U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES
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1 U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES MEDICARE FEE-FOR-SERVICE CLAIMS CONTRACT DIRECTORY AS OF May 28, 2010 LIST OF CONTRACTORS BY TYPE AND JURISDICTION: A/B MACS: PAGE A/B MAC JURISDICTION A/B MAC JURISDICTION A/B MAC JURISDICTION A/B MAC JURISDICTION A/B MAC JURISDICTION A/B MAC JURISDICTION A/B MAC JURISDICTION A/B MAC JURISDICTION A/B MAC JURISDICTION A/B MAC JURISDICTION A/B MAC JURISDICTION A/B MAC JURISDICTION A/B MAC JURISDICTION A/B MAC JURISDICTION A/B MAC JURISDICTION DME MACS: DME MAC JURISDICTION A DME MAC JURISDICTION B DME MAC JURISDICTION C DME MAC JURISDICTION D ACTIVE LEGACY FISCAL INTERMEDIARIES AND CARRIERS: LEGACY CONTRACTOR Cahaba Government Benefit Administrators, LLC Fiscal Intermediary (RHHI Only) LEGACY CONTRACTOR Cahaba Government Benefit Administrators (GBA) LEGACY CONTRACTOR Cigna Government Services (Carrier), LEGACY CONTRACTOR National Government Services, Inc (NGS) LEGACY CONTRACTOR National Government Services, Inc (NGS) LEGACY CONTRACTOR Noridian Administrative Services, LLC (NAS) LEGACY CONTRACTOR Noridian Administrative Services, LLC (NAS) Carrier LEGACY CONTRACTOR Palmetto GBA, LLC LEGACY CONTRACTOR Palmetto GBA, LLC LEGACY CONTRACTOR Pinnacle Business Solutions, Inc, LEGACY CONTRACTOR Pinnacle Business Solutions, Inc, LEGACY CONTRACTOR Trailblazer Health Enterprises, LLC (THE) LEGACY CONTRACTOR Wisconsin Physician Services (WPS) LEGACY CONTRACTOR - Wisconsin Physician Service (WPS)
2 A/B MAC JURISDICTION 1 Palmetto GBA, LLC, Contract HHSM M0002Z PROVIDER SERVICE AREA: California, Hawaii, Nevada, American Samoa, Guam, and Northern Mariana Islands J1 MAC PROJECT OFFICER: Jim Massa, J1 MAC CONTRACTING OFFICER: Cathy Baldwin, J1 MAC CONTRACT SPECIALIST: Brenda Clark, Bruce W. Hughes President & Chief Operating Officer 17 Technology Circle Mail Code: AG-A03 Columbia, SC Phone: Fax: Dickie Butler, Vice President Medicare Systems/EDI Phone: Fax: Ray Blair, Compliance Officer Phone: Fax: Mike Barlow, Vice President J1 Program Manager 4249 Easton Way, Suite 400 Columbus, Ohio Phone: Phone: Joe Wright, Vice President Chief Financial Officer Phone: Fax: Larry Leslie, Contract Admin. Phone: Fax: J1 SUBS: First Coast Service Options, Inc.; PPS Info Tech.; Trailblazer Health Enterprises, LLC HCFA , Part A and RHHI (SC, NC and RHHI Jurisdiction C) HCFA , Part B (SC, OH, and WV) HHSM C, Competitive Bidding Implementation Contractor HHSM C, National Supplier Clearinghouse (NSC) HHSM M0009Z, Medical Home Demonstration HHSM C, Single Testing Contractor OORRB005, Railroad Retirement Board, Part B PARENT COMPANY: Blue Cross Blue Shield of South Carolina A/B MAC JURISDICTION 2 2
3 PROVIDER SERVICE AREA: Alaska, Idaho, Oregon, and Washington J2 MAC PROJECT OFFICER: Pamela Bragg J2 MAC CONTRACTING OFFICER: Pam Collins J2 MAC CONTRACT SPECIALIST: UNDER CORRECTIVE ACTION 3
4 A/B MAC JURISDICTION 3 Noridian Administrative Services, LLC (NAS), Contract HHSM M0005Z PROVIDER SERVICE AREA: Arizona, Montana, North Dakota, South Dakota, Utah, and Wyoming J3 MAC PROJECT OFFICER: Steven Smetak, J3 MAC CONTRACTING OFFICER:, J3 MAC CONTRACT SPECIALIST: Salem Fussell, Mr. Mike Hamerlik President and Chief Executive Officer nd Street South P.O. Box 6055 Fargo, ND Phone: Paul O Donnell, Vice President J3 Program Manager nd Street South P.O. Box 6055 Fargo, ND Phone: Martha Rust, Senior Vice President Chief Financial Officer Phone: Craig Campbell, Executive Vice President Chief Administrative Officer nd Street South Fargo, ND Phone: Karla Thormodson, Contract Admin Phone: Drew Wrigley, Compliance Officer Phone: J3 SUBS: MEC Tech; Thomson-Reuters; Seven Seas Tech.; Deloitte-Touch, LLP; eservices; Fox Systems ; EDS; RSM McGladrey; AZ Health-e Connections; Marketing with a Flair HHSM M0004Z, DME MAC Jurisdiction D HHSM M0007Z, PDAC HCFA , Legacy Part B for AK, OR, WA HCFA , Legacy Part A for ID, MN, OR CMS , Legacy Part A for AK, WA PARENT COMPANY: Noridian Mutual Insurance Company 4
5 A/B MAC JURISDICTION 4 Trailblazer Health Enterprises, LLC (THE), Contract HHSM M0001Z PROVIDER SERVICE AREA: Colorado, New Mexico, Oklahoma, and Texas J4 MAC PROJECT OFFICER: Terry Bird, J4 MAC CONTRACTING OFFICER:, J4 MAC CONTRACT SPECIALIST: Holly Lane, Mr. Gil Glover President and Chief Operating Officer TrailBlazer Health Enterprises, LLC 8330 LBJ Freeway, Executive Center 3 Dallas, TX Phone: Fax: gil.glover@trailblazerhealth.com Renee Cotton, Vice President Program Management Operations Phone: Fax: Ken Kerns, Vice President Program Management Operations Phone: Fax: Scott Manning, Vice President J4 Program Manager 8330 LBJ Freeway, Executive Center III Dallas, TX Phone: Fax: Ernest Lopez Chief Financial Officer Phone: Fax: Mike Smith Chief Information Officer Phone: Fax: HHSM C, Section 1011 HCFA , Legacy Part B Virginia PARENT COMPANY: Blue Cross and Blue Shield of South Carolina 5
6 A/B MAC JURISDICTION 5 Wisconsin Physician Services (WPS), Contract HHSM M0002Z PROVIDER SERVICE AREA: Iowa, Kansas, Missouri, and Nebraska J5 MAC PROJECT OFFICER: Pamela Bragg, J5 MAC CONTRACTING OFFICER: Christina Honey, J5 MAC CONTRACT SPECIALIST: Todd Vanderdonck, Ms. Jared Adair Sr. Vice President, Medicare Operations Wisconsin Physicians Service (WPS) P.O. Box 8190 Madison, WI Phone: Fax: Jared.Adair@wpsic.com William Bathke Executive Vice President Chief Operating Officer 1717 W. Broadway P.O. Box 8190 Madison, WI Phone: Fax: Shelia Bechmann, Vice President Medicare Systems and Technology Phone: Fax: Gary Lapotka Director, Medicare Compliance Phone: Fax: Ms. Janet Kyle Vice President, Medicare Program Management Wisconsin Physicians Service (WPS) 3333 Farnam St, Ste 700 P.O. Box 1604 Omaha, NE Phone: Janet.Kyle@wpsic.com Kris Martin J5 Program Manager 3333 Farnam St. P.O. Box 1604 Omaha, NE Phone: Fax: John Degler, Vice President Corporate EDI Phone: Fax: Frances Dye, Contract Admin Phone: Fax: J5 SUBS: Mutual of Omaha; EDS 6
7 HCFA , Legacy Part B Contract for Illinois, Minnesota, Michigan, and Wisconsin HCFA , Legacy Part A Contract (Most states) PARENT COMPANY: None 7
8 A/B MAC JURISDICTION 6 PROVIDER SERVICE AREA: Illinois, Minnesota, and Wisconsin J6 MAC PROJECT OFFICER: Steven Smetak, J6 MAC CONTRACTING OFFICER: Desiree Wheeler, J6 MAC CONTRACT SPECIALIST: UNDER CORRECTIVE ACTION 8
9 A/B MAC JURISDICTION 7 PROVIDER SERVICE AREA: Arkansas, Louisiana, and Mississippi J7 MAC PROJECT OFFICER: Virginia Adams, J7 MAC CONTRACTING OFFICER: TBD J7 MAC CONTRACT SPECIALIST: UNDER CORRECTIVE ACTION 9
10 A/B MAC JURISDICTION 8 PROVIDER SERVICE AREA: Indiana and Michigan J8 MAC PROJECT OFFICER: Marybeth Jason, J8 MAC CONTRACTING OFFICER: Juanita Wilson, J8 MAC CONTRACT SPECIALIST: UNDER CORRECTIVE ACTION 10
11 A/B MAC JURISDICTION 9 First Coast Service Options, Inc. (FCSO), Contract HHSM M0008Z PROVIDER SERVICE AREA: Florida, Puerto Rico, and U.S. Virgin Islands J9 MAC PROJECT OFFICER: Amy Drake, J9 MAC CONTRACTING OFFICER:, J9 MAC CONTRACT SPECIALIST: Melanie Jones, Ms. Sandy Coston President and Chief Executive Officer 532 Riverside Ave 20 Tower Jacksonville, Florida Phone: Fax: sandy.coston@fcso.com John Frantz, Vice President Chief Information Officer Phone: Fax: Lamar James, VP Operations J9 Project Manager, VP Operations 532 Riverside Avenue Jacksonville, FL Phone: Fax: Lamar.James@FCSO.com Jonathon Hogan, Vice President Chief Financial Officer Phone: Fax: Marco Turner, Contracting Officer Phone: Fax: J9 SUBS: Triple-S Salud, Inc. HCFA , QIC Part B North HCFA , QIC PDRC PARENT COMPANY: Blue Cross Blue Shield of Florida 11
12 A/B MAC JURISDICTION 10 Cahaba Government Benefit Administrators (GBA), Contract HHSM M0004Z PROVIDER SERVICE AREA: Alabama, Georgia, and Tennessee J10 MAC PROJECT OFFICER: Bobbie Sullivan, J10 MAC CONTRACTING OFFICER:, J10 MAC CONTRACT SPECIALIST: Melanie Jones, Ms. Sherrie LeMier President and Chief Operating Officer PO Box Birmingham, Alabama Phone: Fax: Kevin Overlaur Medicare Systems/EDI Phone: Fax: Molly Echols, Compliance Officer Phone: Fax: Scott Shelton J10 Program Manager 300 Corporate Parkway Birmingham, Alabama Phone: Fax: Pamela Miller Chief Financial Officer Phone: Fax: Fred Schlich, Contract Admin Phone: Fax: J10 SUBS: Allison Payment Systems, LLC; Emdeon Business Services HCFA , Legacy RHHI for Colorado, Iowa, Kansas, Missouri, Nebraska, North Dakota, South Dakota, Utah, Wyoming, Delaware, District of Columbia, Maryland, Pennsylvania, Virginia, West Virginia HCFA , Legacy Part B contract for Mississippi PARENT COMPANY: Blue Cross Blue Shield of Alabama 12
13 A/B MAC JURISDICTION 11- Palmetto GBA PROVIDER SERVICE AREA: North Carolina, South Carolina, Virginia, and West Virginia J11 MAC PROJECT OFFICER: James Massa, J11 MAC CONTRACTING OFFICER: Cathy Baldwin, J11 MAC CONTRACT SPECIALIST: BID PROTEST PENDING- UNDER STAY OF PERFORMANCE 13
14 A/B MAC JURISDICTION 12 Highmark Medicare Services, Inc. (HMS), Contract HHSM M0001Z PROVIDER SERVICE AREA: Delaware, District of Columbia, Maryland, New Jersey, and Pennsylvania J12 MAC PROJECT OFFICER: James Throne, J12 MAC CONTRACTING OFFICER: Tina Honey, J12 MAC CONTRACT SPECIALIST: Edward Farmer, Mr. Patrick Kiley President and Senior Medicare Executive Highmark Medicare Services, Inc. P.O. Box Camp Hill, PA Phone: Fax: Edward Pigan, Medicare CIO Phone: Fax: David Vaughan Vice President and J12 Program Manager P.O. Box Camp Hill, PA Phone: Fax: James Chiado, Chief Financial Officer Phone: Fax: Gayeta Porter, Contract Admin Phone: Fax: E. James Bylotus, Compliance Officer Phone: Fax: J12 SUBS: Holloway & CO.; TerraHealth Inc.; Merit Healthcare Consulting, Inc.; FCG Solutions, Inc. None. PARENT COMPANY: Highmark, Inc. 14
15 A/B MAC JURISDICTION 13 National Government Services, Inc. (NGS), Contract HHSM M0004Z PROVIDER SERVICE AREA: Connecticut and New York J13 MAC PROJECT OFFICER: Marybeth Jason, J13 MAC CONTRACTING OFFICER: Cathy Baldwin, J13 MAC CONTRACT SPECIALIST: John Webster, Sandra Miller President 8115 Knue Rd. Indianapolis, IN Phone: Fax: Michael Kapp VP and NGS Chief Financial Officer Phone: Todd Reiger NGS Medicare Chief Financial Officer Phone: Fax: Scott Kimbell J13 Project Manager 9901 Linn Station Rd. Louisville, KY Phone: or Fax: David Marshall NGS Chief Operating Officer 8115 Knue Rd. Indianapolis, IN Phone: Fax: Tim Mascheck VP of Information Technology Phone: Stacie Amburn Contract Administrator Phone: Fax: Jeff Hannah Chief Administrative Officer 8115 Knue Rd. Indianapolis, IN Phone: Fax: Wendy Perkins, Compliance Officer Phone: J13 Subs: J14 MAC- Part A/RHHI, National Heritage Insurance Company (NHIC), Contract HHSM M0001Z 15
16 HHSM M0002Z, DME MAC Jurisdiction B HCFA , Indiana/Kentucky- Part B XVIII CA RHHI & WI RHHI (multiple states) HCFA , Part A for IA, MI, OH, KY, VA, WV, WI, IL XVIII, Federal Qualified Health Centers Next Generation Desktop PARENT COMPANY: Wellpoint 16
17 A/B MAC JURISDICTION 14 National Heritage Insurance Company (NHIC), Contract HHSM M0002Z PROVIDER SERVICE AREA: Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont J14 MAC PROJECT OFFICER: Lindsey Kittrell, J14 MAC CONTRACTING OFFICER: Cathy Baldwin, J14 MAC CONTRACT SPECIALIST: Alice Calabro, Ms. Anne Bockhoff Dalton Vice President 75 Sgt. William B. Terry Drive Hingham, Massachusetts Phone: Fax: Robert Harrington J14 Project Manager 75 Sgt. William B Terry Drive Hingham, Massachusetts Phone: Fax: Dorothy Pines J14 Contract Manager Phone: Jane Hite Chief Information Officer 75 Sgt. William B. Terry Drive Hingham, Massachusetts Phone: Fax: Trace Woodward Chief Financial Officer/Finance Director 402 Otterson Drive Chico, CA Phone: Fax: Neil Walsh Compliance Officer Phone: J14 SUBS: National Government Services (NGS) HHSM M0001Z, DME MAC Jurisdiction A PARENT COMPANY: Hewlett-Packard 17
18 A/B MAC JURISDICTION 15 PROVIDER SERVICE AREA: Kentucky and Ohio J15 MAC PROJECT OFFICER: James Throne, J15 MAC CONTRACTING OFFICER: J15 MAC CONTRACT SPECIALIST: UNDER CORRECTIVE ACTION 18
19 DME MAC JURISDICTION A National Heritage Insurance Company (NHIC), Contract HHSM M0001Z Provider Service Area: Connecticut, Delaware, District of Columbia, Maine, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, and Vermont JA MAC PROJECT OFFICER: Martin Furman, JA MAC CONTRACTING OFFICER: Cathy Baldwin, JA MAC CONTRACT SPECIALIST: Alice Calabro, Anne Bockhoff Dalton Vice President 75 Sgt William Terry Drive Hingham, MA Phone: Fax: Jane Hite Chief Information Officer Phone: Fax: Neil Walsh, Compliance Officer Phone: Fax: Andrew Conn JA Program Director 75 Sgt William Terry Drive Hingham, MA Phone: Fax: Trace Woodward Chief Financial Officer Phone: Fax: Dorothy Pines, Contract Admin. Phone: JA SUBS: National Government Services (NGS) HHSM M0002Z, A/B MAC Jurisdiction 14 PARENT COMPANY: HP Enterprises, Inc. 19
20 DME MAC JURISDICTION B National Government Services, Inc (NGS), Contract HHSM M0002Z Provider Service Area: Illinois, Indiana, Kentucky, Michigan, Minnesota, Ohio, and Wisconsin JB MAC PROJECT OFFICER: Martin Furman, JB MAC CONTRACTING OFFICER: Cathy Baldwin, JB MAC CONTRACT SPECIALIST: Alice Calabro, Sandra Miller President 8115 Knue Rd. Indianapolis, IN Sandra.miller@wellpoint.com Phone: Fax: Tim Masheck Chief Information Officer Phone: Wendy Perkins, Compliance Officer Phone: David Barnett JB Program Director 8115 Knue Road Indianapolis, IN Phone: Todd Reiger Chief Financial Officer Phone: Fax: Joel Allgeier, Contract Admin Phone: JB SUBS: None HHSM M0004Z, A/B MAC Jurisdiction 13 HCFA , IN, KY Legacy Part B HCFA , IA, MI, OH, KY, VA, WV, WI, IL - Part A XVIII CA RHHI & WI RHHI & Federal Qualified Health Centers (multiple states) Next Generation Desktop PARENT COMPANY: Wellpoint 20
21 DME MAC JURISDICTION C CIGNA Government Services (CGS), Contract HHSM M0006Z Provider Service Area: Alabama, Arkansas, Colorado, Florida, Georgia, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, Puerto Rico, South Carolina, Tennessee, Texas, U.S. Virgin Islands, Virginia, and West Virginia JC MAC PROJECT OFFICER: Ed Lain, JC MAC CONTRACTING OFFICER: Cathy Baldwin, JC MAC CONTRACT SPECIALIST: Brenda Clark, Brian Setzer President and Chief Operating Officer 2 Vantage Way, Metro Center Nashville, TN Phone: Fax: Cheryl Haynes Medicare Systems/EDI Phone: Fax: Linda Martin, Compliance Officer Phone: Fax: Melissa Kirchenbauer JC Program Manager 2 Vantage Way, Metro Center Nashville, TN Phone: Fax: Melody Kief Chief Financial Officer Phone: Fax: Robert Madgett, Contract Admin Phone: Fax: JC SUBS: None HCFA , Legacy Part B North Carolina and Idaho PARENT COMPANY: CIGNA Corporation 21
22 DME MAC JURISDICTION D Noridian Administrative Services, LLC (NAS), Contract HHSM M0004Z Provider Service Area: Alaska, American Samoa, Arizona, California, Guan, Hawaii, Idaho, Iowa, Kansas, Missouri, Montana, Nebraska, Nevada, North Dakota, Northern Mariana Islands, Oregon, South Dakota, Utah, Washington, and Wyoming JD MAC PROJECT OFFICER: Ed Lain, JD MAC CONTRACTING OFFICER: Cathy Baldwin, JD MAC CONTRACT SPECIALIST: Brenda Clark, Mike Hamerlik President th Street S, Suite 1 Fargo, ND Phone: Troy Aswege Medicare Systems/EDI Phone: Drew Wrigley, Compliance Officer Phone: Emy Stenerson JD Program Manager th Street S, Suite 1 Fargo, ND Phone: Martha Rust Chief Financial Officer Phone: Karla Thormodson, Contract Admin Phone: Fax: JD SUBS: MEC Technologies; Hewlett Packard/EDS; Deloitte & Touche; RSM McGladrey; Advanced Healthcare; Iron Mountain Info; Don Olsen, PT/ATP. CMS , Legacy Part A for AK, WA HHSM M0007Z, PDAC HCFA , Legacy Part B for AK, OR, WA HCFA , Legacy Part A for ID, MN, OR, WA, AK HHSM M0005Z, A/B MAC Jurisdiction 3 PARENT COMPANY: None 22
23 LEGACY CONTRACTOR Cahaba Government Benefit Administrators, LLC Fiscal Intermediary (RHHI Only), Contract HCFA PROVIDER SERVICE AREA: Colorado, Iowa, Kansas, Missouri, Nebraska, North Dakota, South Dakota, Utah, Wyoming, Delaware, District of Columbia, Maryland, Pennsylvania, Virginia, West Virginia LEGACY CONTRACTOR MANAGER: Chris Kerr, LEGACY CONTRACTING OFFICER: Kathy Markman, LEGACY CONTRACT SPECIALIST: TBD Ms. Sherrie LeMier President and Chief Operating Officer PO Box Birmingham, Alabama Phone: Fax: Kevin Overlaur Medicare Systems/EDI Phone: Phone: Fax: Molly Echols, Compliance Officer Phone: Fax: Brandon Ward Vice President 300 Corporate Parkway Birmingham, Alabama Phone: Ron Whitehead Chief Financial Officer 300 Corporate Parkway Birmingham, Alabama Phone: Fred Schlich, Contract Admin Phone: Fax: LEGACY SUBS: Allison Payment Systems, LLC; Emdeon Business Services; Mayer Hoffman McCann; Dr. James Strong HHSM M0004Z, Jurisdiction 10 A/B MAC HCFA , Part B Carrier for Mississippi PARENT COMPANY: Blue Cross Blue Shield of Alabama 23
24 LEGACY CONTRACTOR Cahaba Government Benefit Administrators (GBA) (Carrier) Contract HCFA PROVIDER SERVICE AREA: Mississippi LEGACY CONTRACTOR MANAGER: Chris Kerr, LEGACY CONTRACTING OFFICER: Kathy Markman, LEGACY CONTRACT SPECIALIST: TBD Ms. Sherrie LeMier President and Chief Operating Officer PO Box Birmingham, Alabama Phone: Fax: Kevin Overlaur Medicare Systems/EDI Phone: Fax: Molly Echols, Compliance Officer Phone: Fax: Brandon Ward Vice President 300 Corporate Parkway Birmingham, Alabama Phone: Ron Whitehead Chief Financial Officer 300 Corporate Parkway Birmingham, Alabama, Fred Schlich, Contract Admin Phone: Fax: 205) LEGACY SUBS: Allison Payment Systems, LLC; Emdeon Business Services; Mayer Hoffman McCann; Dr. James Strong HHSM M0004Z, Jurisdiction 10 MAC HCFA , Legacy RHHI for CO, IA, KS, MS, NC, ND, SD, UT, WY, DE, DC, MD, PA, VA, WV PARENT COMPANY: Blue Cross Blue Shield of Alabama 24
25 LEGACY CONTRACTOR Cigna Government Services (Carrier), Contract HCFA PROVIDER SERVICE AREA: Idaho, North Carolina LEGACY CONTRACTOR MANAGER: Lori Borelli, LEGACY CONTRACTING OFFICER: Kathy Markman, LEGACY CONTRACT SPECIALIST: TBD Brian Setzer President and Chief Operating Officer Two Vantage Way Nashville, TN Phone: Fax: John Kimball Medicare Systems/EDI Phone: Fax: Linda Martin, Compliance Officer Phone: Fax: Melissa Lamb Program Manager Two Vantage Way Nashville, TN Phone: Fax: Mike Logan Chief Financial Officer Phone: Fax: Robert Madgett, Contract Admin Phone: Fax: LEGACY SUBS: Overland Solutions Inc. (OSI), Broadpath, Jacobson Solutions, Fsi, Inc. HHSM M0006Z, DME MAC Jurisdiction C PARENT COMPANY: CIGNA Corporation 25
26 LEGACY CONTRACTOR National Government Services, Inc (NGS) Fiscal Intermediary, Contract HCFA RHHI (CA and WI) National FQHC FI PROVIDER SERVICE AREA: Indiana, Michigan, Ohio, Kentucky, Virginia, West Virginia, Wisconsin, Illinois LEGACY CONTRACTOR MANAGER: Marilyn Bryan, LEGACY CONTRACTING OFFICER: Kathy Markman, LEGACY CONTRACT SPECIALIST: TBD Sandra Miller President and Chief Operating Officer 8115 Knue Road Indianapolis, IN Phone: Fax: Robert Hartnett Director, Mainframe Systems/EDI Phone: Fax: Wendy Perkins, Chief Compliance Officer Phone: Fax: Jim Elmore Program Director, Title XVIII 8115 Knue Road Indianapolis, IN Phone: Fax: Todd Reiger Chief Financial Officer Phone: Fax: Stacie Amburn, Contract Admin Phone: Fax: LEGACY SUBS: None HHSM M0004Z, AB MAC Jurisdiction 13 HHSM M0002Z, DME MAC Jurisdiction B HCFA , Legacy Part B for IN, KY XVIII CA RHHI & WI RHHI (multiple states) XVIII- Federal Qualified Health Centers Next Generation Desktop (NGD) PARENT COMPANY: Wellpoint 26
27 LEGACY CONTRACTOR National Government Services, Inc (NGS) Carrier, Contract HCFA PROVIDER SERVICE AREA: Indiana, Kentucky LEGACY CONTRACTOR MANAGER: Marilyn Bryan, LEGACY CONTRACTING OFFICER: Kathy Markman, LEGACY CONTRACT SPECIALIST: TBD Sandra Miller President and Chief Operating Officer 8115 Knue Road Indianapolis, IN Phone: Fax: Robert Hartnett Director, Mainframe Systems/EDI Phone: Fax: Wendy Perkins, Chief Compliance Officer Phone: Fax: Jim Elmore Program Director, Title XVIII 8115 Knue Road Indianapolis, IN Phone: Fax: Todd Reiger Chief Financial Officer Phone: Fax: Stacie Amburn, Contract Admin Phone: Fax: LEGACY SUBS: None HHSM M0004Z, AB MAC Jurisdiction 13 HHSM M0002Z, DME MAC Jurisdiction B XVIII CA RHHI & WI RHHI (multiple states) HCFA , Legacy Part A for IN, MI, OH, KY, VA, WV, WI, IL XVIII- Federal Qualified Health Centers Next Generation Desktop (NGD) PARENT COMPANY: Wellpoint 27
28 LEGACY CONTRACTOR Noridian Administrative Services, LLC (NAS) Fiscal Intermediary, Contract HCFA PROVIDER SERVICE AREA: Alaska, Washington, Oregon, Idaho, Minnesota LEGACY CONTRACTOR MANAGER: James Underhill, LEGACY CONTRACTING OFFICER: Kathy Markman, LEGACY CONTRACT SPECIALIST: TBD Michael Hamerlik President and Chief Executive Officer th Street South, Suite 1 Fargo, ND Phone: Denise Christianson Part A/B Claims Processing Phone: Drew Wrigley, Compliance Officer Phone: Kaylin Frappier, Vice President Program Manager th Street South, Suite 1 Fargo, ND Phone: Martha Rust Chief Financial Officer Phone: Karla Thormodson, Contract Admin Phone: LEGACY SUBS: None CMS , Legacy Part A for AK, WA HHSM M0004Z, DME MAC Jurisdiction D HHSM M0007Z, PDAC HHSM M0005Z, A/B MAC Jurisdiction 3 HCFA , Legacy Part B for AK, WA, OR PARENT COMPANY: Noridian Mutual Insurance Company 28
29 LEGACY CONTRACTOR Noridian Administrative Services, LLC (NAS) Carrier, Contract HCFA PROVIDER SERVICE AREA: Alaska, Washington, Oregon LEGACY CONTRACTOR MANAGER: James Underhill, LEGACY CONTRACTING OFFICER: Kathy Markman, LEGACY CONTRACT SPECIALIST: TBD Michael Hamerlik President and Chief Executive Officer th Street South, Suite 1 Fargo, ND Phone: Denise Christianson Part A/B Claims Processing Phone: Drew Wrigley, Compliance Officer Phone: Kaylin Frappier, Vice President Program Manager th Street South, Suite 1 Fargo, ND Phone: Martha Rust Chief Financial Officer Phone: Karla Thormodson, Contract Admin Phone: LEGACY SUBS: None CMS , Legacy Part A for AK, WA HHSM M0004Z, DME MAC Jurisdiction D HHSM M0007Z, PDAC HHSM M0005Z, A/B MAC Jurisdiction 3 HCFA , Legacy Part A for ID, MN, OR PARENT COMPANY: Noridian Mutual Insurance Company 29
30 LEGACY CONTRACTOR Palmetto GBA, LLC Fiscal Intermediary, Contract HCFA PROVIDER SERVICE AREA: North Carolina, South Carolina LEGACY CONTRACTOR MANAGER: Sandra Brown, LEGACY CONTRACTING OFFICER: Kathy Markman, LEGACY CONTRACT SPECIALIST: TBD Bruce Hughes President & Chief Operating Officer 17 Technology Circle Mail Code: AG-A03 Columbia, SC Phone: Fax: Sheri Thompson, Asst Vice President J11 Program Manager 17 Technology Circle Columbia, SC Phone: Fax: Joe Johnson Asst Vice President Systems/EDI Phone: Fax: Ann Archibald, Compliance Officer Phone: Fax: Neal Burkhead, Vice President J11 Program Manager 17 Technology Circle Columbia, SC Phone: Fax: Dickie Butler CIO, Medicare Systems/EDI Phone: Fax: Joe Wright Chief Financial Officer Phone: Fax: Larry Leslie, Contract Admin. Phone: Fax: LEGACY SUBS: Heffler, Radetich, and Associates, LLP HHSM M0002Z, A/B MAC Jurisdiction 1 HHSM C, Competitive Bidding Implementation Contractor HHSM C, National Supplier Clearinghouse (NSC) HHSM M0009Z, Medical Home Demonstration 30
31 HHSM C, Single Testing Contractor OORRB005, Railroad Retirement Board, Part B HCFA , Part B for OH, SC, WV PARENT COMPANY: BlueCross BlueShield of South Carolina 31
32 LEGACY CONTRACTOR Palmetto GBA, LLC Carrier, Contract HCFA PROVIDER SERVICE AREA: Ohio, South Carolina, West Virginia LEGACY CONTRACTOR MANAGER: Sandra Brown, LEGACY CONTRACTING OFFICER: Kathy Markman, LEGACY CONTRACT SPECIALIST: TBD Bruce Hughes President & Chief Operating Officer 17 Technology Circle Mail Code: AG-A03 Columbia, SC Phone: Fax: Sheri Thompson, Asst Vice President J11 Program Manager 17 Technology Circle Columbia, SC Phone: Fax: Joe Johnson Asst Vice President Systems/EDI Phone: Fax: Ann Archibald, Compliance Officer Phone: Fax: Neal Burkhead, Vice President J11 Program Manager 17 Technology Circle Columbia, SC Phone: Fax: Dickie Butler CIO, Medicare Systems/EDI Phone: Fax: Joe Wright Chief Financial Officer Phone: Fax: Larry Leslie, Contract Admin. Phone: Fax: LEGACY SUBS: Heffler, Radetich, and Associates, LLP HCFA , Part A and RHHI (SC, NC and RHHI Jurisdiction C) HHSM C, Competitive Bidding Implementation Contractor HHSM C, National Supplier Clearinghouse (NSC) HHSM M0009Z, Medical Home Demonstration 32
33 HHSM C, Single Testing Contractor OORRB005, Railroad Retirement Board, Part B HHSM M0002Z, AB MAC Jurisdiction 1 PARENT COMPANY: BlueCross BlueShield of South Carolina 33
34 LEGACY CONTRACTOR Pinnacle Business Solutions, Inc, Fiscal Intermediary, Contract HCFA PROVIDER SERVICE AREA: Arkansas, Louisiana, Mississippi LEGACY CONTRACTOR MANAGER: Alan Conroy, LEGACY CONTRACTING OFFICER: Kathy Markman, LEGACY CONTRACT SPECIALIST: TBD Regina Favors President and Chief Operating Officer 515 West Pershing Blvd North Little Rock, AR Phone: Fax: David Bailey EDI Operations Manager Phone: Fax: Dan Bloodworth Senior VP and Chief Financial Officer Phone: Fax: Charlie Clem Executive VP and CIO for Systems Phone: Fax: Charlene Kane Chief Medicare Compliance Officer Phone: Fax: HCFA , Legacy Part B for AR, LA PARENT COMPANY: Arkansas Blue Cross Blue Shield 34
35 LEGACY CONTRACTOR Pinnacle Business Solutions, Inc, Carrier, Contract HCFA PROVIDER SERVICE AREA: Arkansas, Louisiana LEGACY CONTRACTOR MANAGER: Alan Conroy, LEGACY CONTRACTING OFFICER: Kathy Markman, LEGACY CONTRACT SPECIALIST: TBD Regina Favors President and Chief Operating Officer 515 West Pershing Blvd North Little Rock, AR Phone: Fax: David Bailey EDI Operations Manager Phone: Fax: Dan Bloodworth Senior VP and Chief Financial Officer Phone: Fax: Charlie Clem Executive VP and CIO for Systems Phone: Fax: Charlene Kane Chief Medicare Compliance Officer Phone: Fax: HCFA , Legacy Part A for AR, LA, MS PARENT COMPANY: Arkansas Blue Cross Blue Shield 35
36 LEGACY CONTRACTOR Trailblazer Health Enterprises, LLC (THE) Carrier, Contract HCFA PROVIDER SERVICE AREA: Virginia LEGACY CONTRACTOR MANAGER: Terry Bird, LEGACY CONTRACTING OFFICER: Kathy Markman, LEGACY CONTRACT SPECIALIST: TBD Mr. Gil Glover President and Chief Operating Officer TrailBlazer Health Enterprises, LLC 8330 LBJ Freeway, Executive Center 3 Dallas, TX Phone: Fax: gil.glover@trailblazerhealth.com Renee Cotton, Vice President Program Management Operations Phone: Fax: Ken Kerns, Vice President Program Management Operations Phone: Fax: Scott Manning, Vice President Program Manager 8330 LBJ Freeway, Executive Center III Dallas, TX Phone: Fax: Ernest Lopez Chief Financial Officer Phone: Fax: Mike Smith Chief Information Officer Phone: Fax: HHSM C, Section 1011 HHSM M0001Z, AB MAC Jurisdiction 4 PARENT COMPANY: Blue Cross and Blue Shield of South Carolina 36
37 LEGACY CONTRACTOR Wisconsin Physician Services (WPS) Fiscal Intermediary, Contract HCFA PROVIDER SERVICE AREA: Nationwide LEGACY CONTRACTOR MANAGER: Joni Jones, LEGACY CONTRACTING OFFICER: Kathy Markman, LEGACY CONTRACT SPECIALIST: TBD cc: Ms. Jared Adair Sr. Vice President, Medicare Operations Wisconsin Physicians Service (WPS) P.O. Box 8190 Madison, WI Phone: Fax: Ms. Janet Kyle Vice President, Medicare Program Management Wisconsin Physicians Service (WPS) 3333 Farnam St, Ste 700 P.O. Box 1604 Omaha, NE Phone: William Bathke Executive Vice President Chief Operating Officer 1717 W. Broadway P.O. Box 8190 Madison, WI Phone: Fax: Gary Lapotka Director, Medicare Compliance Phone: Fax: Sheila Bechmann, Vice President Medicare Systems and Technology Phone: Fax: John Degler, Vice President Corporate EDI Phone: Fax: LEGACY SUB-CONTRACTS: Mutual of Omaha; EDS HHSM M0002Z, A/B MAC Jurisdiction 5 HCFA , Legacy Part B Carrier for IL, MI, WI, MN PARENT COMPANY: None 37
38 LEGACY CONTRACTOR - Wisconsin Physician Service (WPS) Carrier, Contract HCFA PART B PROVIDER SERVICE AREA: Illinois, Michigan, Wisconsin, Minnesota LEGACY CONTRACTOR MANAGER: Joni Jones, LEGACY CONTRACTING OFFICER: Kathy Markman, LEGACY CONTRACT SPECIALIST: TBD cc: Ms. Jared Adair Sr. Vice President, Medicare Operations Wisconsin Physicians Service (WPS) P.O. Box 8190 Madison, WI Phone: Fax: Jared.Adair@wpsic.com Ms. Janet Kyle Vice President, Medicare Program Management Wisconsin Physicians Service (WPS) 3333 Farnam St, Ste 700 P.O. Box 1604 Omaha, NE Phone: Janet.Kyle@wpsic.com William Bathke Executive Vice President Chief Operating Officer 1717 W. Broadway P.O. Box 8190 Madison, WI Phone: Fax: Gary Lapotka Director, Medicare Compliance Phone: Fax: Sheila Bechmann, Vice President Medicare Systems and Technology Phone: Fax: Sheila.Bechmann@wpsic.com John Degler, Vice President Corporate EDI Phone: Fax: LEGACY SUB-CONTRACTS: Mutual of Omaha; EDS HHSM M0002Z, A/B MAC Jurisdiction 5 HCFA , Legacy Fiscal Intermediary (Most States) PARENT COMPANY: None 38
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