Medicare Administrative Contractor (MAC) Jurisdiction H (JH) - Synopsis/Draft RFP / Presolicitation
Closed Solicitation Posted
This opportunity was awarded. See the award notice from .
- Solicitation number
- 75FCMC26R0001
- Agency
-
Centers for Medicare and Medicaid Services
Department of Health and Human Services
- Responses due
- Set-aside
- No set-aside
Opportunity facts
- NAICS code
- 524114 Direct Health and Medical Insurance Carriers
- Place of performance
- Baltimore, Maryland, United States
Notice details come from SAM.gov. Updated .
About this opportunity
The Centers for Medicare and Medicaid Services (CMS) is seeking a Medicare Administrative Contractor (MAC) to provide Part A/Part B health insurance benefit administration services for Jurisdiction H, which encompasses Arkansas, Colorado, Louisiana, Mississippi, New Mexico, Oklahoma, and Texas. The contractor will be responsible for Medicare claims processing and payment services in support of the traditional Medicare fee-for-service program. This Cost-Plus-Award-Fee (CPAF) contract includes implementation services, program management, Medicare Integrity Program operations, and Recovery Audit Contractor services. The solicitation (75FCMC26R0001) requires proposals to be submitted by 11:00 AM EST on September 8, 2025, with a 60-calendar day acceptance period. Evaluation factors include technical capabilities, past performance, and small business utilization, with offerors required to aim for 23% of total contract value to go to small businesses. The contract structure includes one base year and six option years, with a minimum award fee of 4 percent.
This procurement does not utilize any set-aside designations and is classified under NAICS code 524114 (Direct Health and Medical Insurance Carriers) with a small business size standard of $47 million. The contract will be administered from Baltimore, Maryland, though specific incumbent contractor information is not disclosed in the available documentation. While the exact contract value has not been specified, it will be determined at award and involves processing substantial Medicare workloads across the seven-state jurisdiction. The timeline spans multiple years with the base period followed by six potential option years, indicating a long-term commitment to Medicare administration services. The solicitation emphasizes complex beneficiary inquiries, specialized projects including Veterans Affairs Medicare Equivalent Remittance Advice, and Indian Health Services claims processing as key service components.
Notice text
The purpose of this contract is to obtain a Part A/Part B (A/B) Medicare Administrative Contractor (hereinafter referred to as “the contractor” or “MAC” or “A/B MAC”) to provide specified health insurance benefit administration services, including Medicare claims processing and payment services, in support of the “traditional” Medicare program (also known as the Medicare fee-for-service or FFS, program) for Jurisdiction H. Jurisdiction H includes the states of Arkansas, Colorado, Louisiana, Mississippi, New Mexico, Oklahoma, and Texas.
Files
| File | Type | Posted |
|---|---|---|
| Solicitation - 75FCMC26R0001 Final.pdf | ||
| JH RFP Questions and Responses (JH RFP 75FCMC26R0001) Final 008082025.xlsx | XLSX spreadsheet | |
| JH RFP Final Backpages Question Updates 08082025.docx | DOCX document | |
| Solicitation - 75FCMC26R0001 Final.pdf | ||
| JH Final Attachments.zip | ZIP file |
Notice history
| Notice | Type | Posted |
|---|---|---|
| Medicare Administrative Contractor (MAC) Jurisdiction H (JH) - Synopsis/Draft RFP / Presolicitation | Award Notice | |
| This notice | Solicitation | |
| Medicare Administrative Contractor (MAC) Jurisdiction H (JH) - Synopsis/Draft RFP / Presolicitation | Pre-Solicitation |
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