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U.S. Department Of Health And Human Services·Maryland

Medicare Administrative Contractor (MAC) Jurisdiction 8 (J8) - Synopsis/Draft RFP / Presolicitation

Closes tomorrow$50M – $500MRequest for Proposal
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Description

The Centers for Medicare & Medicaid Services (CMS) is seeking a Medicare Administrative Contractor (MAC) to provide specified health insurance benefit administration services, including Medicare claims processing and payment services, in support of the Medicare Program for Jurisdiction 8, which encompasses the states of Indiana and Michigan. The contractor will perform numerous functions to support healthcare services for Medicare beneficiaries, including performing claims-related activities and establishing relationships with providers of Medicare services. The contract is anticipated to include a base year plus eight one-year options. • The contractor will be responsible for performing claims-related activities and establishing relationships with providers of Medicare services. • The contractor will be required to 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. • The contract is anticipated to include a base year plus eight 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 $47.0 million.

Attached files

Contact

Alyssa Jones

[email protected]

(410) 786-1535

Key dates

Opened
8/4/2026
Questions due
8/17/2026
Closes
11/2/2026
Projected award
9/1/2027
Duration
9 years

Last updated

Details

Type
Request for Proposal
Industry
Healthcare and Medical Services
NAICS
524114
Solicitation №
75FCMC27R0001

Budget estimate

$50,000,000 – $500,000,000

Given the complexity and scope of the Medicare Administrative Contractor (MAC) services, the budget amount is likely to be substantial. The contract duration of 9 years, including a base year and eight one-year options, suggests a long-term commitment. Considering the small business size standard of $47.0 million, the annual budget could be in the range of tens to hundreds of millions of dollars. However, without specific information on the contract value, it's challenging to provide an accurate estimate. Factors influencing the budget include the number of Medicare beneficiaries, the volume of claims processed, and the contractor's performance. A possible budget range could be between $50 million and $500 million per year, considering the contract's scope and the industry standards.

AI estimate from the solicitation

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