Part A West Qualified Independent Contractor (QIC)
Awarded Limited / Sole Source Justification Posted
- Solicitation number
- RFP75FCMC26R0011
- Agency
-
Centers for Medicare and Medicaid Services
Department of Health and Human Services
- Set-aside
- No set-aside
Opportunity facts
- Contract number
- HHSM500200400007I-75FCMC26F0021 Federal contract award
- Awardee
- Maximus Federal Services, Inc.
- NAICS code
- Not on record
- PSC
- R499 Support- Professional: Other
- Place of performance
- McLean, Virginia, United States
- Points of contact
Notice details come from SAM.gov. Updated .
About this opportunity
The Centers for Medicare and Medicaid Services (CMS) issued a Justification for an Exception to Fair Opportunity for a sole-source task order awarding Medicare claims adjudication services to Maximus Federal Services, Inc. under an existing IDIQ contract. The task order, valued at $33,195,597.43, covers a three-year performance period from January 1, 2026 through December 31, 2028, and requires the contractor to conduct reconsiderations of initial Medicare claims determinations for Part A and Part B claims across 22 states and territories. The primary justification for the sole-source award is the need for operational continuity to comply with a federal court order (Alexander v. Azar) that mandated implementation of a new temporary retrospective review process for Medicare beneficiaries. CMS emphasized that Maximus Federal Services has demonstrated successful past performance in this QIC role since 2016, making them the logical continuation vendor for this critical function. The agency indicated that future procurement needs beyond this contract will be pursued through competitive procurement processes.
Notice text
The purpose of this work is to conduct reconsiderations of initial Medicare claims determinations in the Part A West jurisdiction.
Awarded contract HHSM500200400007I to unknown vendor for unknown amount on 2025-12-18.
Files
| File | Type | Posted |
|---|---|---|
| Part A West LFO.pdf |
Similar open opportunities
| Opportunity | Agency | Set-aside | Responses due |
|---|---|---|---|
| Request for Information - CMS' Qualified Independent Contractor (QIC) Program | Centers for Medicare and Medicaid Services | No set-aside | |
| Medicare Administrative Contractor (MAC) Jurisdiction 8 (J8) - Final Solicitation | Centers for Medicare and Medicaid Services | No set-aside |
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