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Article Details New Opportunities and Risks for Medicare Contractors Provided by Medicare Prescription Drug Bill

John S. Pachter and Jonathan D. Shaffer, partners in the law firm of Smith Pachter McWhorter PLC, focus on new business opportunities and risks for health care companies, such as carriers and fiscal intermediaries, and information technology companies in an article entitled MEDICARE CONTRACTING REFORM: NEW OPPORTUNITIES, NEW RISKS. The article discusses the following:

The Medicare Prescription Drug, Improvement, and Modernization Act not only provides a prescription drug benefit for senior citizens but also dramatically changes the way contracts will be awarded by the Centers for Medicare and Medicaid Services to payors such as carriers and fiscal intermediaries. These changes will provide new business opportunities for prospective contractors and teaming possibilities for existing payors interested in retaining a market presence as Medicare Administrative Contractors for CMS.

Later this year, contracts will be awarded for the first time by CMS to Medicare Administrative Contractors based on full and open competition. These new contracts will be subject to the Federal Acquisition Regulation and the Cost Accounting Standards.

The FCR analysis describes the contracting changes mandated by the Medicare Modernization Act, the solicitation process contemplated by CMS, and some of the compliance issues that will face Medicare Administrative Contractors.

The article, available here, was co-authored by John S. Pachter and Jonathan D. Shaffer of Smith Pachter McWhorter PLC, Alexander J. Brittin of the Brittin Law Group, P.L.L.C., and William Keating and Frank Beatty of Navigant Consulting. For more information, contact John Pachter at or Jonathan Shaffer at