Qualified Independent Contractor (QIC) Part A East Jurisdiction
Awarded Limited / Sole Source Justification Posted
- Solicitation number
- 75FCMC26F0024
- Agency
-
Centers for Medicare and Medicaid Services
Department of Health and Human Services
- Set-aside
- No set-aside
Opportunity facts
- Contract number
- HHSM-500-2004-00005I-75FCMC26F0024 Federal contract award
- Awardee
- C2C Innovative Solutions, Inc.
- NAICS code
- Not on record
- PSC
- R499 Support- Professional: Other
- Place of performance
- Jacksonville, Florida 32202, United States
Notice details come from SAM.gov. Updated .
About this opportunity
The Centers for Medicare and Medicaid Services (CMS) published this Limited/Sole Source Justification Notice on December 16, 2025, for a Qualified Independent Contractor (QIC) Part A East Jurisdiction task order under a Multiple Award IDIQ Contract. The contract requires the vendor to provide Medicare claims adjudication and reconsideration services, processing reconsideration requests for Medicare Part A and Part B claims across 18 states and territories, including hospital inpatient, home health, skilled nursing, hospice, and institutional claims. The justification for the limited source procurement is based on a logical follow-on rationale, leveraging the vendor's existing expertise and the recent Alexander v. Azar court order that established a temporary retrospective review process requiring specialized handling of aged claims dating back to 2009. The task order was awarded to C2C Innovative Solutions, Inc. with a total projected cost of $55,366,573.68 for a three-year performance period from January 1, 2026, through December 31, 2028. This contract represents a continuation of critical Medicare administrative services under a firm-fixed price structure.
Notice text
This posting provides notice that the limited-sources justification (LSJ) for the Qualified Independent Contractor (QIC) Part A East Jurisdiction procurement being posted pursuant to FAR 8.405-6(a)(2), which requires the ordering activity to publish a notice and post the justification within 14 days after placing an order exceeding the simplified acquisition threshold that is supported by an LSJ.
The QIC is responsible for all reconsiderations requested as a result of Medicare Administrative Contractors (MACs) redeterminations of Medicare Part A and Part B of A claims. This workload includes processing reconsideration requests for, at a minimum, hospital inpatient, home health, skilled nursing home, hospice, and other Part A services and claims. It also includes institutional claims which are paid from the Part B Trust Fund (sometimes referred to as “Part B of A”). The QIC shall also be responsible for the expedited reconsideration workload comprised of, at a minimum, service termination and hospital discharge reviews performed by Quality Improvement Organizations (QIOs). It shall be noted that the QIC is also responsible for reconsiderations based on “initial determinations” regarding Medicare Secondary Payer (MSP) recovery claims against beneficiaries or providers/suppliers where the redetermination was processed by a MAC. Such recovery claims against beneficiaries routinely include both Part A & Part B claims.
Awarded contract HHSM-500-2004-00005I to unknown vendor for unknown amount on 2025-12-16.
Files
| File | Type | Posted |
|---|---|---|
| Part A East LFO - JEFO - Redacted.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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