National Government Services (NGS) has held the DME MAC Jurisdiction B contract for many years. These contracts come up for rebid every five years. However, NGS lost the DME MAC contract in 2015 to Cigna Government Services (who currently administers the Jurisdiction C DME MAC contract). In response, NGS filed a protest with the Government Accountability Office (GAO). Review of the protest details tells us that CMS went with CGS based on cost efficiency. Interestingly, in a general matchup comparison of the two proposals, the GAO found that NGS fared better than CGS only in their technical approach. It was the cost differential that sealed the deal. The NGS proposal was a cool 47 million dollars more than the CGS proposal. Ultimately, NGS’s protest was denied and CMS will move forward with CGS as the Jurisdiction B DME MAC contractor.
CGS will administer both the Jurisdiction C and B DME MAC contracts. According to the contract award there are approximately 18,000 suppliers in Jurisdiction B which accounts for 21% of the DME claims workload for the country. Currently, CGS (under the Jurisdiction C contract) is handling 41% of the DME claims workload servicing roughly 33,000 suppliers. CMS expects to have the Jurisdiction B contract transitioned without issue by May 2016. Join us on February 23rd for our annual Look Ahead webcast as we dive into what these changes mean with Reimbursement Consultant, Andrea Stark and Healthcare Attorney, Jeff Baird of Brown & Fortunato.
CGS will administer both the Jurisdiction C and B DME MAC contracts. According to the contract award there are approximately 18,000 suppliers in Jurisdiction B which accounts for 21% of the DME claims workload for the country. Currently, CGS (under the Jurisdiction C contract) is handling 41% of the DME claims workload servicing roughly 33,000 suppliers. CMS expects to have the Jurisdiction B contract transitioned without issue by May 2016. Join us on February 23rd for our annual Look Ahead webcast as we dive into what these changes mean with Reimbursement Consultant, Andrea Stark and Healthcare Attorney, Jeff Baird of Brown & Fortunato.