R -- Durable Medical Equipment (DME) - Medicare Administrative Contractor (MAC)

Section 911 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) requires the Centers for Medicare and Medicaid Services (CMS) to take the necessary steps between now and 2011 to implement Medicare Contracting Reform (MCR). MCR will bring standard contracting principles to Medicare such as competition and performance incentives that the government has long applied to other federal programs under the Federal Acquisition Regulation (FAR). The CMS is required to replace the current contracting authority under Title XVIII of the Social Security Act with the new Medicare Administrative Contractor (MAC) authority. The law directs CMS to conduct full and open competitions for new MACs, who will perform the work currently being handled by fiscal intermediaries, carriers, regional home health intermediaries, and durable medical equipment regional carriers in administering the Medicare fee-for-service program. As such, CMS anticipates conducting a full and open competition for the Durable Medical Equipment – Medicare Administrative Contractors (DME-MAC). The DME-MAC will provide specified fee-for-service health insurance benefit administration services, including Medicare claims processing and payment services, for durable medical equipment, prosthetics, orthotics and supplies. In addition to the core DME-MAC workload, CMS anticipates including several optional services to be performed. Optional services include functions related to national supplier enrollment, data analysis and coding and Enterprise Data Center (EDC) services. It is anticipated that the competition will result in award of four DME-MAC contracts. CMS also anticipates that each contract will be a “stand-alone” contract. Each contract will include a base year and four, one-year options. Any questions should be directed to Ms. Cathy Baldwin, Contract Specialist, at (410) 786-5791, or by sending e-mail to [email protected]. E-mail communications should include company name and size (Large/Small), address, point of contact, phone and fax numbers. Any additional information and documents on this requirement will be posted to FEDBIZOPPS. CMS anticipates release of the Request for Proposal (RFP) in late March 2005.