R -- MEDICARE PART B CLAIMS PROCESSING

Notice Date

November 9, 2001

Contracting Office

Department of Health and Human Services, Centers for Medicare & Medicaid Services, formerly known as the Health Care Financing Administration, Acquisition and Grants Group, 7500 Security Blvd. C2-21-15, Central Building, Baltimore, MD, 21244-1850

ZIP Code

21244-1850

Solicitation Number

CMS-02-01-MCD

Response Due

November 15, 2001

Point of Contact

Bart Smetana, Contracting Officer, Phone 410-786-7909, Fax 410-786-9643, Email bsmetana@cms.hhs.gov -- Darrell Bachman, Contract Specialist, Phone 410-786-7442, Fax 410-786-9643, Email DBachman@cms.hhs.gov

Description

The Centers for Medicare and Medicaid Services (CMS), formerly known as the Health Care Financing Administration, intends to procure through full and open competition a contract for the processing of Medicare Part B claims in the states of Ohio and West Virginia. The contractor will perform all of the duties of a Medicare Part B Carrier as described in Section 1842 of the Social Security Act, with the exception of post-payment medical review, data analysis, including data analysis to support the pre-payment review activities, all benefit integrity activities excluding complaint screening, and certain MIP provider education activities, all of which will be the responsibility of a Program Safeguard Contractor (PSC). This PSC will be competitively selected through a competition under CMS's existing PSC Indefinite Delivery Indefinite Quantity contract vehicle, in a procurement that will run concurrently with the Ohio/West Virginia Medicare Part B claims processing procurement. In addition, CMS will be simultaneously procuring, through a GSA competition, a Medicare Contractor Data Center to provide data processing services for the Ohio/West Virginia workload. To be awarded the Medicare Part B claims processing contract for Ohio and West Virginia, the contractor must be a current Medicare Part B Carrier or meet the statutory definition of a Carrier. For purposes of this procurement the statutory definition of a Carrier is as follows: ?with respect to providers of services and other persons, a voluntary association, corporation, partnership, or other non-governmental organization which is lawfully engaged in providing, paying for, or reimbursing the costs of health services under group insurance policies or contracts, medical or hospital service agreements, membership or subscription contracts, or similar group arrangements, in consideration of premiums or other periodic charges payable to the Carrier, including a health benefits plan duly sponsored or underwritten by an employee organization and with respect to providers of services only, any agency or organization with which an agreement is in effect under Section 1816 of the Social Security Act.? =20 Interested parties are asked to respond in writing to this notice when requesting a copy of the Invitation to Compete (ITC). Telephone request for the ITC will not be accepted. Any organization receiving an ITC will automatically receive any amendments to the solicitation. It is anticipated that solicitation number CMS-02-01-MCD will be released approximately November 15, 2001. Requests shall be mailed to the above address or faxed to 410-786-9643. Please direct any inquiries to Bart Smetana at 410.786.7909 or e-mail at bsmetana@cms.hhs.gov

Web Link

Visit this URL for the latest information about this (http://www.eps.gov/spg/HHS/HCFA/AGG/CMS-02-01-MCD/listing.html)

Record

Loren Data Corp. 20011114/RSOL003.HTM (D-313 SN5127T9)