What is a MAC? 12 Part A/B MAC jurisdictions 4 Durable Medical Equipment (DME) MAC jurisdictions NGS handles JK and J6 A/B includes Home Health and Hospice (HH+H) as well as Federally Qualified Health Centers (FQHCs) under Medicare Part A. CMS relies on Medicare Administrative Contractors (MACs) to serve as the primary operational contact between the Medicare Fee-for-Service (FFS) program and enrolled health care providers for Medicare Part A (hospital) and Part B (medical).

MAC Responsibilities Data analysis Educate and train providers for proper billing Ensure services are coded and billed correctly Make proper payments Process first level appeals Enroll Medicare providers Process claims accurately and timely Determine medical necessity from national coverage and develop local coverage where needed Respond to Inquiries Coordination with other government and health care entities Collect Overpayments Timely processing

The HUB of the Medicare FFS Program NGS interacts with the following entities: Benefits Coordination & Recovery Center (BCRC) Recovery Auditors (RAs) Qualified Independent Contractors (QICs) Supplemental Medical Review Contractor (SMRCs) Medicare Administrative Contractors (MACs) Zone Program Integrity Contractors (ZPICs) Call Center Operations (COO) Quality Improvement Organizations (QIOs) CMS Regional Office Survey & Certification Healthcare Integrated General Ledger Accounting System (HIGLAS) Virtual Data Centers (VDCs)

Phone calls answered in 2017 Part A and B providers served NGS 3,300,000 Phone calls answered in 2017 225,000,000 Claims processed in 2017 Excess of $1 billion paid each month 400,000 Part A and B providers served NGS Total MAC Savings to the Trust Fund in 2017: $283.4 million (Medical Review only) NGS Total JK/J6 Administrative Savings from OY3 to OY4: Over $5.2 million