Part A/B Medicare Administrative Contractor (MAC) Jurisdiction M (JM) RFP

This award is the result of a competitive procurement. The contract type is not fixed price because of the ongoing changes in the Medicare program requirements directed by mandatory legislation and because resulting performance uncertainties in many functional areas are such that reasonable estimates of their cost impact cannot be made. The purpose of this contract is to obtain a Medicare Administrative Contractor (herein after referred to as “the contractor” or “MAC”) 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, program) for Jurisdiction M. JM includes the states of North Carolina, South Carolina, Virginia, and West Virginia. The JM MAC is also responsible for processing Medicare Home Health and Hospice (HHH) billings in 16 states: the states of Alabama, Arkansas, Florida, Georgia, Illinois, Indiana, Kentucky, Louisiana, Mississippi, New Mexico, North Carolina, Ohio, Oklahoma, South Carolina, Tennessee and Texas.