CMS awards Company's National Government Services subsidiary Medicare
Administrative Contract for New York and Connecticut
INDIANAPOLIS, May 5 /PRNewswire-FirstCall/ -- WellPoint, Inc. (NYSE: WLP) announced today that its National Government Services, Inc., subsidiary was selected by the Centers for Medicare & Medicaid Services to administer the Medicare Administrative Contract (MAC) for Jurisdiction 13, which includes the states of New York and Connecticut.
National Government Services will perform key Medicare administrative functions for its contracts with hospitals, skilled nursing facilities and physicians, including: Appeals, Audit and Reimbursement, Claims Processing, Medical Review and Local Coverage Determinations. It will also complete unique requirements for Medicare's contracts in these two states, including: Coordinated Care Benefits Demonstration, Rural Health Clinics, Federally Qualified Health Centers and Low Vision Demonstration.
"This contract represents CMS' confidence in our ability to deliver excellent service and value to our federal government partners," said Sandy Miller, senior vice president of WellPoint's Federal Government Solutions business. "The Jurisdiction 13 contract is the first for Medicare Part A and B services awarded to National Government Services under new federal guidelines. We are committed to serving CMS as a trusted partner, and we're looking forward to competing for and winning additional contracts in the coming months."
The contract consists of one base year and four one-year options, and is worth up to $323 million over the five-year period. This MAC contract applies to Part A and Part B sections of Medicare, which include hospitals, skilled nursing facilities (Part A) and physicians (Part B). National Government Services will partner with MedUS Services (formerly known as HealthNow), the Upstate New York Part B incumbent, for the administration of this contract. MedUS Services will process a portion of the J13 Part B Claims, Appeals, Medical Review, Provider Enrollment, and Provider Outreach workloads.
The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA, Section 911) requires CMS to implement Medicare Contracting Reform by October 2011. With full implementation, CMS will replace its current claims payment contractors (Fiscal Intermediaries and Carriers) with new contract entities called Medicare Administrative Contractors. CMS plans to award a total of 23 MAC contracts, fifteen of which will be with A/B MACs that will administer both the Part A and Part B work in 15 designated geographical jurisdictions.
About WellPoint, Inc.
WellPoint, Inc. is the largest health benefits company in terms of medical membership in the United States. WellPoint is an independent licensee of the Blue Cross and Blue Shield Association and serves its members as the Blue Cross licensee for California; the Blue Cross and Blue Shield licensee for Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri (excluding 30 counties in the Kansas City area), Nevada, New Hampshire, New York (as Empire Blue Cross Blue Shield in 10 New York City metropolitan and surrounding counties and as Empire Blue Cross or Empire Blue Cross Blue Shield in selected upstate counties only), Ohio, Virginia (excluding the city of Fairfax, the town of Vienna and the area east of State Route 123.), Wisconsin; and through UniCare. Additional information about WellPoint is available at http://www.wellpoint.com .
|SOURCE WellPoint, Inc.|
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