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75FCMC22C0003

Definitive Contract

Overview

Government Description
Part a/part B Medicare Administrative Contractor (MAC) Jurisdiction K (JK). Provides health insurance benefit administration services, including medicare claims processing and payment services, for jurisdiction K, which encompasses Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island, and Vermont. The JK MAC is also responsible for processing medicare Home Health and Hospice (HHH) billings in Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont. Additional work includes cost report desk review and audit services, S-10 reviews, medicare secondary payer hospital audit services, provider enrollment, redeterminations and appeals, reopenings, prior authorizations for opd and rsnat, print and mail services, banking relations, hard copy and NARA record storage, and aged record disposal initiative services.
Place of Performance
Indianapolis, IN 46250 United States
Pricing
Cost Plus Award Fee
Set Aside
None
Extent Competed
Full And Open Competition
Analysis Notes
Amendment Since initial award the Potential Award value has increased 4% from $785,518,166 to $817,903,412.
Subcontracting Plan This Definitive Contract has an Individual Subcontract Plan. The Department of Health and Human Services has an overall small business subcontracting goal of 32%
National Government Services was awarded Definitive Contract 75FCMC22C0003 (75FCMC-22-C-0003) for Part A/B Medicare Administrative Contractor (MAC) Jurisdiction K (JK) worth up to $817,903,412 by the CMS Office of Acquisition and Grants Management in January 2021. The contract has a duration of 7 years and was awarded through solicitation Part A/B Medicare Administrative Contractor (MAC) Jurisdiction K (JK) Solicitation full & open with NAICS 524114 and PSC G007 via direct negotiation acquisition procedures with 2 bids received. As of today, the Definitive Contract has a total reported backlog of $394,522,364 and funded backlog of $156,602,122.

Status
(Open)

Last Modified 3/31/26
Period of Performance
1/1/22
Start Date
12/31/26
Current End Date
12/31/28
Potential End Date
61.0% Complete

Obligations and Backlog
$423.4M
Total Obligated
$580.0M
Current Award
$817.9M
Potential Award
52% Funded
$156.6M
Funded Backlog
$394.5M
Total Backlog

Award Hierarchy

Definitive Contract

75FCMC22C0003

Subcontracts

-

Activity Timeline

Interactive chart of timeline of amendments to 75FCMC22C0003

Labor Services Billing

Annual labor billing rates and FTE reported for 75FCMC22C0003

Subcontract Awards

Disclosed subcontracts for 75FCMC22C0003

Opportunity Lifecycle

Procurement history for 75FCMC22C0003

Transaction History

Modifications to 75FCMC22C0003

People

Suggested agency contacts for 75FCMC22C0003

Competition

Number of Bidders
2
Solicitation Procedures
Negotiated Proposal/Quote
Evaluated Preference
None
Commercial Item Acquisition
Commercial Item Procedures Not Used
Simplified Procedures for Commercial Items
No

Other Categorizations

Subcontracting Plan
Individual Subcontract Plan
Cost Accounting Standards
Exempt
Business Size Determination
Large Business
Awardee UEI
TJNDFEALGTB5
Awardee CAGE
3NKX7
Agency Detail
Awarding Office
75FCMC OFC OF ACQUISITION AND GRANTS MGMT
Funding Office
75FCMC
Created By
hhsedrannbauer
Last Modified By
hhsmislam
Approved By
hhsmislam

Legislative

Legislative Mandates
None Applicable
Performance District
IN-07
Senators
Todd Young
Mike Braun
Representative
André Carson

Budget Funding

Federal Account Budget Subfunction Object Class Total Percentage
Program Management, Centers for Medicare and Medicaid Services, Health and Human Services (075-0511) Health care services Other services from non-Federal sources (25.2) $117,396,017 65%
Health Care Fraud and Abuse Control Account, Health and Human Services (075-8393) Medicare Other services from non-Federal sources (25.2) $39,220,004 22%
Health Care Fraud and Abuse Control Account, Health and Human Services (075-8393) Medicare Medical care (25.6) $22,107,213 12%
Modified: 3/31/26