75FCMC24R0002 A/B MAC Jurisdiction F (JF) RFP- Solicitation   3

The purpose of this contract is to obtain a Part A/Part B (A/B) Medicare Administrative Contractor (hereinafter referred to as the contractor or MAC or A/B MAC ) to provide specified health insurance benefit administration services, including Medicare claims processing and payment services, in support of the traditional Medicare program (also known as the Medicare fee-for-service or FFS, program) for Jurisdiction F (JF). Jurisdiction F encompasses the following states: Alaska, Arizona, Idaho, Montana, North Dakota, Oregon, South Dakota, Utah, Washington, and Wyoming.

Background
The Centers for Medicare & Medicaid Services (CMS) is issuing this contract to obtain a Part A/Part B Medicare Administrative Contractor (A/B MAC) for Jurisdiction F, which includes Alaska, Arizona, Idaho, Montana, North Dakota, Oregon, South Dakota, Utah, Washington, and Wyoming.

The goal of this contract is to provide health insurance benefit administration services and support the traditional Medicare program by processing claims and making payments.

Work Details
The contractor will be responsible for the following tasks:
1. Provide Medicare claims processing and payment services for Part A and Part B benefits.
2. Manage the Medicare Integrity Program (MIP) to ensure compliance and integrity in claims processing.
3. Support Recovery Audit Contractor (RAC) operations to identify and recover improper payments.
4. Implement program management activities including oversight of operations and reporting requirements.
5. Establish separate cost accounts for each Task Directive issued under the contract.
6. Deliverables include periodic reports on claims processing efficiency, integrity audits, and financial management of contract funds.

Period of Performance
The period of performance will commence from the effective date of contract award and will last for 12 months with six one-year options available for renewal.

Place of Performance
The services will be performed in Jurisdiction F which encompasses Alaska, Arizona, Idaho, Montana, North Dakota, Oregon, South Dakota, Utah, Washington, and Wyoming.