Notice ID: 220312
Contract Award Number: HHSM-500-2004-00007I
Task/Delivery Order Number:75FCMC22F0001
Description of Supplies or Services: The estimated value of the proposed action is $70,623,738.00
“The purpose of the proposed logical follow-on Part C QIC task order is to provide adjudication services in support of the coverage determinations, reconsiderations, and appeals requirements set forth at section 1852(g) of the Social Security Act (the Act), as amended by Title II of the Medicare
Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) (Pub. L. 108-173). The contractor shall act as an independent review entity (IRE), referred to as the Part C QIC, responsible for conducting reconsiderations of adverse organization determinations and adverse reconsiderations made by Medicare Advantage (MA) Organizations (MAO). Organization determinations and reconsiderations include the amount of cost sharing, if any, that the enrollee is required to pay. The contractor is also responsible for reviewing MAO dismissals of appellant reconsideration requests…”
“The Part C QIC program is currently in its final renewal period which will conclude on April 30, 2022, approximately 5 months before the end of the current QIC IDIQ ordering period, which goes through September 22, 2022. CMS plans to renew the QIC IDIQ contracts with the four aforementioned QICs for another three (3) years.”
