Medicare Administrative Contractor (MAC) Jurisdiction H (JH) - Synopsis/Draft RFP / Presolicitation   3

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) to provide health insurance benefit administration services, including Medicare claims processing and payment services, for Jurisdiction H.

Jurisdiction H encompasses the states of Arkansas, Colorado, Louisiana, Mississippi, New Mexico, Oklahoma, and Texas. The goal of this contract is to support the traditional Medicare program (Medicare fee-for-service).

Work Details
The contractor will be responsible for the following tasks:
1. Implementation of Part A and Part B services within specified timeframes.
2. Program Management (PM), Medicare Integrity Program (MIP), and Recovery Audit Contractor (RAC) operations during the base period and subsequent option years.
3. Transition activities for outgoing contractors.
4. Medical review for therapy claims using KX Modifier.
5. Veterans Affairs Medicare Equivalent Remittance Advice Project (VA RECLAIM).
6. Compliance with all relevant regulations and guidelines as outlined in the Statement of Work (SOW) provided in Attachment J.01.

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 extension.

Place of Performance
The services will be performed across Jurisdiction H, which includes Arkansas, Colorado, Louisiana, Mississippi, New Mexico, Oklahoma, and Texas.