RAC Region 2

This solicitation seeks proposals to provide Recovery Audit Contractor services for Medicare Fee-for-Service claims paid in Region 2. The Department of Health and Human Services Centers for Medicare and Medicaid Services seeks to reduce improper Medicare payments through efficient detection and correction of improper payments on claims submitted to A/B Medicare Administrative Contractors. The selected contractor must review claims using appropriate methods, work with CMS and MACs to adjust claims and recoup overpayments or pay underpayments, support the appeals process, and report review status by updating the RAC Data Warehouse and providing monthly reports. Proposals are due by October 12, 2021.

There is no set-aside designation specified. The NAICS code is 541611 and PSC code R499. The contractor will perform services across Region 2 as depicted in the appendices for an unspecified period of performance and budget. Key details include that the contractor must review all applicable claim types submitted to MACs in Region 2, excluding DMEPOS and HH/H claims, and meet required volumes for claim reviews across provider types while following CMS medical review processes and communication guidelines.