BALTIMORE--Medicare has announced new carrier jurisdictions, including those for the four DMERCs, to be used when it puts DME claims processing business up for bid next month.

Part of an overall change in Medicare's claims processing program, the reconfiguration is designed to "balance the allocations of workloads, promote competition, account for integration of claims-processing activities and mitigate the risk to the Medicare program during the transition to the new contractors," according to a CMS statement issued last Thursday.

As mandated by the Medicare Modernization Act, CMS must put all fee-for-service claims processing business up for bid--including Part A, Part B, DME and home health and hospice--and award all contracts by 2011. The new claims payment contractors will be called Medicare Administrative Contractors, or MACs. The agency will award four "specialty" DME MACs, 15 primary MACs and four other specialty MACs serving home health and hospice providers.

Next month, the agency will begin the contractor reform process with the DMERCs, and will issue a DME MAC request for proposal. Winners, to be chosen by December, will cover geographic areas that resemble current DMERC regions, but with several realignments. For example, CMS has switched Maryland and the District of Columbia from Region B to Region A, and Virginia and West Virginia from Region B to Region C. The new MAC jurisdictions include:

Region A--Connecticut, Delaware, District of Columbia, Maine, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island and Vermont.

Region B--Illinois, Indiana, Kentucky, Michigan, Minnesota, Ohio and Wisconsin.

Region C--Alabama, Arkansas, Colorado, Florida, Georgia, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, Puerto Rico, South Carolina, Tennessee, Texas, U.S. Virgin Islands, Virginia and West Virginia.

Region D--Alaska, American Samoa, Arizona, California, Guam, Hawaii, Idaho, Iowa, Kansas, Missouri, Montana, Nebraska, Nevada, North Dakota, Northern Mariana Islands, Oregon, South Dakota, Utah, Washington and Wyoming.

CMS said the DME carrier regions were altered to coordinate with new regions for handling Part A and B claims, and that an analysis shows the changes will "affect a relatively small percentage of providers and beneficiaries in these areas." Currently, Part A and B carriers operate in 51 overlapping jurisdictions. In the coming years, CMS plans to award contracts for MACs that will process both Part A and B claims within only 15 jurisdictions.

More information, including a map of all new MAC jurisdictions and a timeline for contract awards, is available at www.cms.hhs.gov/medicarereform/contractingreform.

For more news, visit this week's HomeCare Monday, available at www.homecaremonday.com.

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