Radiologist association rebuffs CMS consolidation effort: 5 things to know

Efforts by CMS to consolidate Medicare Administrative Contractor jurisdictions will impede care access for Medicare beneficiaries, according to the American College of Radiology. 

The organization has submitted comments to CMS regarding the potential change, according to an Oct. 9 news release from the association.

Here are five things to know about the CMS proposal and the radiologists' response:

  1. Medicare Administrative Contractors are private healthcare insurers awarded geographic jurisdiction contracts to process Medicare claims. Currently, CMS has 16 contracts with seven companies that provide claims administration.

  2. In a September request for information letter, CMS proposed consolidating four MAC jurisdictions into two jurisdictions. Additionally, CMS proposed extending the contract award period from seven to 10 years.

  3. The American College of Radiology provided feedback to CMS' request for information in an Oct. 4 letter.

  4. The organization expressed concerns that consolidation and increased jurisdiction sizes would lead to communication challenges between physicians and MACs. The organization also showed concern over "potential monopolistic effects" the consolidation could have on the market.

In regards to extending contract awards from seven to 10 years, the American College of Radiology said the increase could potentially disincentivize poorly performing contractors to improve and meet with physician stakeholders. 

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