AdQIC LFO
Past New Requirement Updated
- Agency
-
Centers for Medicare and Medicaid Services
Department of Health and Human Services
- Solicitation expected
- Not on record
- Estimated value
- $20,000,000 to $50,000,000
- Set-aside
- No set-aside
Forecast facts
- Anticipated award
- NAICS code
- 541611 Administrative Management and General Management Consulting Services
- Points of contact
-
- Malissa Shin malissa.shin@cms.hhs.gov (410) 786-0109
- Michael T. Torrisi michael.torrisi@cms.hhs.gov
Forecast details come from HHS's procurement forecast. Agencies' dates and values are estimates.
About this forecast
The Department of Health and Human Services Centers for Medicare and Medicaid Services (CMS) is seeking a Logical Follow On (LFO) contract for the Administrative Quality Improvement Contractor (AdQIC) to provide comprehensive administrative support for Medicare appeals processes. The primary objectives include delivering appeals training, coordinating case file storage, facilitating referrals to the Medicare Appeals Council, and supporting eligibility determinations for retrospective appeals. The estimated contract award date is September 1, 2026, with the solicitation posted on December 10, 2025, under the NAICS code 541611 for Administrative Management and General Management Consulting Services.
The contract will establish an Eligibility Contractor (EC) to serve as a single point of contact for retrospective appeal requests from Medicare beneficiaries or their representatives, operating under 42 CFR 405.932. Key points of contact for this opportunity are Malissa Shin and Michael Torrisi, both from CMS, who can be reached at their respective government email addresses. While specific award values are not disclosed in the forecast, the contract involves critical administrative support functions for Medicare appeals processes, with the contractor responsible for coordinating communications between various stakeholders including Medicare Administrative Contractors (MACs) and Administrative Law Judges (ALJs).
Forecast text
Logical Follow On (LFO) of Task Order No. 75FCMC21F0001). The Administrative QIC (AdQIC) provides appeals training and coordination, long term case file storage, referrals to the Medicare Appeals Council within the Departmental Appeals Board (herein Appeals Council), and notifying Medicare Administrative Contractors (MACs) to effectuate Administrative Law Judges (ALJ) and Appeals Council decisions. In addition, the AdQIC will support CMS in making eligibility determinations for retrospective appeals where the contractor shall be known as the "Eligibility Contractor (EC)." The EC shall serve as a single point of contact for incoming retrospective appeal requests submitted by beneficiaries (or their appointed or authorized representatives), or, as applicable, the successors filing on behalf of a deceased beneficiary, under 42 Code of Federal Regulations (CFR) 405.932.
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