Medicare Administrative Contractor (MAC) Jurisdiction 8 (J8) - Synopsis/Draft RFP / Presolicitation

The Centers for Medicare & Medicaid Services (CMS) is seeking a Medicare Administrative Contractor (MAC) to provide specified health insurance benefit administration services, including Medicare claims processing and payment services, in support of the Medicare Program for Jurisdiction 8, which encompasses the states of Indiana and Michigan. The contractor will perform numerous functions to support healthcare services for Medicare beneficiaries, including performing claims-related activities and establishing relationships with providers of Medicare services. The contract is anticipated to include a base year plus eight one-year options. • The contractor will be responsible for performing claims-related activities and establishing relationships with providers of Medicare services. • The contractor will be required to perform the requirements of this contract in accordance with applicable laws, regulations, Medicare manuals, as well as CMS requirements to ensure the financial integrity of the Medicare FFS Program. • The contract is anticipated to include a base year plus eight one-year options. • The NAICS code applicable to this procurement is 524114, Direct Health and Medical Insurance Carriers, with a small business size standard of $47.0 million.