QIC Jurisdictions

320.7 - QIC Jurisdictions (Rev. 4380, Issued: 08-30-19, Effective: 07-08-19, Implementation: 10- 01-19) A. Part A QIC Jurisdictions The Part A QIC jurisdictions are as follows: Jurisdiction Normal States Exceptions Part A East QIC jurisdiction Alabama, Arkansas, Colorado, Connecticut, Delaware, Florida, Georgia, Louisiana, Maine, Maryland, Mississippi, Massachusetts, New Hampshire, New Mexico, New Jersey, New York, Texas, Oklahoma, North Carolina, Pennsylvania, Puerto Rico, Rhode Island, South Carolina, Tennessee, Vermont, Virgin Islands, Virginia, West Virginia, and Washington DC and Mutual of Omaha claims where the service was rendered in one of the above listed States. Chain Providers (including ESRD) – the State where the MAC processed the claim. For providers who previously submitted claims to Mutual of Omaha (currently processed by WPS), the jurisdiction continues to be the State where the service was rendered. Indian Health Services claims Nationwide Foreign claims- Eastern Mexico, Canadian Provinces of New Brunswick, Newfoundland, Nova Scotia, Quebec, and Prince Edward Island Rural Health Clinic claims Nationwide Part A West QIC jurisdiction Alaska, American Samoa, Arizona, California, Guam, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Michigan, Minnesota, Missouri, Montana, Nebraska, Nevada, North Dakota, Northern Mariana Islands, Ohio, Oregon, South Dakota, Utah, Washington, Wisconsin and Wyoming and Mutual of Omaha claims where the service was rendered in one of the above listed States. Chain Providers (including ESRD) - the State where the MAC processed the claim. For providers who previously submitted claims to Mutual of Omaha (currently processed by WPS), the jurisdiction continues to be the State where the service was rendered. Foreign claims- Western Mexico, Canadian Provinces of Ontario, Saskatchewan, Alberta, Manitoba, British Columbia, Vancouver, and Yukon Territories. B. Part B and DME QIC Jurisdictions There is one DME QIC jurisdiction assigned to process all reconsiderations of DME claims for all states and territories. There are two QIC jurisdictions for Part B claims, a North and a South jurisdiction. Refer to the table below. Jurisdiction Normal States Exceptions Part B South Jurisdiction Alabama, Arkansas, Colorado, Florida, Georgia, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, Puerto Rico, South Carolina, Tennessee, Texas, Virginia, West Virginia, Virgin Islands. Note: Railroad Retirement Board reconsiderations are also included in this workload jurisdiction. Part B North Jurisdiction Alaska, American Samoa, Arizona, California, Connecticut, Delaware, Guam, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New York, North Dakota, Northern Mariana Islands, Ohio, Oregon, Pennsylvania, Rhode Island, South Dakota, Utah, Vermont, Washington, Washington DC, Wisconsin and Wyoming. DME QIC Jurisdiction All states and territories