Trailblazer Loses Medicare Contract

By Joni Lovvorn • November 16th, 2011

This report was published by the Texas Medical Association Nov 15, 2011

The Centers for Medicare & Medicaid Services (CMS) says Highmark Medicare Services  will replace TrailBlazer Healthcare Enterprises in paying Medicare Part A and Part B fee-for-service claims in Texas by late July 2012. Highmark also will handle claims in Arkansas, Colorado, Louisiana, Mississippi, New Mexico, and Oklahoma. It now administers claims in Delaware, New Jersey, Pennsylvania, Maryland, and the District of Columbia. 

CMS says the change is part of its plan to reduce the number of Medicare administrator jurisdictions from 15 to 10 by 2016.

TrailBlazer issued a statement saying it is “very disappointed in the outcome of the competitive bidding process” and has asked CMS for “a full debriefing on this award decision, and will determine our next steps and overall course of action based on the information we acquire in that process.” 

TrailBlazer said its contract runs through August 2012 and any transition to Highmark “will include extensive communications with providers and other impacted parties about transition requirements and activities. Throughout such a transition, TrailBlazer will continue to provide cost-effective, efficient administrative services to the Medicare program and superior customer service to health care providers.”

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