Various elements of the Agency’s original strategy for implementing Section 911 of the MMA evolved over the years.
RATE IDOCTOR FOR MAC MAC
CMS procures all MAC contracts according to the Federal Acquisition Regulation. Section 911 of the Medicare Prescription Drug Improvement, and Modernization Act (MMA) of 2003 directed CMS to replace the Part A Fiscal Intermediaries (FIs) and Part B carriers with MACs. Coordinate with CMS and other FFS contractors.Review medical records for selected claims.Establish local coverage determinations (LCD’s).
Educate providers about Medicare FFS billing requirements.Handle redetermination requests (1st stage appeals process).Handle provider reimbursement services and audit institutional provider cost reports.Enroll providers in the Medicare FFS program.Make and account for Medicare FFS payments.
MACs are multi-state, regional contractors responsible for administering both Medicare Part A and Medicare Part B claims.
CMS relies on a network of MACs to serve as the primary operational contact between the Medicare FFS program and the health care providers enrolled in the program.
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