Medicare Administrative Contractor (MAC) Jurisdiction H (JH) - Synopsis/Draft RFP / Presolicitation
Title:  

Medicare Administrative Contractor (MAC) Jurisdiction H (JH) - Synopsis/Draft RFP / Presolicitation

Agency:  

U.S. Department Of Health And Human Services

State:  

Maryland

NAICS Code:  

524114

Industry:  

Healthcare and Medical Services

Solicitation Type:  

Request for Proposal

Solicitation ID:  

75FCMC26R0001

Open Date:  

7/1/2025

Questions Due Date:  

7/15/2025

Close Date:  

9/2/2025

Projected Award Date:  

7/1/2025

Project Duration:  

7 years

Last Updated:  

7/9/2025

Description:
The Centers for Medicare & Medicaid Services (CMS) is seeking a Medicare Administrative Contractor (MAC) to provide health insurance benefit administration services, including Medicare claims processing and payment services, for Jurisdiction H, which includes the states of Arkansas, Colorado, Louisiana, Mississippi, New Mexico, Oklahoma, and Texas. The contract will have a base year plus six one-year options, and the contractor will perform various functions, including claims-related activities and establishing relationships with providers of Medicare services. The contractor will be required to submit deliverables, including reports and data, and will be evaluated based on their technical and business proposals. • The contract will be a Cost Reimbursement type contract with a Cost-Plus-Award-Fee (CPAF) pricing arrangement. • The contractor will be required to perform various tasks, including program management, Medicare integrity program, and support of recovery audit program operations. • The contractor will be evaluated based on their technical and business proposals, including their staffing plan, operations, targeted and demonstrated experience, past performance, small business utilization, and ability to address Section 508 accessibility standards. • The contract will have a base year plus six one-year options, with a total contract period of 7 years. • The contractor will be required to submit deliverables, including reports and data, and will be evaluated based on their performance and compliance with the contract requirements.
Attached Files:

Please visit the bid source via the “Link to Bid Source” button below for documentation.

Contact Information:

Edward Drannbauer

edward.drannbauer@cms.hhs.gov

Budget Estimate (AI):

$200,000,000 – $500,000,000

The estimated cost of this contract is not explicitly stated, but based on the scope of work and the fact that it is a Cost Reimbursement type contract with a Cost-Plus-Award-Fee (CPAF) pricing arrangement, it is likely to be a large contract with a value in the hundreds of millions of dollars. The contract has a base year plus six one-year options, and the contractor will be required to perform various tasks, including program management, Medicare integrity program, and support of recovery audit program operations. The contractor will also be required to submit deliverables, including reports and data, and will be evaluated based on their performance and compliance with the contract requirements. The budget estimation is influenced by factors such as the scope of work, the pricing arrangement, and the contract period. The contractor's performance and compliance with the contract requirements will also impact the budget. A reasonable estimate for the low end of the budget range could be $200 million, and for the high end, $500 million.

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