ATTACHMENT RECIPIENT LIST

PacificSource

UniCare

California – Anthem Blue Cross

California – Anthem Blue Cross and Blue Shield Federal Employee Program

Colorado – Anthem Blue Cross and Blue Shield

Nevada – Anthem Blue Cross and Blue Shield

California – Anthem BlueCross Medi-Cal

California – Anthem BlueCross Healthy Families

California – ACS Medi-Cal

West Virginia – UniCare Health Plan of West Virginia, Inc.

1. RAC Region 1 (Performant Recovery)

2. RAC Region 2 (Cotiviti)

3. RAC Region 3 (Cotiviti)

4. RAC Region 4 (HMS Federal Solutions)

5. RAC Region 5 (Performant Recovery, DME)

MAC JE (Noridian)

MAC JF (Noridian)

MAC JH (Novitas Solutions)

MAC J5 (WPS)

MAC JM (Palmetto)

MAC JL (Novitas Solutions)

MAC JK (NGS)

MAC JN (First Coast)

MAC JJ (Palmetto)

MAC J15 (CGS)

MAC J6 (NGS)

MAC J8 (WPS)

Comprehensive Error Rate Testing – CERT (AdvanceMed)

Program Error Rate Measurement – PERM (CNI, Cycle 1)

Program Error Rate Measurement – PERM (AdvanceMed)

Supplemental Medical Review Contractor – SMRC (Noridian)

Railroad Retirement Board – RRB (Palmetto)

DME MAC A (Noridian)

DME MAC D (Noridian)

DME MAC B (CGS)

DME MAC C (CGS)

UPIC North-Eastern (Safeguard Services)

UPIC Mid-West (AdvanceMed)

UPIC South-West (Qlarant)

UPIC South-East (Safeguard Services)

UPIC West (Qlarant)

QIC Part A – West (Maximus)

QIC Part A – East (C2C Solutions)

QIC Part B – North (C2C Solutions)

QIC Part B – South (C2C Solutions)

QIC DME (C2C Solutions)