Part A/B Medicare Administrative Contractor (MAC) Jurisdiction M (JM) RFP

This award, resulting from a competitive procurement process, establishes a Medicare Administrative Contractor to provide health insurance benefit administration services for Jurisdiction M. The contractor is responsible for Medicare claims processing and payment services for the fee-for-service program within North Carolina, South Carolina, Virginia, and West Virginia. Additionally, the scope includes processing Medicare Home Health and Hospice billings across sixteen states, including Alabama, Arkansas, Florida, Georgia, Illinois, Indiana, Kentucky, Louisiana, Mississippi, New Mexico, North Carolina, Ohio, Oklahoma, South Carolina, Tennessee, and Texas. Managed by the Department of Health and Human Services under solicitation 75FCMC22C0037, the contract utilizes a flexible pricing structure rather than a fixed price. This approach accounts for performance uncertainties and ongoing changes to Medicare program requirements driven by mandatory legislation, which prevent reasonable cost estimates. The contract falls under NAICS code 524114 and is administered by the Office of Acq Grants Management.