Part A/B Medicare Administrative Contractor (MAC) Jurisdiction 15 (15) RFP
Closed Solicitation Posted
This opportunity was awarded. See its 2 award notices in the notice history.
- Solicitation number
- 75FCMC23R0003
- 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
- United States
Notice details come from SAM.gov. Updated .
About this opportunity
This solicitation seeks a contractor to provide Part A/B Medicare Administrative Contractor services for Jurisdiction 15, which includes claims processing and payment services for the states of Kentucky and Ohio. The contractor will also process Medicare Home Health and Hospice claims for 16 additional states and the District of Columbia. The Department of Health and Human Services Centers for Medicare and Medicaid Services issued this request for proposal to obtain these administrative services through a cost reimbursement contract with a one year base period and six one-year option periods. Proposals will be evaluated based on technical approach, past performance, and price/cost. The deadline for questions is January 9, 2023.
There is no set-aside designation for this procurement. The primary NAICS code is 524292 and PSC code R499. The incumbent MAC contractor is Palmetto GBA. The total contract value will depend on actual workload and costs but is estimated to exceed $100 million annually. The place of performance will be within the United States.
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 15. Jurisdiction 15 includes the states of Kentucky and Ohio. The J15 MAC is also responsible for processing Medicare Home Health and Hospice (HHH) billings in the District of Columbia and the following 15 states: Colorado, Delaware, Iowa, Kansas, Maryland, Missouri, Montana, Nebraska, North Dakota, Pennsylvania, South Dakota, Utah, Virginia, West Virginia and Wyoming.
Files
| File | Type | Posted |
|---|---|---|
| RFP 75FCMC23R0003 12-15-2022.pdf | ||
| RFP 75FCMC23R0003 11-30-22.docx | DOCX document | |
| RFP Attachments.zip | ZIP file | |
| RFP Questions and Responses.xlsx | XLSX spreadsheet |
Notice history
| Notice | Type | Posted |
|---|---|---|
| Part A/B Medicare Administrative Contractor (MAC) Jurisdiction 15 (15) RFP | Award Notice | |
| This notice | Solicitation | |
| Part A/B Medicare Administrative Contractor (MAC) Jurisdiction M (JM) RFP | Award Notice | |
| Part A/B Medicare Administrative Contractor (MAC) Jurisdiction 15 (15) RFP | Pre-Solicitation | |
| Part A/B Medicare Administrative Contractor (MAC) Jurisdiction M (JM) RFP | Solicitation | |
| Part A/B Medicare Administrative Contractor (MAC) Jurisdiction M (JM) Synopsis/Draft RFP | Pre-Solicitation |
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