RAC Contractor Announced for NC:

CMS has announced the names of the new national Recovery Audit Contractors (RACs), including the contractor for North Carolina. Connolly Consulting Associates of Wilton, CT received the contract for Region C, which includes North Carolina. North Carolina is now scheduled for implementation on August 1, 2009.

October 1, 2008

1 Part B Announcement from CIGNA Government Services

KRAS Gene Mutation Testing: CIGNA Government Services will allow KRAS Gene Mutation Testing in the care of patients with metastatic colon cancer who are being considered for an Epidermal Growth Factor Receptor inhibitor as second line therapy effective 01 October 2008. Read more...
http://www.cignagovernmentservices.com/partb/pubs/news/2008/0908/cope8427.html

MAC Info:

The status of MAC contracts under Cycle One of the roll-out is as follows:

• August 2007, CMS awarded the J4 A/B MAC contract to Trailblazer Health Enterprises. Trailblazer is scheduled to assume full responsibility by spring 2008.
• September 2007, CMS awarded the J5 A/B MAC contract to Wisconsin Physicians Services Health Insurance Corporation. The company is scheduled to assume full responsibility by September 2008.
• October, 2007, CMS awarded the J12 A/B MAC contract to Highmark Medicare Services, Inc. On November 5, 2007, Palmetto GBA filed a protest against the award with the Government Accountability Office (GAO). Currently, the contact is under a stay of performance until CMS completes corrective action on certain aspects of the award decision.
• October, 2007, CMS awarded the J1 A/B MAC contract to Palmetto GBA. On November 13, 2007, National Heritage Insurance Company filed a protest against the award. The deadline for the GAO decision on the protest was February 21, 2008. The filing of the protest triggered an automatic stay on performance of the contract while the GAO's decision was pending.

To summarize, at this time five MAC contracts have been awarded: J1, J3, J4, J5, and J12, and two awards have been protested: J1 and J12. The Cycle Two MAC roll out starting in 2008 will include seven MAC A/B jurisdictions: J6, J8, J9, J10, J14, and J15.

CACs' Role Remains. MACs will continue to use the Carrier Advisory Committees (CACs) unless or until there is a change to the Program Integrity Manual (PIM). To date, the three MAC contractors that have implemented services are not planning to change the CAC process, and these three have kept in place a CAC from each state. What has changed is representation; to date, each MAC has opted to have one medical director, rather than one medical director for each state within the MAC's jurisdiction. Note: The implementation of regional MACs will result in the consolidation of local coverage determinations (LCDs). Having input into that final LCD is an important issue as this transition process continues and states begin to use regional decisions. Ongoing communication individually and between the CACs and MACs will be vital in the ongoing transition process and for consistency in the future.