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U.S. Department Of Health And Human Services·United States of America

Request for Information - CMS' Qualified Independent Contractor (QIC) Program

Closes 11/5/2026$30MRequest for Information
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Description

The Centers for Medicare & Medicaid Services (CMS) issued an RFI to gather market intelligence on vendors capable of serving as Qualified Independent Contractors (QICs) for Medicare claim reconsiderations across multiple lines of business (Original Medicare Parts A, B, DME, Medicare Advantage, Part D, and administrative support). The agency seeks detailed information on firms’ experience, technical capability, security/compliance posture, and ability to operate conflict‑free under CMS’s QIC framework. Responses are due by 11 a.m. ET on 5 Nov 2026; no contract award is guaranteed and no funding is disclosed. • Scope covers eight QIC lines of business (OM Parts A/B/DME, Part C, Part D, Administrative QIC). • Vendors must demonstrate capability in claims processing, appeals, data handling, secure IT infrastructure, and conflict‑of‑interest compliance. • The solicitation is market research only (RFI); there is no monetary award, and responses become government property.

Attached files

Contact

Mohammed Islam(Primary)

[email protected]

Key dates

Opened
10/15/2026
Closes
11/5/2026

Last updated

Details

Type
Request for Information
Industry
Consulting Services
NAICS
541611
Solicitation №
RFICMSQIC2026

Budget estimate

$0 – $30,000,000

No monetary award is disclosed because the RFI is purely for market research. If CMS later awards QIC IDIQ contracts, typical per‑claim unit‑price contracts for Medicare adjudication range from $5 to $25 per claim, potentially reaching $20‑$30 million annually for a large‑scale national QIC. Thus the eventual budget could be in the low‑to‑mid tens of millions, but the RFI itself carries no direct payment.

AI estimate from the solicitation

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