Medicare Compliance & Reimbursement

Congress inspects blueprints for new claims payment contractors

The days of doing business with fiscal intermediaries (FIs) and carriers are numbered. What's next: the transformation of plain old fee-for-service into a "premier health plan," according to the Centers for Medicare & Medicaid Services.

Initial plans issued to Congress Feb. 7 would allow private contractors to begin bidding for the job of Medicare Administrative Contractor (MAC) as soon as March 2005. Current carriers and FIs would be officially closed out between 2007 and 2008.

Under the plan, Part A and Part B would be integrated into one, allowing a "single point of contact" for all of your claims-related business, CMS says. The reform also promises a "modernized administrative IT platform" that would store and manage all Medicare data in one centralized location.

The blueprint also outlines goals to minimize and prevent disruption of claims processing.

According to President Bush's budget proposal, the contracting reforms would require $58.8 million in 2006, with "significant additional investment" required thereafter. Savings could reach $900 by the end of 2010, the proposal claims.