What the buyer needs
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The buyer requires a USA-based vendor to provide Medicare administrative services, specifically acting as a Medicare administrative contractor to support health insurance benefit administration for the Medicare program within a defined geographic area. The selected contractor must perform offsite health care service support functions, establish relationships with institutional and professional health care providers, and receive and control Medicare claims from beneficiaries, suppliers, and providers. Furthermore, the contractor must execute standard or required editing on these claims to verify completeness and determine if payment should occur. The buyer limits eligibility strictly to onshore USA organizations. The buyer is currently looking for proposals and has not provided specific budget amounts, evaluation criteria, or key dates in the presolicitation notice.
Incumbent and award research
Likely prior awards for this requirement
Likely matchAwarded by the same buying office (75FCMC) with descriptions matching "medicare administrative", performed in MD. The notice does not name its current contract, so confirm before relying on it.
| Vendor and award | Value | Ends |
|---|---|---|
| NORIDIAN HEALTHCARE SOLUTIONS, LLC75FCMC24C0011 · THE PURPOSE OF THIS CONTRACT IS TO OBTAIN A DURABLE MEDICAL EQUIPMENT (DME) MEDICARE ADMIN | $68.5M | Feb 28, 2031 |
| PALMETTO GBA, LLC75FCMC22C0037 · PART A/PART B MEDICARE ADMINISTRATIVE CONTRACTOR (MAC) JURISDICTION M (JM) | $817.9M | Aug 31, 2029 |
| CHAGS HEALTH INFORMATION TECHNOLOGY, LLC75FCMC23F0121 · CMS REQUIRES WEBSITE SCAN AND ANALYSIS SERVICES TO SCAN MEDICARE ADMINISTRATIVE CONTRACTOR | $310.7K | Aug 31, 2027 |
| WELLPOINT FEDERAL SOLUTIONS, INC.75FCMC22C0003 · PART A/PART B MEDICARE ADMINISTRATIVE CONTRACTOR (MAC) JURISDICTION K (JK) | $483.6M | Aug 31, 2027 |
| CGS ADMINISTRATORS, LLC75FCMC20C0025 · DURABLE MEDICAL EQUIPMENT (DME) MEDICARE ADMINISTRATIVE CONTRACTOR (MAC) FOR JURISDICTION | $267.3M | Aug 31, 2027 |
Market context
Awards in the same category (Direct Health and Medical Insurance Carriers). This is not this requirement's award history.
Recent similar awards: Department of Health and Human Services, NAICS 524114, performed in MD
| Vendor and award | Value | Ends |
|---|---|---|
| MANAGED CARE ADVISORS, INC.75D30122C12935 · WTCHP NATIONWIDE PROVIDER NETWORK | $113.6M | Feb 28, 2027 |
| HARVARD PILGRIM HEALTH CARE, INC.HHSF22301004T · TAS::75 0600::TAS TASK ORDER #3-CDER EVALUATION OF POTENTIAL EXPOSURE/OUTCOME ASSOCIATIONS | $1.5M | Aug 31, 2013 |
Top vendors in this category: Department of Health and Human Services, NAICS 524114, since Oct 1, 2024
35 contract awards in this NAICS over the period.
- 1. PALMETTO GBA, LLC$549.4M
- 2. NORIDIAN HEALTHCARE SOLUTIONS, LLC$493.6M
- 3. WELLPOINT FEDERAL SOLUTIONS, INC.$385.7M
- 4. NOVITAS SOLUTIONS, INC.$351.2M
- 5. CGS ADMINISTRATORS, LLC$265.8M
Source: USAspending.gov federal award data (U.S. federal public data). A contract is called the incumbent only when the notice or its documents cite it by number.