Part A/B MAC Current Jurisdictions 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 Medical claims [or Durable Medical Equipment] claims for Medicare Fee-For-Service (FFS) beneficiaries. There are currently 12 Part A/B MACs.   The vast majority of Part A/B coverage policy is determined on a local level by the MACs. Federal law mandates that MACs establish a Contractor Advisory Committee (CAC) for each state within its Medicare jurisdiction to serve as a resource to the local Medicare contractors and assist MACs in the development of LCDs. Each state CAC is comprised of physicians from various medical specialties. Currently, there are pathology CAC representatives in more than 40 states. CAC members are the ‘official voice’ for Medicare local coverage policies. In their advisory role, CAC members provide input on Medicare coverage policy decisions and communicate between practitioners and administrators/policy setters, with the CAC member as the communicating medium. © 2016 College of American Pathologists. All rights reserved.

Part A/B MAC Consolidations Jurisdiction Current Former States Current Contractor E 1 CA, HI, NV Noridian Administrative Services F 2 AK, ID, OR, WA 3 AZ, MT, ND, SD, UT, WY G 5 IA, KS, MO, NE Wisconsin Physicians Service Insurance Corporation 6 IL, MN, WI National Government Services, Inc. H 4 CO, NM, OK, TX Novitas Solutions, Inc. 7 AR, LA, MS I 8 IN, MI 15 KY, OH CIGNA Government Services J 10 AL, GA, TN Cahaba Government Benefit Administrators K 13 CT, NY 14 ME, MA, NH, RI, VT L 12 DE, DC, MD, NJ, PA Novitas Solutions, Inc M 11 NC, SC, VA, WV Palmetto Government Benefits Administrators N 9 FL, PR First Coast Service Options, Inc In 2010, CMS announced that it would consolidate the original 15 A/B MACs contract areas into 10 contracts. There are presently twelve (12) A/B MACs, and CMS has decided against consolidating the final two A/B MAC contracts c (J5 & J6; and J8 & J15), because it believes further consolidation could adversely impact competition in the MAC marketplace.

Medicare Contract Reform Draft Schedule for Future Part A/B MAC Procurements Jurisdiction MAC RFP to be Posted Target Award Date Original End of Current Contract POP New End of Contract POP with Proposed Extension F Noridian Apr. 2017 Feb. 2018 Aug. 2016 Aug. 2018 8 WPS Oct. 2017 Dec. 2016 Feb. 2019 H Novitas Mar. 2018 Jan. 2019 Feb. 2017 Jul. 2019 5 Jun. 2019 Jul. 2017 Dec. 2019 6 NGS Nov. 2019 Dec. 2017 May. 2020 E Apr. 2020 Oct. 2020 L Feb. 2021 Jan. 2018 Aug. 2021 K Sep. 2020 Jul. 2021 Jan. 2022 N First Coast Dec. 2021 Jun. 2022 M Palmetto Jun. 2021 Apr. 2022 Mar. 2020 Oct. 2022 15 CGS Feb. 2023 Aug. 2020 Aug. 2023 *Jurisdiction J (JJ) is intentionally not included on this chart at this time as it is currently an active procurement. The Medicare Access and CHIP Reauthorization Act (MACRA) enacted on April 16, 2015, included language in Section 509 that extends MAC contract terms from five to ten years, and requires CMS to publish performance information on each MAC. The legislation applies to all contracts in effect at the time of enactment, meaning that current MAC contracts in place can be extended another five years to a maximum of ten. This also means that the Agency is required to immediately make public performance information on each MAC.