Home Health & Hospice Week

CIGNA Government Services has announced the date it will take over Cahaba GBA's home health Medicare contracting region, and it could mean a hectic summer for home care providers.

CIGNA will begin operating as the Jurisdiction 15 Home Health & Hospice Medicare Administrative Contractor (HHH MAC) on June 13, CIGNA says in a new post to its website. The Centers for Medicare & Medicaid Services announced the contract award with no implementation date late last fall (see Eli's HCW, Vol. XIX, No. 43, p. 341).

CMS originally awarded the J15 workload to Highmark Medicare Services (see Eli's HCW, Vol. XVIII, No. 3, p. 19). But after a protest, CMS switched to CIGNA. CIGNA will service Cahaba's current region covering Iowa, Nebraska, Kansas, Missouri, South Dakota, North Dakota, Montana, Wyoming, Colorado, Utah, Delaware, Maryland, Pennsylvania, Virginia, West Virginia, and the District of Columbia. CIGNA currently is the Durable Medical Equipment Medicare Administrative Contractor (DME MAC) for Jurisdiction C, the contractor notes on its site.

"Not only does CIGNA not have any experience with home health and hospice, but they are subcontracting it out to contractor Riverbend GBA (BlueCross BlueShield of Tennessee)," laments consultant Tom Boyd with Boyd & Nicholas in Rohnert Park, Calif. Instead of subcontracting with Cahaba, CIGNA will be using another set of folks with no home health or hospice experience.

"Given the size of the transfer, Riverbend's other duties, the inexperience of the personnel and that all involved are government subcontractors (winners of low bid), I do believe we will have problems with the transfer from CAHABA to Riverbend GBA," Boyd predicts.

With CIGNA's schedule in place, only one HHH MAC is left undetermined -- the contractor for Jurisdiction 6, which includes home health and hospice states AK, AZ, CA, HI, ID, MI, MN, NV, NJ, NY, OR, WI, WA. CMS's contract award in that jurisdiction is under protest, according to CMS's contracting reform site. CMS had named Noridian Administrative Services as the incoming home health MAC for J6, but whether that award will stand remains to be seen.

The transition for J14 (to NHIC) has been fully implemented, and Palmetto GBA's "transition" to itself for J11 occurred Jan. 24. "The J11 Home Health and Hospice implementation went very well," Palmetto told providers in an e-mail message on that date.

Resource: Contracting reform information is at www.cms.gov/MedicareContractingReform -- go to the "Spotlight" link in the left column for a list of jurisdictions and their contract statuses.