A Medical Device Daily
The Centers for Medicare & Medicaid Services (CMS) has selected TrailBlazer Health Enterprises (Dallas) to administer the claims process for both Part A and Part B fee-for-service Medicare in Texas, New Mexico, Colorado and Oklahoma.
TrailBlazer’s contract to serve as the Medicare Administrative Contractor (MAC) for the region is for five years and has a total estimated value of $376.5 million. The four-state region, known as Jurisdiction 4 in CMS’ new A/B MAC program, includes roughly 3.9 million Medicare beneficiaries.
CMS is in the process of replacing its fiscal intermediaries (for Part A claims) and carriers (for Part B claims) with 15 A/B MACs that will handle claims and perform related functions for both Parts A and B. Part A of Medicare provides coverage for inpatient hospital services, skilled nursing facilities, home health services and hospice care; Part B covers fees from physicians, laboratories and other practitioners.
Goals of the transition to MACs include promoting more competition among contractors, increasing efficiency, and improving service to beneficiaries and providers, according to CMS.
“TrailBlazer Health Enterprises is pleased that our proposal to CMS for Jurisdiction 4 was selected as the best overall value to the government,” said Martha Mahaffey, TrailBlazer president. “We are proud of our service to the Medicare program over the past 40 years, and we look forward to working with CMS through the important transition to A/B MACs.”
Claims workloads from the fiscal intermediaries and carriers will be transitioned to TrailBlazer on an incremental basis. TrailBlazer will begin implementation activities immediately and expects to assume full responsibility for Jurisdiction 4 claims no later than spring 2008.
“We want the beneficiaries and providers in Jurisdiction 4 to experience a seamless transition,” Mahaffey said. “We will request input from all stakeholders, including CMS, providers, fiscal intermediaries and carriers.”
TrailBlazer is a diversified government contractor, providing services to Medicare and other government programs. TrailBlazer has helped administer Medicare since the program’s inception in 1966, serving as both a fiscal intermediary and carrier.
In other contract news, Masimo (Irvine, California), the inventor of Pulse CO-Oximetry and Read-Through Motion and Low Perfusion pulse oximetry, reported a partnership with Apria Healthcare (Lake Forest, California) to provide pulse oximetry products and accessories for Apria’s home healthcare business. Apria Healthcare is a provider of integrated home healthcare products and services, offering a comprehensive range of home respiratory therapy, diabetic supplies, medications and equipment, home infusion therapy and home medical equipment services.
Apria conducted a competitive bid in which Masimo was selected due to the superior clinical performance of its Masimo SET pulse oximetry technology, which significantly enhances the ability of Apria’s customers to detect hypoxic events in the home care setting. Masimo develops monitoring technologies intended to improve patient care.