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Part A/B Medicare Administrative Contractor (MAC) Jurisdiction K (JK) Synopsis

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75FCMC21R0001SYNFederal

Contract Overview

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

AI Contract Overview

The Centers for Medicare & Medicaid Services (CMS) plans to solicit proposals for a Medicare Administrative Contractor (MAC) to manage health insurance benefit administration services, including claims processing and payment functions, for Jurisdiction K, which includes Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island, and Vermont. The contractor will be responsible for supporting Medicare Fee-For-Service (FFS) operations, handling both inpatient (Part A) and outpatient (Part B) claims, maintaining provider relationships, and ensuring compliance with relevant laws, regulations, and CMS guidelines to maintain the program's financial integrity. The procurement will follow FAR Part 15 negotiation procedures and aims to award the contract based on the best overall value, balancing technical merit and cost rather than simply the lowest price or highest technical rating. The contract is expected to have a base year plus six one-year option periods, under NAICS code 524114, with a small business size standard of $41.5 million. CMS anticipates releasing the solicitation around December 2020, with proposals due by January 2021 and award around December 2021, contingent on funding availability. Offerors must monitor the official solicitation posting site for any amendments or changes to submission deadlines. The Office of Acquisition and Grants Management within the Department of Health and Human Services is overseeing this requirement, with designated points of contact available for further inquiries.

General Info

CMS seeks Medicare Administrative Contractor for Jurisdiction K claims processing, compliance, and provider support.

Agency

Department Of Health And Human Services → Office Of Acq Grants Management

NAICS

524114 - Direct Health and Medical Insurance Carriers

Place of Performance

MD, USA

Set-Aside

NONE

Documents

No documents available

Documents will appear here when they are available.

AI Contract Breakdown

Uniform Contract Format

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Timeline

PhasePresolicitation

PostedNov 16

Presolicitation

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Organization & Contact Information

AgencyDepartment Of Health And Human Services → Office Of Acq Grants Management

Contacts2 people available

OfficeBALTIMORE, MD, 21244, USA

Organization / AgencyDepartment Of Health And Human Services → Office Of Acq Grants Management

Office AddressBALTIMORE, MD, 21244, USA

Contacts

Tamara Jones

Mohammed Islam

Full Description

The Centers for Medicare & Medicaid Services (CMS) intends to issue a Request for Proposal to obtain a Medicare Administrative Contractor (hereinafter referred to as - the contractor) to provide specified health insurance benefit administration services, including Medicare claims processing and payment services, in support of the Medicare Program (also known as the Medicare Fee-For-Service or FFS) for Jurisdiction K. Jurisdiction K encompasses the following states: Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island, and Vermont. The contractor shall perform numerous functions to support healthcare services for Medicare beneficiaries, which include performing claims-related activities and establishing relationships with providers of Medicare services, both institutional and professional, both in-patient (Part A) and out-patient (Part B). The contractor will perform the requirements of this contract in accordance with applicable laws, regulations, Medicare manuals, as well as CMS requirements to ensure the financial integrity of the Medicare FFS Program. Pursuant to the authority of FAR Part 15, Contracting by Negotiation, CMS intends to conduct a full and open procurement to fulfill this need. Accordingly, the Contracting Officer will seek to award to the vendor whose proposal represents the best solution to CMS requirements at a fair and reasonable price. Award will be made to the Offeror whose proposal offers the best overall value to the Government using FAR 15.101-1 trade-off processes, which, allows the Government to consider award to other than the lowest cost Offeror or other than the highest technically rated Offeror; affording the Government the most advantageous balance of cost and technical factors as defined in the upcoming solicitation. The resulting contract is anticipated to include a base year plus six (6) one-year options. The NAICS code applicable to this procurement is 524114, Direct Health and Medical Insurance Carriers, with a small business size standard of $41.5 million. CMS anticipates releasing a solicitation for Jurisdiction K on or about December 2020 with proposals due approximately January 2021. Award is anticipated to be approximately December 2021. It will be the offeror's responsibility to check the same site where the solicitation is posted for any amendments and/or changes to the RFP issue and closing date. This solicitation is pending availability of funds.