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Medicare J-11 MAC/ Medicare New MAC “M”


Palmetto Government Benefits Administrator, LLC (Palmetto GBA) was awarded a contract for the combined administration of Part A/Part B Medicare claims payment in Jurisdiction 11 comprised of North Carolina, South Carolina, Virginia, and West Virginia. The contract also included the home health and hospice claims workload from providers in Alabama, Arkansas, Florida, Georgia, Illinois, Indiana, Kentucky, Louisiana, Mississippi, New Mexico, North Carolina, Ohio,  Oklahoma, South Carolina, Tennessee and Texas. 

However, on February 2, 2009 a protest against the award was filed with GAO.  As a result of questions raised during GAO's review of the protest, CMS took voluntary corrective action on certain aspects of the award decision.  CMS announced completion of its corrective action on May 21,2010 and that Palmetto GBA was awarded the contract for J11.  A new protest was filed with the GAO.  GAO issued a decision in early September 2010 sustaining the agency's contract award, and CMS and Palmetto GBA are now actively implementing the Jurisdiction 11 contract. The legacy fiscal intermediaries and carriers will continue to service the providers until the MAC contract is implemented.