CIGNA To Take Over Ohio Medicare, June 18

CIGNA Government Services has announced that it will assume Medicare Part B operations in Ohio effective June 18 for physicians and Part A claims for hospitals, effective October 17.

This means, regardless of the date of service, all Ohio Medicare claims processing, customer service and payments will be handled by CIGNA according to those dates. Ohio's current contractor, Palmetto Medicare GBA, who lost the Jurisdiction 15 Medicare Administrative Contractor (MAC) bid for Kentucky and Ohio, will transfer all pending and in-process operations to CIGNA at that time, including but not limited to claims, appeals, and enrollment applications.

CIGNA will publish detailed information on upcoming changes that physicians can expect relative to Electronic Data Interchange (EDI) early onboarding activities, electronic funds transfer (EFT) authorization agreements, Local Coverage Determinations (LCDs), and ongoing provider outreach and education activities throughout the transitional period.  They will mail "welcome letters" to the Medicare provider community in each state, and will also post these documents on their website: http://www.cignagovernmentservices.com/j15/index.html.  

The Ohio Osteopathic Association met, January 14th, with CIGNA Medical Director Gary Oakes, MD, to discuss the transition and express concerns that the new Medicare contractor will not have an office in Ohio.  According to Dr. Oakes, most issues are handled by phone or by e-mail so the company does not plan to have anyone on the ground in Ohio.

Ohio physicians who are currently serving on Palmetto's Carrier Advisory Committee (CAC) will initially continue to serve in the same position with CIGNA to develop local policy determinations and address other specialty-specific issues. The Physician Outreach and Education committee (POE), which includes staff from the OOA and other physician organizations, will also be continued, but will only meet twice a year instead of quarterly.