CMS has awarded contracts to four specialty contractors (DME MACs) to administer Medicare claims from suppliers of durable medical equipment, prosthetics, and orthotics, a combined potential value of $542 million. As a result of the recent Medicare reforms, a competitive billing process was used to select the contractors for the first time in Medicare's 40-year history. The DME MACs can earn award fees based on their ability to meet the following performance requirements set by CMS: enhanced provider customer service, increased payment accuracy, improved provider education and training leading to correct claims submission, and realized cost savings resulting from efficiencies and innovation.
The DME MACs will replace the current Durable Medical Equipment Regional Carriers and will assume full responsibility for claims processing on July 1.The contracts are up for competitive bidding at least every five years.
