The Centers for Medicare & Medicaid Services (CMS) recently awarded the contract for combined administration and payment of Part A and Part B Medicare claims in California to South Carolina-based Palmetto GBA. Although the contract doesn’t officially take effect until August 4, the transition has already begun with a final implementation date scheduled for September 2. CMA is working closely with Palmetto to ensure a smooth transition.

Palmetto is one of five new Medicare Administrative Contractors (MACs) named by CMS as required by the Medicare Modernization Act of 2003. The MAC contracts, which combine administration of both Part A and Part B claims, are part of an effort to streamline the fee-for-service payment system.

As you know, NHIC has been California’s Medicare carrier for more than a decade, processing claims for physicians, laboratories and other practitioners under Medicare Part B. NHIC will continue processing Medicare claims for California through September 1. Physicians will soon, however, be able to begin submitting electronic claims to Palmetto as part of its “early boarding” transition plan. Although physicians will be able to continue using their current EDI submitter numbers, they will need to complete a new electronic funds transfer (EFT) form. Watch the mail for more information from Palmetto on the early boarding plan.

At CMA’s request, Palmetto will be producing a physician “to do” check-list with deadlines so physicians can easily manage the transition. This checklist will soon be available on the Palmetto website. Physicians are encouraged to sign up for Palmetto’s listserv so they can directly receive all of the latest information on the transition.

CMA is also helping Palmetto develop extensive provider education seminars to help physicians with the transition. The seminars will be help in-person, online, and via telephone. Stay tuned for more information.

Contact: Reimbursement Help Line, 888/401-5911 or fnavarro@cmanet.org.