Medicare Administrative Contractor (MAC) Services - Medicare Parts A & B (Medicare Fee-for-Service) - Jurisdiction G (JG)

The Centers for Medicare & Medicaid Services (CMS) is conducting market research for Medicare Administrative Contractor (MAC) Services for Medicare Parts A & B in Jurisdiction G, which encompasses Illinois, Iowa, Kansas, Minnesota, Missouri, Nebraska, and Wisconsin. This pre-solicitation seeks contractors capable of providing comprehensive Medicare fee-for-service health insurance benefit administration services, including claims processing, provider enrollment, medical review, appeals management, financial oversight, customer service, and fraud detection. The contractor will be responsible for implementing Medicare policy, managing provider relationships, conducting medical reviews, processing claims accurately, and supporting Medicare program integrity while maintaining required infrastructure and data security standards. CMS is specifically seeking to identify the availability and capability of potential small businesses, including 8(a), service-disabled veteran-owned, HUBZone, small disadvantaged, veteran-owned, and women-owned small businesses to meet these extensive performance requirements. Responses to this sources sought notice are due electronically by 11:00 AM EST on September 12, 2025, with submissions limited to a maximum of 10 pages.

This opportunity does not include any set-aside designation and represents a market research exercise only, with no contract to be awarded directly from this notice. The scope of work involves processing approximately 140 million Medicare A/B claims annually, handling 1.9 million claims re-openings, managing 250,000 claims redeterminations, and responding to 75 million provider inquiries. Potential contractors must demonstrate proficiency in utilizing various CMS systems and managing the complex administrative requirements associated with Medicare fee-for-service operations. The document does not identify current incumbents or specify award values, focusing instead on gathering market intelligence about contractor capabilities. The extensive operational requirements suggest this will be a large-scale, multi-year contract given the volume of claims processing and administrative services required across the seven-state jurisdiction.