Who is the Medicare MAC for Illinois?
CGS takes care of Jurisdiction DME B and DME C which covers: Alabama, Arkansas, Colorado, Florida, Georgia, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia, West Virginia, Puerto Rico, U.S. Virgin Islands, Illinois, Indiana, Kentucky, Michigan, Minnesota, Ohio, ...
What is my Medicare Mac?
A Medicare Administrative Contractor (MAC) is a private health care insurer that has been awarded a geographic jurisdiction to process Medicare Part A and Part B (A/B) medical claims or Durable Medical Equipment (DME) claims for Medicare Fee-For-Service (FFS) beneficiaries.
What Medicare jurisdiction is Illinois?
Jurisdiction 6National Government Services (NGS) administers Medicare health insurance for the Centers for Medicare & Medicaid Services (CMS) for Jurisdiction 6 which includes the State of Illinois.
What states are in Medicare Jurisdiction C?
DME MAC Jurisdiction C – DME Facts JC processes FFS Medicare DME claims for Alabama, Arkansas, Colorado, Florida, Georgia, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, Puerto Rico, South Carolina, Tennessee, Texas, U.S. Virgin Islands, Virginia, and West Virginia.
What is the MAC locality?
However, the Medicare Administrative Contractors (MACs) have been allowed to process claims using what we refer to as the “locality rule”. The “locality rule” allows for when patients normally seek medical attention at a few regional hospitals on a regular basis.
How many MACs are there for the DME?
FourHow Many Macs Exist? Currently, there are 12 Medicare Part A and B MACs that assist with Original Medicare (Medicare Parts A and B). Four of these MACs also process home health and hospice claims in addition to their typical Medicare Part A and Part B claims. There are also four durable medical equipment (DME) MACs.
What states are in Medicare Region B?
Jurisdiction B is serviced by CGS and includes Illinois, Indiana, Kentucky, Michigan, Minnesota, Ohio and Wisconsin.
What states are in Medicare Region A?
DME MAC Jurisdiction A - DME FactsJA processes FFS Medicare DME claims for Connecticut, Delaware, District of Columbia, Maine, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island and Vermont.Total Number of Fee-for-Service Beneficiaries: 7,649,029 (as of 9/30/2021)More items...•
Where is Medicare Jurisdiction A?
United StatesCenters for Medicare & Medicaid Services / Jurisdiction
What is DME MAC C?
A Durable Medical Equipment Medicare Administrative Contractor (DME MAC) is a private insurance company that has a contract with Medicare to process durable medical equipment (DME) claims.
What does CGS mean in Medicare?
CGS Medicare stands for a Celerian Group Company. The company provides a variety of services for Medicare beneficiaries, healthcare providers, and medical equipment suppliers.
What states does noridian Medicare cover?
Noridian now administers the Medicare program as a Medicare Administrative Contractor (MAC) for Jurisdictions E and F. Jurisdiction E serves Part A and Part B providers in the states of California, Hawaii and Nevada as well as Guam, American Samoa and the Northern Mariana Islands.
Current Maps and Lists
To find out who the current A/B and DME MACs are, use these maps and lists to help you determine which MAC is of most interest to you.
DME MACs
The DME MACs process Medicare Durable Medical Equipment, Orthotics, and Prosthetics (DMEPOS) claims for a defined geographic area or "jurisdiction," servicing suppliers of DMEPOS. Learn more about the DME MAC in each jurisdiction.
What's a MAC and what do they do?
A Medicare Administrative Contractor (MAC) is a private health care insurer that has been awarded a geographic jurisdiction to process Medicare Part A and Part B (A/B) medical claims or Durable Medical Equipment (DME) claims for Medicare Fee-For-Service (FFS) beneficiaries.
DME MACs
The DME MACs process Medicare Durable Medical Equipment, Orthotics, and Prosthetics (DMEPOS) claims for a defined geographic area or "jurisdiction", servicing suppliers of DMEPOS. Learn more about DME MACs at Who are the MACs.
Relationships between MACs and Functional Contractors
MACs work with multiple functional contractors to administer the full FFS operational environment. Learn more about the relationships between the MACs and the functional contractors by viewing the diagram of MACs: The Hub of the Medicare FFS Program (PDF) and reading about what the functional contractors do at Functional Contractors Overview (PDF).
SPOTLIGHT & RELEASES
09/15/2021 : CMS released the Second Evaluation Report and associated Findings At-a-Glance for the Illinois capitated model demonstration under the Medicare-Medicaid Financial Alignment Initiative
Key Dates
September 14, 2016 - CMS, Illinois, & participating plans execute an updated three-way contract
MMAI Model
On February 22, 2013, the Department of Health and Human Services announced that the State of Illinois will partner with the Centers for Medicare & Medicaid Services (CMS) to test a new model for providing Medicare-Medicaid enrollees with a more coordinated, person-centered care experience.
