New Medicare Administrative Carrier for Jurisdiction 12: Highmark Medicare Services Acquired by Diversified Service Options, Inc.

Monday, April 16, 2012

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Diversified Service Options (DSO) acquired Highmark Medicare Services (Highmark) on January 1, 2012. DSO is a holding company and a wholly-owned subsidiary of Blue Cross and Blue Shield of Florida, Inc. (BCBS Florida). Highmark had the contract with the Centers for Medicare & Medicaid Services (CMS) to be the Medicare Administrative Contractor (MAC), formerly known as a "Carrier" or "Fiscal Intermediary," for Jurisdiction 12, which includes Delaware, New Jersey, Pennsylvania, Maryland and Washington, D.C. For Part B services, Jurisdiction 12 also includes the counties of Arlington and Fairfax in Virginia and the city of Alexandria in Virginia.

As of March 1, 2012, Highmark changed its name to Novitas Solutions, Inc. (Novitas). Novitas has now assumed the duties of Highmark as the Part A and B Medicare Administrative Contractor (MAC) for Jurisdiction 12.

Additionally, Novitas will now serve as the Part A and B MAC for Jurisdiction H, which includes Arkansas, Colorado, Louisiana, Mississippi, New Mexico, Oklahoma, Texas and the Indian Health Service (IHS).

First Coast Service Options, Inc. (First Coast), is also a wholly-owned subsidiary of Blue Cross and Blue Shield of Florida, Inc. First Coast is the current MAC for Jurisdiction 9, which includes Florida. Although plans for a merger between First Coast and Novitas are not known at this time, it is speculated that such an arrangement may occur in the future.


Sources Include:

Blue Cross Blue Shield of Florida, Inc. Press Release, "Diversified Service Options of Florida to Acquire Highmark Medicare Services:  Will Expand Medicare Operations" (Dec. 8, 2011).

Healthcare Data Management, "What Happened to Highmark Medicare Services?"  (Mar. 16, 2012).  From:  http://www.healthcarebiller.com/2012/03/16/what-happened-to-highmark-medicare-services/

Novitas Solutions, Inc. Press Release, "Highmark Medicare Services Inc. Changes Name to Novitas Solutions, Inc." (Apr. 10, 2012). From: https://www.novitas-solutions.com/parta/info-alerts.html


George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law.  He is the President and Managing Partner of The Health Law Firm, which has a national practice.  Its main office is in the Orlando, Florida, area.  www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone:  (407) 331-6620.


Tags: Medicare Administrative Carrier (MAC), Medicare Audit, MAC Audit, CMS Audit, ZPIC Audit, First Coast Service Options (FCSO), Medicare (MAC) Jurisdiction 12, Highmark Medicare Audit, Medicare (MAC) Jurisdiction 9, Novitas Solutions, Inc., Highmark Medicare Services

4/16/2012

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