Eligibility Appeals Operations Support (EAOS)

The Centers for Medicare & Medicaid Services awarded contract HHSM-500-2013-00167C to Maximus Federal Services, Inc. for Eligibility Appeals Operations Support. Effective September 25, 2013, this agreement was established through full and open competition to support both Federally-facilitated and State-based Marketplaces under the Patient Protection and Affordable Care Act of 2010. The scope of work involves the comprehensive management of the eligibility appeals process, including the operation of informal resolution processes, review of appeal requests, case management for the Exchanges, and the provision of recommendations to federal employees. This Cost-Plus-Fixed-Fee contract consists of a 12-month base period followed by four 12-month option periods. The total potential value of the contract, including all optional tasks and periods, is 383,164,686 dollars. To maintain operational standards, the contractor is also responsible for implementing ongoing training to ensure staff compliance with current laws, policies, and guidelines.