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

The tender in brief

A Medicare claims processing contract for Indiana and Michigan, for large health insurers with Medicare experience

CMS seeks a Medicare Administrative Contractor for Jurisdiction 8 (Indiana and Michigan) to process Part A and Part B Medicare claims, handle provider enrollment, appeals, medical review, and program integrity. The contract starts with an implementation period, then a base period, followed by up to eight one-year option periods. Work includes managing 155,592 boxes of Medicare records and handling millions of web portal transactions.

Who can win it

• Must be a Medicare Administrative Contractor or have relevant Medicare claims processing experience
• Must have experience with Medicare Part A and Part B claims processing systems
• Must be able to handle large-scale Medicare claims processing for Indiana and Michigan