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Appeals Administration

Active
Federal

Contract Overview

Solicitation details, issuing organization, response deadlines, documents, and interested companies for this government contract opportunity.

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The Appeals Administration subcontract, managed by the Department of Health and Human Services Office of Acquisition and Grants Management, focuses on the legal and administrative processing of Medicare payment and coverage appeals for prime contractors on CMS Medicare Administrative Contractor projects. The scope of work involves processing appeal requests, reviewing case files, and issuing formal determinations through various workflow stages, requiring specialized expertise in administrative law and Medicare appeals regulations. This opportunity is categorized under NAICS code 541110 and is based in Baltimore. The solicitation was posted on August 4, 2026, with a response deadline of November 2, 2026. The primary objective of the contract is to ensure the delivery of accurate appeal determinations and comprehensive case resolution reports.

General Info

HHS subcontract for Medicare appeal processing and legal determinations based in Baltimore.

NAICS

541110 - Offices of Lawyers

Place of Performance

Baltimore, MD, USA

Set-Aside

NONE

Documents

This scope was carved out of 75FCMC27R0001.

The full solicitation package (9 documents), including the RFP, is on the prime solicitation, not on this scope.

View the prime solicitation

Medicare Administrative Contractor (MAC) Jurisdiction 8 (J8) - Synopsis/Draft RFP / Presolicitation

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Timeline

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Organization & Contact Information

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AgencyDepartment Of Health And Human Services → Ofc Of Acquisition And Grants Management
ContactsNo contacts available
OfficeN/A
Office AddressN/A
ContactsNo contact information available

Full Description

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Manages the legal and administrative process for appealing Medicare payment or coverage decisions for prime contractors on CMS Medicare Administrative Contractor (MAC) projects. Processes appeals requests, reviews case files, and issues determinations across multiple workflow stages. Requires knowledge of Medicare appeals regulations and administrative law. Delivers appeal determinations and case resolution reports.

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