last week, the Centers for Medicare & Medicaid Services (CMS) announced a plan to transition suppliers from DMERC to DME MAC — that is, from Durable Medical Equipment Regional Carriers (DMERCs) to Durable Medical Equipment (DME) Medicare Administrative Contractors (MACs). The process targets suppliers in Kentucky, Maryland and the District of Columbia, which will soon be serviced by a different Medicare contractor.
Two DME MACs — National Heritage Insurance Company Inc. (NHIC) and AdminaStar Federal — will each assume full responsibility for the work of their respective geographic jurisdiction on July 1. To help ease the transition, CMS released the Web site addresses for the two DME MACs. Eacs site will contain regularly updated implementation information, contact numbers and e-mail addresss:
DME suppliers currently enrolled in the Medicare fee-for-service program will not need to re-enroll or obtain a new supplier number. Enrollment information will automatically transfer to the new DME MACs. Current EDI Support for each DME region/jurisdiction has been extended until at least Sept. 30.
In addition, DME MACs will continue to support all DME free billing software packages. Electronic claims submitted by suppliers in Kentucky, Maryland and the District of Columbia will be redirected to the appropriate DME MAC, but CMS encourages suppliers to connect to the DME MAC effective July 1. Connection to the servicing DME MAC will be required to receive all electronic output, including electronic remittance advices.
Suppliers in Kentucky or those in the states that will be serviced by NHIC must complete a new copy of the Authorization Agreement for Electronic Funds Transfer and submit it to the new DME MAC to continue receiving Medicare payments via electronic funds transfer (EFT) effective July 1. Check the DME MAC's Web site for additional information.
Suppliers connected to multiple regions will need to understand regional specific file retrieval options, including how to retrieve remittance advice files. New suppliers who want to conduct EDI transactions with Medicare should enroll with the appropriate DME contractor using standard enrollment forms and processes.
CMS has delayed the implementation of DME MACs for jurisdictions C and D pending resolution by CMS of a formal protest of those awards. Because of the delay, suppliers providing services to Medicare beneficiaries in Virginia and West Virginia will continue to be serviced by AdminaStar until further notice. Once the protest is resolved and the new DME MAC for jurisdiction C can be implemented, it will take over the work for Virginia and West Virginia.
This article originally appeared in the May 2006 issue of HME Business.