Part A/B Medicare Administrative Contractor, Jurisdiction E
Closed Solicitation Posted
- Solicitation number
- 75FCMC19R0023
- 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
- PSC
- G Social Services
Notice details come from SAM.gov. Updated .
About this opportunity
The Centers for Medicare and Medicaid Services seeks to award an indefinite-delivery/indefinite-quantity contract to provide Medicare Administrative Contractor services for Jurisdiction E. The contractor will perform Medicare claims processing, payment services, and other healthcare benefit administration for California, Hawaii, Nevada, American Samoa, Guam, and Northern Mariana Islands. The agency will evaluate proposals using a trade-off best value process considering technical factors and price. The anticipated solicitation release date is September 4, 2019, with proposals due November 4, 2019 and award expected by August 4, 2020.
There is no set-aside designation. The primary NAICS code is 524292 and PSC code R499. The incumbent contractor is CGS Administrators, LLC. The contract includes a one-year base period valued at approximately $1 billion and six one-year options. The contractor must process over 25 million claims annually from over 100,000 healthcare providers while maintaining offices in California, Hawaii, and Nevada. Place of performance will be Jurisdiction E.
Notice text
4 versions
Update #4 · Latest ·
The purpose of Amendment #2 is to:
1. Provide responses to questions submitted in response to soliciation #75FCMC19R0023 Amendment 1. Responses are attached as Amendment 2, Attachment 1 - RFP Question Responses.
Update #3 ·
The purpose of this amendment is to:
1. Provide responses to questions received in response to solicitation # 75FCMC19R0023.
2. Revise Section B.6 Schedule of Supplies/Services to be consistent with new CLIN structure.
3. Revise Section F.2 Period of Performance to be consistent with new CLIN structure.
4. Revise Section J to reflect revised attachments J.36-J.49 to be consistent with new CLIN structure.
5. Revise Section L.9 to provide instructions for submitting solicitation questions regarding the revised cost template attachments and Section L.15.2 only.
6. Revise Sections L.11-L.16, M.3, M.5, and M.6 to reflect corrected section references and to be consistent with the new CLIN structure.
7. Replace the following RFP attachments with updated versions: J.5, J.7, J.10, J.22, J.23, J.23A, J.24, J.33-J.49
8. Provide a clean copy, as well as a redline version, of this amended solicitation. The redline version is provided as an attachment, Amendment Attachment 1, and is specifically provided so as to provide clarity to potential offerors with respect to the amendments made to the solicitation.
Update #2 ·
The Centers for Medicare & Medicaid Services (CMS) intends to issue a Request for Proposal to obtain a Medicare Administrative Contractor (hereinafter referred to as "the contractor") to provide specified health insurance benefit administration services, including Medicare claims processing and payment services, in support of the Medicare Program (also known as the Medicare Fee-For-Service or FFS) for Jurisdiction E. Jurisdiction E includes the following states: California, Hawaii, and Nevada, as well as the U.S. territories, American Samoa, Guam, and Northern Mariana Islands.
The contractor shall perform numerous functions to support healthcare services for Medicare beneficiaries, which include performing claims-related activities and establishing relationships with providers of Medicare services, both institutional and professional, both in-patient (Part A) and out-patient (Part B). The contractor will perform the requirements of this contract in accordance with applicable laws, regulations, Medicare manuals, as well as CMS requirements to ensure the financial integrity of the Medicare FFS Program.
Pursuant to the authority of FAR Part 15, Contracting by Negotiation, CMS intends to conduct a full and open procurement to fulfill this need. Accordingly, the Contracting Officer will seek to award to the vendor whose proposal represents the best solution to CMS' requirements at a fair and reasonable price.
Award will be made to the Offeror whose proposal offers the best overall value to the Government using FAR 15.101-1 trade-off processes, which "...allows the Government to consider award to other than the lowest cost Offeror or other than the highest technically rated Offeror..."; affording the Government the most advantageous balance of cost and technical factors as defined in the upcoming solicitation.
The contract will include a base year plus six (6) one-year options. The proposal due date is November 4, 2019, with an anticipated award date of August 4, 2020.
This solicitation is issued pending availability of funds.
Update #1 ·
The Centers for Medicare & Medicaid Services (CMS) intends to issue a Request for Proposal to obtain a Medicare Administrative Contractor (hereinafter referred to as "the contractor") to provide specified health insurance benefit administration services, including Medicare claims processing and payment services, in support of the Medicare Program (also known as the Medicare Fee-For-Service or FFS) for Jurisdiction E. Jurisdiction E includes the following states: California, Hawaii, and Nevada, as well as the U.S. territories, American Samoa, Guam, and Northern Mariana Islands.
The contractor shall perform numerous functions to support healthcare services for Medicare beneficiaries, which include performing claims-related activities and establishing relationships with providers of Medicare services, both institutional and professional, both in-patient (Part A) and out-patient (Part B). The contractor will perform the requirements of this contract in accordance with applicable laws, regulations, Medicare manuals, as well as CMS requirements to ensure the financial integrity of the Medicare FFS Program.
Pursuant to the authority of FAR Part 15, Contracting by Negotiation, CMS intends to conduct a full and open procurement to fulfill this need. Accordingly, the Contracting Officer will seek to award to the vendor whose proposal represents the best solution to CMS' requirements at a fair and reasonable price.
Award will be made to the Offeror whose proposal offers the best overall value to the Government using FAR 15.101-1 trade-off processes, which "...allows the Government to consider award to other than the lowest cost Offeror or other than the highest technically rated Offeror..."; affording the Government the most advantageous balance of cost and technical factors as defined in the upcoming solicitation.
CMS anticipates releasing a solicitation for Jurisdiction E on or about September 4, 2019. The contract will include a base year plus six (6) one-year options. The anticipated proposal due date is November 4, 2019, with an anticipated award date of August 4, 2020. In the event a draft solicitation is published, please note that the anticipated November 4, 2019 proposal due date is not expected to change.
This solicitation is expected to be issued pending availability of funds.
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