Durable Medical Equipment (DME) Medicare Administrative Contractor (MAC) Jurisdiction B Synopsis/Draft RFP

The Centers for Medicare and Medicaid Services intends to award an indefinite-delivery/indefinite-quantity contract to provide Durable Medical Equipment Medicare Administrative Contractor services for Jurisdiction B, which includes Illinois, Indiana, Kentucky, Michigan, Minnesota, Ohio and Wisconsin. The contractor will be responsible for processing Medicare Fee-for-Service claims and making payments to support the Medicare program, as well as conducting medical reviews, provider outreach and education, and operating call centers to handle beneficiary inquiries. Proposals will be evaluated on the basis of technical approach and past performance, and must be submitted by May 2, 2022 for the base period of one year plus six one-year options.

There is no set-aside designation for this procurement. The primary NAICS code is 524114 with a $41.5 million size standard. The current contractor is CGS Administrators, and the potential value of the award is unspecified but incumbent contract volumes include over 41,000 boxes of records and annual claims workloads. The selected contractor must be prepared to assume full claims processing responsibilities six months after contract award.