Part B North Qualified Independent Contractor

The Centers for Medicare and Medicaid Services is forecasting a future procurement for a Qualified Independent Contractor to handle reconsiderations of redeterminations made by Medicare Administrative Contractors on Medicare Part B claims. This role involves reviewing and resolving appeals from providers or beneficiaries who dispute the initial payment decisions, ensuring that claims are evaluated fairly and in accordance with Medicare regulations. The contractor will be responsible for conducting thorough, timely, and unbiased reviews, maintaining strict compliance with federal standards, and providing clear, documented decisions that uphold the integrity of the Medicare program. The opportunity is classified under NAICS code 541611 for administrative management and general management consulting services, reflecting the administrative and analytical nature of the work. The contracting officer responsible for this effort is Mark Smolenski, and Cyqwenthia Boyd serves as the program point of contact. Although the solicitation has not yet been released and no set-aside details are available, the anticipated performance location and specific administrative boundaries have not been defined. This forecast signals the agency’s intent to secure an external contractor to support the complex and high-volume reconsideration process critical to the Medicare Part B appeals system.