The purpose of this contract is to obtain services for the jurisdiction H (part a and B) medicare administrative contractor (MAC). The contractor will provide specified health insurance benefit…
Active Definitive Contract Awarded Last action
- Contract number
- 75FCMC19C0018
- Awardee
-
Novitas Solutions, Inc. UEI PLHWY41UW5V3 Part of Guidewell Mutual Holding Corporation
- Awarding agency
-
Centers for Medicare and Medicaid Services
Department of Health and Human Services
- Obligated
- $952,884,221
Award facts
- Opportunity
-
- 75FCMC18R0005 Solicitation number
- Part A/B Medicare Administrative Contractor, Jurisdiction H Award Notice · Posted Feb 13, 2018
- Contract value 81% obligated
-
- $1,135,256,392.92 Current, with exercised options
- $1,174,140,884.92 Potential, with all options
- Completion date 96% complete
-
- Current, with exercised options
- Potential, with all options
- NAICS code
- 524114 Direct Health and Medical Insurance Carriers
- Set-aside
- No set-aside
- Competition
- Full and Open Competition · 4 offers Negotiated Proposal / Quote
- Pricing
- Cost Plus Award Fee
- Place of performance
- Mechanicsburg, PA, USA
- Legislative mandates
-
- Service Contract Act FAR subpart 22.10
- Service Contract Inventory FAR subpart 4.17
Award details come from SAM.gov/FPDS.
Transactions
| Action | Obligated | Date |
|---|---|---|
| Funding Only Action | $70,000 | |
| Supplemental Agreement for work within scope | $84,782 | |
| Exercise an Option | $31,648,957 | |
| Supplemental Agreement for work within scope | $31,110,043 | |
| Funding Only Action | $186,302 | |
| Funding Only Action | $126,568 | |
| Definitize Change Order | -$95,814 | |
| Definitize Change Order | $1,622,442 | |
| Change Order | $527,975 | |
| Supplemental Agreement for work within scope | $1,975,642 | |
| Supplemental Agreement for work within scope | -$7,832,919 | |
| Other Administrative Action | -$4,655,934 | |
| Exercise an Option | $125,512,932 | |
| Supplemental Agreement for work within scope | -$4,033,590 | |
| Supplemental Agreement for work within scope | $8,100,000 | |
| Supplemental Agreement for work within scope | $142,000 | |
| Definitize Change Order | $1,169,383 | |
| Supplemental Agreement for work within scope | $1,132,089 | |
| Change Order | $173,191 | |
| Other Administrative Action | $0 | |
| Other Administrative Action | $0 | |
| Other Administrative Action | $0 | |
| Supplemental Agreement for work within scope | $15,169,310 | |
| Supplemental Agreement for work within scope | -$67,612 | |
| Supplemental Agreement for work within scope | $397,213 | |
| Supplemental Agreement for work within scope | $67,500,000 | |
| Exercise an Option | $48,011,937 | |
| Supplemental Agreement for work within scope | $1,147,194 | |
| Supplemental Agreement for work within scope | $12,631,604 | |
| Supplemental Agreement for work within scope | $0 | |
| Supplemental Agreement for work within scope | $13,000,000 | |
| Funding Only Action | $7,500,000 | |
| Supplemental Agreement for work within scope | -$5,356,554 | |
| Supplemental Agreement for work within scope | $11,053 | |
| Supplemental Agreement for work within scope | $0 | |
| Change Order | $27,594,720 | |
| Supplemental Agreement for work within scope | $727,427 | |
| Supplemental Agreement for work within scope | $44,686,000 | |
| Supplemental Agreement for work within scope | -$7,021,446 | |
| Exercise an Option | $45,733,144 | |
| Supplemental Agreement for work within scope | $4,330,000 | |
| Other Administrative Action | $0 | |
| Supplemental Agreement for work within scope | $2,000,000 | |
| Supplemental Agreement for work within scope | -$2,626,705 | |
| Supplemental Agreement for work within scope | $0 | |
| Supplemental Agreement for work within scope | $0 | |
| Other Administrative Action | $0 | |
| Supplemental Agreement for work within scope | $1,559,964 | |
| Supplemental Agreement for work within scope | $140,000 | |
| Supplemental Agreement for work within scope | -$12,348,726 |
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About this award
The Centers for Medicare and Medicaid Services awarded a definitive contract to Novitas Solutions, Inc. on May 29, 2019, for Jurisdiction H Part A and Part B Medicare Administrative Contractor services, with a $1.17 billion ceiling, under no set-aside. The cost-plus-award-fee contract covers health insurance benefit administration, including Medicare claims processing and payment, in support of the Medicare fee-for-service program in Arkansas, Colorado, Louisiana, Mississippi, New Mexico, Oklahoma, and Texas. Ultimate completion is February 28, 2027, and place of performance is Mechanicsburg, Pennsylvania. Novitas Solutions, Inc. is a for-profit subsidiary of Guidewell Mutual Holding Corporation.
Subcontract records under the award include Pearl Interactive Network LLC for customer contact center staffing and Servicesource Inc. for mailroom support, with additional subcontractors covering clinical review, provider enrollment processing, and cost report audits.
Service Contract Inventory data shows $121.2 million invoiced in FY2025 across 465 FTEs and 968,215 contractor hours, down from $136.1 million and 486 FTEs in FY2024. Invoicing rose from $112 million in FY2020 and $113 million in FY2021 (civilian-only inventories). The derived government-paid rate climbed from $98.88 per hour in FY2021 to $134.69 per hour in FY2024, then eased to $125.15 per hour in FY2025. That rate is a blended prime-and-subcontractor figure in years with subcontractors, and comparisons across the FY2021 coverage cutover are approximate. In FY2025, four subcontractors performed 4% of contractor hours, and the awardee reported in a prime role.
Description
The purpose of this contract is to obtain services for the jurisdiction H (part a and B) medicare administrative contractor (MAC). The contractor will provide specified health insurance benefit administration services, including medicare claims processing and payment services, in support of the medicare program (also known as the medicare fee-for-service, or FFS, program) for jurisdiction H. Jurisdiction H includes the following states: arkansas, colorado, louisiana, mississippi, new mexico, oklahoma, and texas.
Subawards
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Quick answers
Who was awarded contract 75FCMC19C0018?
75FCMC19C0018 was awarded to Novitas Solutions, Inc. by Centers for Medicare and Medicaid Services (Department of Health and Human Services) on May 29, 2019.
How much is contract 75FCMC19C0018 worth?
The government has obligated $952,884,221 on 75FCMC19C0018. Its current value, with exercised options, is $1,135,256,393. Its potential value, with all options, is $1,174,140,885.
Was contract 75FCMC19C0018 competed?
The extent of competition for 75FCMC19C0018 was full and open competition. The government received 4 offers.
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