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Palmetto GBA Awarded Jurisdiction J MAC Contract

Published on 

Tuesday, September 26, 2017

 | Miscellaneous 

If you deal in the world of Medicare Parts A and B and you live in the state of Alabama, Georgia, or Tennessee, there was big news for you in early September.  On September 7, 2017, CMS awarded Palmetto GBA (Palmetto) a new contract for the administration of Medicare Part A and Part B Fee-for-Service (FFS) claims in the states of Alabama, Georgia, and Tennessee (A/B MAC Jurisdiction J).  Jurisdiction J is currently handled by Medicare Administrative Contractor (MAC) Cahaba GBA.

So if you are a provider in Jurisdiction J, what do you need to know about this change?

The A/B MAC Jurisdiction J Palmetto Contract…

  • Will provide Medicare services to more than 400 hospitals, 52,000 physicians, and 2.5 million Medicare beneficiaries.
  • Has a total estimated value of $274.6 million.
  • Includes a base year and four option years, for a maximum duration of five years.
  • Includes the following duties for Palmetto – processing and paying Medicare Part A and Part B provider claims, enrolling and auditing Medicare providers, educating providers on Medicare coverage requirements, and other duties.

Palmetto GBA …

  • Is currently the A/B MAC for Jurisdiction M, which includes the states of North Carolina, South Carolina, Virginia, and West Virginia.
  • Is also the MAC for Home Health and Hospice providers in Alabama, Arkansas, Florida, Georgia, Illinois, Indiana, Kentucky, Louisiana, Mississippi, New Mexico, North Carolina, Ohio, Oklahoma, South Carolina, Tennessee and Texas.
  • Will be opening an office in Birmingham, AL; Palmetto will also perform the contract from offices in Columbia, Florence, and Camden, SC.
  • Palmetto’s website - palmettogba.com

The Transition and Resources

  • The implementation effective date for Part A in all 3 states is January 29, 2018
  • The implementation effective date for Part B is February 26, 2018.
  • CMS and Palmetto anticipate a smooth transition, with few, if any, service issues for Medicare beneficiaries and providers.
  • Palmetto GBA’s goal is to communicate early, often and continually throughout the implementation to ensure all stakeholders, providers, medical and hospital associations and Members of Congress, are well-informed with consistent, open and clear information.
  • Palmetto's Transition Website site includes general information, FAQs, and Outreach and Education
  • Palmetto prefers questions concerning the transition be submitted via Twitter or Facebook (see Palmetto Transition FAQs)
  • Face-to-Face JJ Implementation Workshops are planned for the end of October and the beginning of November. As soon as the dates and locations are determined, they will be advertised on the JJ website for registration.
  • There are already educational videos on the Palmetto Transition Education and Outreach webpage about Palmetto GBA and some of their eServices features such as eUtilization, eAudits, eCBR (comparative billing reports), and Managing Your Medicare Information.

What Providers Need to Do

  • Register for listserv email updates from Palmetto GBA. To register simply select listserv at the top of the Palmetto's Transition Website
  • Visit this website for Medicare program information and updates. Palmetto GBA’s website is continually updated with the most current information.
  • Read the MMP Wednesday@One newsletter for future information about Palmetto and the Jurisdiction J transition.
Article Author: Debbie Rubio, BS MT (ASCP)
Debbie Rubio, BS MT (ASCP), was the Manager of Regulatory Affairs and Compliance at Medical Management Plus, Inc. Debbie has over twenty-seven years of experience in healthcare including nine years as the Clinical Compliance Coordinator at a large multi-facility health system. In her current position, Debbie monitors, interprets and communicates current and upcoming regulatory and compliance issues as they relate to specific entities concerning Medicare and other payers.

This material was compiled to share information.  MMP, Inc. is not offering legal advice. Every reasonable effort has been taken to ensure the information is accurate and useful.