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Part A/Part B Medicare Administrative Contractor (MAC) Jurisdiction L (JL) Synopsis

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75FCMC20R0008SYNFederal

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 issue a Request for Proposal (RFP) to secure a Medicare Administrative Contractor (MAC) for Jurisdiction L, covering Delaware, Maryland, New Jersey, Pennsylvania, the District of Columbia, and select areas in Virginia. The contractor will be responsible for administering Medicare health insurance benefits, including processing and payment of claims for both Part A (inpatient) and Part B (outpatient) services. Duties include managing claims-related activities and fostering relationships with professional and institutional Medicare providers within the jurisdiction, ensuring compliance with all relevant laws, regulations, and CMS policies to maintain the financial integrity of the Medicare Fee-For-Service program. This procurement will follow a full and open negotiation process under FAR Part 15, with award based on the best overall value that balances technical merit and cost rather than simply the lowest price. The contract is expected to have a base year followed by six one-year option periods. The NAICS code for this contract is 524114, with a small business size standard of $41.5 million. The solicitation was anticipated to be released around August 2020, with proposals due in October 2020 and award expected by August 2021, contingent upon funding availability. Potential offerors are advised to monitor the official posting site regularly for any amendments or updates to the solicitation.

General Info

CMS seeks Medicare contractor for Jurisdiction L to manage claims, compliance, and provider relations.

Agency

Department Of Health And Human Services → Ofc Of Acquisition And 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

PostedJul 16

Presolicitation

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Organization & Contact Information

AgencyDepartment Of Health And Human Services → Ofc Of Acquisition And Grants Management

Contacts2 people available

OfficeBALTIMORE, MD, 21244, USA

Organization / AgencyDepartment Of Health And Human Services → Ofc Of Acquisition And Grants Management

Office AddressBALTIMORE, MD, 21244, USA

Contacts

Mark Werder

Rachel Johnson

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 L. Jurisdiction L includes the following states: Delaware, Maryland, New Jersey, Pennsylvania, the District of Columbia, Part B services in Arlington and Fairfax counties in Virginia and the city of Alexandria, Virginia. 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 L on or about August 2020 with proposals due approximately October 2020. Award is anticipated to be approximately August 2021. It will be the offeror's responsibility to frequently 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 expected to be issued pending availability of funds.