CMS: Novitas Switch No Problem

This fall's switch from TrailBlazer Health Enterprises to Novitas Solutions to administer Texas Medicare claims will not cause problems for physicians, Centers for Medicare & Medicaid Services (CMS) Acting Administrator Marilyn Tavenner assured U.S. Rep. Michael Burgess, MD (R-Texas). She said in a letter to Representative Burgess that CMS is working with Novitas and TrailBlazer to make sure the change does not disrupt services to physicians caring for Medicare patients.

Ms. Tavenner wrote Representative Burgess in response to his May 4 letter expressing concern about the change and its impact on physicians. He had raised concerns over several issues, including physicians having to complete new electronic funds transfer agreements and using a new electronic claims filing system. Every member of the Texas House delegation signed the letter.

The company will also handle claims in Arkansas, Colorado, Louisiana, Mississippi, New Mexico, and Oklahoma. Texas physicians will switch to Novitas, formerly known as Highmark Medicare Services, on Nov. 19. Hospitals and skilled nursing facilities will switch Oct. 29.

Concerned over the change's impact on physician and patients, TMA and the Colorado, New Mexico, and Oklahoma state medical societies backed TrailBlazer's appeal of the CMS decision to award a claims administration contract to Novitas. They wrote Ms. Tavenner that the decision to change contractors was "ill considered and will cause substantial disruption when consistency and stability is needed."

TMA is working closely with Novitas to make sure Texas physicians stay informed and have the information they need to make a smooth transition from TrailBlazer to Novitas. Novitas created a transition page on its website to keep physicians informed.

  Action, July 2, 2012