Working with your local Medicare contractor to shape patient care

When hospitals pursue appropriate Medicare coverage by interacting effectively with their local Medicare contractor, they have an opportunity to provide their patients with greater access to care and help their hospital meet important revenue objectives. This is especially true when ensuring Medicare coverage of appropriate cardiovascular services. Local contractors are private entities that administer national Medicare policies regionally and interpret the "gray areas" of coverage. This article will examine the local Medicare network; the way local contractors make Medicare policy; and how hospitals like yours can influence Medicare policy, with the ultimate goal of appropriately improving beneficiaries' access to care.