Medicare Administrative Contractor (MAC) Resources Survey Your CR/PR Program & Your MAC Question Title * 1. Please provide the following information: Program Name: Institution Name: City: State: MAC Jurisdiction (e.g., JE, JF, JH, J5, J6, J8, JN, JJ, JM, JL, JK, J15): Question Title * 2. Who is your Medicare Administrative Contractor (MAC)? NGS CIGNA (CGS) Noridian Novitas Palmetto FCSO WPS CAHABA I don’t know Other: Question Title * 3. Do you know who your state/regional affiliate representative(s) is for your MAC? Yes No If yes, please provide full name(s): Question Title * 4. Do you know how to contact your representative with local policy/reimbursement issues? Yes No If yes, please describe communication process: Question Title * 5. How do you receive information about Cardiac and Pulmonary Rehab issues relative to Medicare policies in your MAC? (choose as many as apply) Directly from the MAC web page & publications From AACVPR From my state/regional affiliate or its website From my business office Do not receive information regarding Cardiopulmonary services relative to my MAC Other: Question Title * 6. What are significant issues for your program, relative to your MAC? (rank 1-most significant, 7 least significant) 1 2 3 4 5 6 7 Co-pay barriers 1 2 3 4 5 6 7 Bundled payment models that are coming in the near future or in 2017 1 2 3 4 5 6 7 Payments 1 2 3 4 5 6 7 Lack of information/communication 1 2 3 4 5 6 7 Denials 1 2 3 4 5 6 7 CMS’ non-allowance of nonphysician practitioners to provide direct physician supervision for CR and PR services 1 2 3 4 5 6 7 Unreasonable/unjustified restriction of services Question Title * 7. Please list additional issues for your program, relative to your MAC, that were not listed above: Question Title * 8. Does your MAC have an LCD (Local Coverage Determination) and/or an Article specific to CR? Yes No I don't know Not Applicable - PR Program Question Title * 9. Does your MAC have an LCD (Local Coverage Determination) and/or an Article specific to PR? Yes No I don't know Not Applicable - CR Program Question Title * 10. Please feel free to provide any additional comments related to your CR/PR program and your MAC: Done