CMS Selects Palmetto GBA to Administer Medicare Claims in 3 States, 3 U.S. Territories
COLUMBIA, S.C., Nov. 5 /PRNewswire/ — Palmetto GBA, a leading provider of technical and administrative services for the federal government, today announced it has been selected by the federal Centers for Medicare & Medicaid Services (CMS) to process fee-for-service Medicare claims and perform related duties for California, Hawaii, Nevada, American Samoa, Guam and the Northern Mariana Islands.
CMS awarded Palmetto GBA a contract with a base period of one year and four one-year options to serve as the Medicare Administrative Contractor (MAC) for those states and U.S. territories, known as MAC Jurisdiction 1. The contract has a potential value of approximately $400 million. As the MAC, Palmetto GBA will process claims for both Parts A and B of the Medicare benefit program.
To support the contract, Palmetto GBA and its two largest subcontractors, TrailBlazer Health Enterprises and First Coast Service Options, will add approximately 750 full-time jobs. The majority of those positions will be at Palmetto GBA’s existing locations in Columbia, S.C. and Columbus, Ohio; at TrailBlazer’s office in Dallas, Texas; and First Coast’s office in Jacksonville, Fla.
Palmetto GBA will begin implementation activities immediately. It will assume full responsibility for claims in Jurisdiction 1 no later than June 2008.
“This very significant award is a reflection of the dedication our employees have shown in providing outstanding service to Medicare beneficiaries and providers since the Medicare program was created,” Palmetto GBA President Bruce Hughes said. “We are excited about the opportunity to serve the people with Medicare and the physicians and providers who care for them in the states and territories of Jurisdiction 1.”
Acting CMS Administrator Kerry Weems said Palmetto GBA was chosen as the Jurisdiction 1 MAC because the company “offered the best overall value to the government, from both a cost and technical perspective.”
CMS is in the process of selecting 15 MACs to process claims for both Parts A and B of Medicare. The MACs will replace fiscal intermediaries, which currently process Part A claims, and carriers, which currently process Part B claims. Medicare Part A helps cover fees from hospitals, skilled nursing facilities and other institutional providers. Part B covers fees from physicians, laboratories and other practitioners. The Medicare Modernization Act of 2003 mandated creation of the MACs, which were established to increase efficiency and improve service by giving beneficiaries and providers a single point of contact for the Medicare program.
About Palmetto GBA
Based in Columbia, S.C., Palmetto GBA is a wholly owned subsidiary of BlueCross BlueShield of South Carolina. Palmetto GBA’s principal business is providing administrative services for the Medicare health benefit program. The company has offices in South Carolina, Florida, Georgia, Ohio and Illinois. Palmetto GBA and BlueCross BlueShield of South Carolina are independent licensees of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans.
About TrailBlazer Health Enterprises
Based in Dallas, TrailBlazer Health Enterprises, LLC is a wholly owned subsidiary of BlueCross BlueShield of South Carolina. TrailBlazer is a diversified government contractor, providing services to Medicare and other government programs. In addition to its Dallas headquarters, the company has offices in Denison, Texas; San Antonio, Texas; and Timonium, Md. TrailBlazer Health Enterprises and BlueCross BlueShield of South Carolina are independent licensees of the Blue Cross and Blue Shield Association.
About First Coast Service Options
FCSO contracts with the Centers for Medicare & Medicaid Services and the Blue Cross and Blue Shield Association to provide quality Medicare administrative services to more than 3 million beneficiaries and the health care providers who care for them in Florida and Connecticut. One of the nation’s largest Medicare administrators, the company has more than 1,200 staff at the company’s headquarters in Jacksonville, Fla., and field offices in Miami, Orlando, Tampa and Meriden, Conn. FCSO is a wholly owned subsidiary of Blue Cross and Blue Shield of Florida, and both are independent licensees of the Blue Cross and Blue Shield Association.
CONTACT: Billy Quarles of BlueCross BlueShield of South Carolina,+1-803-264-5779
Web site: http://www.palmettogba.com/