75FCMC22C0037
Definitive Contract
Overview
Government Description
Part a/part B Medicare Administrative Contractor (MAC) Jurisdiction M (JM) is responsible for providing specified health insurance benefit administration services, including medicare claims processing and payment services, in support of the medicare fee-for-service (FFS) program for jurisdiction M, which encompasses North Carolina, South Carolina, Virginia, and West Virginia. The JM MAC also processes medicare Home Health and Hospice (HHH) billings in 16 states: Alabama, Arkansas, Florida, Georgia, Illinois, Indiana, Kentucky, Louisiana, Mississippi, New Mexico, North Carolina, Ohio, Oklahoma, South Carolina, Tennessee, and Texas. The contractor performs claims-related activities and establishes relationships with institutional and professional providers of medicare services, both in-patient (PART A) and out-patient (PART B), in accordance with applicable laws, regulations, medicare manuals, and CMS requirements to ensure the financial integrity of the medicare FFS program.
Awardee
Awarding / Funding Agency
Place of Performance
Columbia, SC 29203 United States
Pricing
Cost Plus Award Fee
Set Aside
None
Extent Competed
Full And Open Competition
Related Opportunity
Analysis Notes
Amendment Since initial award the Potential Award value has increased 45% from $896,832,974 to $1,298,731,539.
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%
Undisclosed Subcontractors No subcontract awards have been formally disclosed for this contract; however, based on invoice data these subcontractors have worked on this contract: Pgba, CGS Administrators, Heffler, Radetich & Saitta L.L.P, Broadway Ventures, Karna, National Government Services
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%
Undisclosed Subcontractors No subcontract awards have been formally disclosed for this contract; however, based on invoice data these subcontractors have worked on this contract: Pgba, CGS Administrators, Heffler, Radetich & Saitta L.L.P, Broadway Ventures, Karna, National Government Services
Palmetto Gba was awarded
Definitive Contract 75FCMC22C0037 (75FCMC-22-C-0037)
for Part A/Part B Medicare Administrative Contractor (MAC) Jurisdiction M (JM)
worth up to $1,298,731,539
by the CMS Office of Acquisition and Grants Management
in September 2022.
The contract
has a duration of 7 years and
was awarded
through solicitation Part A/B Medicare Administrative Contractor (MAC) Jurisdiction M (JM) RFP
full & open
with
NAICS 524114 and
PSC G007
via direct negotiation acquisition procedures with 1 bid received.
As of today, the Definitive Contract has a total reported backlog of $663,090,040 and funded backlog of $62,616,446.
Status
(Open)
Last Modified 4/7/26
Period of Performance
9/30/22
Start Date
8/31/29
Current End Date
8/31/29
Potential End Date
Obligations and Backlog
$635.6M
Total Obligated
$698.3M
Current Award
$1.3B
Potential Award
$62.6M
Funded Backlog
$663.1M
Total Backlog
Award Hierarchy
Definitive Contract
75FCMC22C0037
Subcontracts
Activity Timeline
Labor Services Billing
Annual labor billing rates and FTE reported for 75FCMC22C0037
| Year | Services Invoiced | Hours | FTE | Blended Rate |
|---|---|---|---|---|
| 2023 | $108,776,480 | 1,379,992.0 | 663.4 | $78.82 |
| 2024 | $187,489,501 | 2,261,410.2 | 1087.2 | $82.91 |
Subcontract Awards
Disclosed subcontracts for 75FCMC22C0037
Opportunity Lifecycle
Procurement history for 75FCMC22C0037
Transaction History
Modifications to 75FCMC22C0037
People
Suggested agency contacts for 75FCMC22C0037
Competition
Number of Bidders
1
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
Yes
Business Size Determination
Large Business
Awardee UEI
CFLDECZBMDV6
Awardee CAGE
3EYS4
Agency Detail
Awarding Office
75FCMC OFC OF ACQUISITION AND GRANTS MGMT
Funding Office
75FCMC
Created By
hhsajones
Last Modified By
hhsaduckworth
Approved By
hhsaduckworth
Legislative
Legislative Mandates
Labor Standards
Performance District
SC-06
Senators
Lindsey Graham
Tim Scott
Tim Scott
Representative
James Clyburn
Budget Funding
| Federal Account | Budget Subfunction | Object Class | Total | Percentage |
|---|---|---|---|---|
| Federal Supplementary Medical Insurance Trust Fund-Treasury Managed, Health and Human Services (075-8004) | Medicare | Other services from non-Federal sources (25.2) | $110,050,251 | 46% |
| 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) | $79,786,938 | 33% |
| Health Care Fraud and Abuse Control Account, Health and Human Services (075-8393) | Medicare | Medical care (25.6) | $33,879,750 | 14% |
| Health Care Fraud and Abuse Control Account, Health and Human Services (075-8393) | Medicare | Other services from non-Federal sources (25.2) | $17,633,390 | 7% |
Modified: 4/7/26