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
- $952,814,221
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 95% 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 |
|---|---|---|
| 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 | |
| Supplemental Agreement for work within scope | $181,673 |
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About this award
The Centers for Medicare and Medicaid Services awarded a $1.174 billion cost-plus-award-fee definitive contract to Novitas Solutions, Inc. for Jurisdiction H (Part A and B) Medicare Administrative Contractor services on June 1, 2019, with an ultimate completion date of February 28, 2027.
Jurisdiction H encompasses Arkansas, Colorado, Louisiana, Mississippi, New Mexico, Oklahoma, and Texas. The contract provides health insurance benefit administration services, including Medicare claims processing and payment services, in support of the Medicare fee-for-service program. Place of performance is Mechanicsburg, Pennsylvania.
Under Service Contract Inventory reporting, Novitas invoiced $121.2 million in FY2025 across 465 FTEs and 968,215 contractor hours, reflecting a derived government-paid hourly rate of $125.15 per hour. The labor footprint has contracted modestly from 494 FTEs in FY2023 to 465 FTEs in FY2025, while blended hourly rates have trended upward from $98.88 per hour in FY2021 to $134.69 per hour in FY2024 before declining slightly to $125.15 per hour in FY2025. Subcontractors performed approximately 4 percent of contractor hours in FY2025; named subcontractors include Pearl Interactive Network LLC (minority-owned, HUBZone, Black American-owned) for customer contact center services; Servicesource Inc. (AbilityOne nonprofit) for mailroom support; and Figliozzi & Company and Heffler, Radetich & Saitta (woman-owned and general accounting firms respectively) for Part A cost report audits, alongside clinical review, provider enrollment, and OCR/file transmission support providers.
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 June 1, 2019.
How much is contract 75FCMC19C0018 worth?
The government has obligated $952,814,221 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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