MAC Contract Awarded

TrailBlazer to Begin Implementation Activities

The Centers for Medicare & Medicaid Services (CMS) announced on August 2, 2007 that it has awarded the second contract for a Part A/Part B Medicare Administrative Contractor (A/B MAC). Using full and open competition, CMS selected TrailBlazer Health Enterprises (TrailBlazer) to be the A/B MAC for Jurisdiction 4 (J4) which is comprised of Colorado, New Mexico, Oklahoma and Texas.

The J4 A/B MAC contract is the second of 15 A/B MAC contracts that will be awarded by 2011 to fulfill requirements of the Medicare Contracting Reform provisions of the Medicare Modernization Act of 2003. This contract award is a major step in support of improved service to beneficiaries, providers, physicians and practitioners as well as greater administrative efficiency and effectiveness for fee-for-service Medicare.

As the J4 A/B MAC, TrailBlazer will immediately begin implementation activities to take over the claims payment work now performed by fiscal intermediaries and carriers in the four¬state jurisdiction. The current fiscal intermediaries and carriers operating in the jurisdiction are:

• Pinnacle Business Solutions (carrier for New Mexico and Oklahoma)
• Healthcare Services Corporation (FI for Oklahoma)
• Mutual of Omaha Insurance Company (FI for some providers in Colorado, New Mexico, Oklahoma and Texas)
• Noridian Mutual Insurance Company (carrier for Colorado)
• TrailBlazer Health Enterprises, LLC (FI for Colorado, New Mexico and Texas; carrier for Texas)

TrailBlazer will assume full responsibility for the J4 A/B MAC work no later than Spring 2008, centering its operations at its headquarters in Richardson, Texas.

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