Medicare Administrative Contractor (MAC) Jurisdiction H (JH) - Synopsis/Draft RFP... Tender

Procurement Summary

Country: USA

Summary: Medicare Administrative Contractor (MAC) Jurisdiction H (JH) - Synopsis/Draft RFP / Presolicitation

Deadline: 02 Sep 2025

Other Information

Notice Type: Tender

TOT Ref.No.: 121894565

Document Ref. No.: 75FCMC26R0001

Financier: Self Financed

Purchaser Ownership: Public

Tender Value: Refer Document

Purchaser's Detail

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Tender Details

Description

The Centers for Medicare & Medicaid Services (CMS) intends to issue a Request for Proposal (RFP) 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 H. Jurisdiction H encompasses the following states: Arkansas, Colorado, Louisiana, Mississippi, New Mexico, Oklahoma, and Texas.

Prior to issuing the final solicitation, with this synopsis CMS is issuing a draft RFP (inclusive of the RFP and attachments) to allow potential offerors an opportunity to review the requirements and submit questions.

Consistent with the statement of work, 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 FAR15.101-1 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 adv...
Active Contract Opportunity
Notice ID : 75FCMC26R0001
Related Notice
Department/Ind. Agency : HEALTH AND HUMAN SERVICES, DEPARTMENT OF
Sub-tier : CENTERS FOR MEDICARE AND MEDICAID SERVICES
Office: OFC OF ACQUISITION AND GRANTS MGMT
General Information
Contract Opportunity Type: Presolicitation (Original)
Original Published Date: Jul 01, 2025 04:54 pm EDT
Original Response Date: Sep 02, 2025 11:00 am EDT
Inactive Policy: 15 days after response date
Original Inactive Date: Sep 17, 2025
Initiative: None

Classification
Original Set Aside:
Product Service Code: G007 - SOCIAL- GOVERNMENT HEALTH INSURANCE PROGRAMS
NAICS Code: 524114 - Direct Health and Medical Insurance Carriers

Place of Performance: Baltimore, MD USA

Documents

 Tender Notice

JH-Attachments-DRAFT.zip

JH-Draft-RFP-Backpages.docx

Solicitation-75FCMC26R0001.pdf