The Centers for Medicare and Medicaid Services (CMS), a civilian agency within the U.S. Department of Health and Human Services, has awarded multiple delivery orders to C2C Innovative Solutions, Inc. (C2C), a subsidiary of TMF Health Quality Institute, under the Qualified Independent Contractor (QIC) Program. C2C, as a QIC, provides independent review services for Medicare appeals. The various delivery orders, with a total ceiling value exceeding $1 billion, cover QIC services for Medicare Parts A, B, D, and Durable Medical Equipment appeals. No set-aside designations were used for these awards. C2C and its parent organization TMF Health Quality Institute, a non-profit, have a long history of providing a range of healthcare quality improvement services to CMS under both prime contracts and subcontracts.
These QIC services are a critical component of the Medicare appeals process, allowing for independent review of disputed claims. Through the Qualified Independent Contractor Program's multiple-award, indefinite-delivery/indefinite-quantity (IDIQ) contract structure, CMS can efficiently procure these specialized services as needed to support the Medicare program. The awards to C2C span from 2005 to the present, demonstrating CMS's continued reliance on C2C's expertise in this area.
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