ClaimsCore Combined Synopsis/Solicitation 75FCMC26R0022

This is a combined synopsis/solicitation for commercial products or commercial services prepared in accordance with FAR part 12. This announcement constitutes the only solicitation. Offers are being requested and a separate written solicitation will not be issued. Solicitation number 75FCMC26R0022 is issued as a request for proposal (RFP) for ClaimsCore. The ClaimsCore program seeks to re-platform Medicare Fee for Service claims processing by replacing legacy Shared Systems including the Multi-Carrier System (MCS), Fiscal Intermediary Shared System (FISS) and Durable Medical Equipment Claims System (DME) as well as the Common Working File (CWF) with a flexible and interoperable platform that reduces administrative burden and sets improvement of the beneficiary experience as the program s guiding objective. CMS intends to procure a Software as a Services (SaaS) Commercially-Available-Off-The-Shelf (COTS) product and complimentary configuration and integration services that will provide CMS with near real-time adjudication and claims status, policy agility, industry leading enterprise tools, improved fraud prevention capabilities, and tighter integration across CMS, Medicare Administrative Contractor (MACs), providers, and partners. This acquisition is not set-aside for small business concerns. This solicitation incorporates provisions and clauses by reference. The full text of provisions and clauses may be accessed electronically at www.acquisition.gov. Contract Line Item Number (CLIN) Structure: See Attached Soliciation-75FCMC26R0022 for a full breakdown of the CLIN structure, items, quantities, and units of measure (including option(s)). See Attachment 1 ClaimsCore Statement of Objectives for full description of the requirements being acquired. See the attached Solicitation - 75FCMC26R0022 and Attachment 5 - FAR 52.212-5 to find the full list of solicitation provisions and contract clauses that apply to the acquisition (see 12.205(a)). Date, Response Times, Place for receipt of offer and Point of Contacts: All questions regarding this solicitation shall be submitted via electronic mail (e-mail) no later than 11:00 am Eastern Time (ET) on March 6, 2026 to Contract Specialist, Lauren Holsey, at Lauren.Holsey@cms.hhs.gov and cc: Contracting Officer, Candace Straker, at Candace.Straker@cms.hhs.gov. Offerors shall submit Phase One (1) proposals via electronic mail (e-mail) no later than 11:00 am Eastern Time (ET) on March 13, 2026 to Contract Specialist, Lauren Holsey, at Lauren.Holsey@cms.hhs.gov and cc: Contracting Officer, Candace Straker, at Candace.Straker@cms.hhs.gov. See Attachment 3 - ClaimsCore Instructions to Offerors for full instructions.

ClaimsCore Combined Synopsis/Solicitation Amendment 0001 - The purpose of this amendment is to 1) provide responses to RFP questions, 2) provide an Amended Solicitation - 75FCMC26R0022, 3) provide an amended Attachment 1 - ClaimsCore SOO, 4) provide an Amended Attachment 3 - ClaimsCore Instructions to Offerors, and 5) rename and provide an amended Attachment 6 - Beneficiary Quantities Claims and Unit Pricing. This is a combined synopsis/solicitation for commercial products or commercial services prepared in accordance with FAR part 12. This announcement constitutes the only solicitation. Offers are being requested and a separate written solicitation will not be issued. Solicitation number 75FCMC26R0022 is issued as a request for proposal (RFP) for ClaimsCore. The ClaimsCore program seeks to re-platform Medicare Fee for Service claims processing by replacing legacy Shared Systems including the Multi-Carrier System (MCS), Fiscal Intermediary Shared System (FISS) and Durable Medical Equipment Claims System (DME) as well as the Common Working File (CWF) with a flexible and interoperable platform that reduces administrative burden and sets improvement of the beneficiary experience as the program s guiding objective. CMS intends to procure a Software as a Services (SaaS) Commercially-Available-Off-The-Shelf (COTS) product and complimentary configuration and integration services that will provide CMS with near real-time adjudication and claims status, policy agility, industry leading enterprise tools, improved fraud prevention capabilities, and tighter integration across CMS, Medicare Administrative Contractor (MACs), providers, and partners. This acquisition is not set-aside for small business concerns. This solicitation incorporates provisions and clauses by reference. The full text of provisions and clauses may be accessed electronically at www.acquisition.gov. Contract Line Item Number (CLIN) Structure: See Attached Soliciation-75FCMC26R0022 for a full breakdown of the CLIN structure, items, quantities, and units of measure (including option(s)). See Attachment 1 ClaimsCore Statement of Objectives for full description of the requirements being acquired. See the attached Solicitation - 75FCMC26R0022 and Attachment 5 - FAR 52.212-5 to find the full list of solicitation provisions and contract clauses that apply to the acquisition (see 12.205(a)). Date, Response Times, Place for receipt of offer and Point of Contacts: All questions regarding this solicitation shall be submitted via electronic mail (e-mail) no later than 11:00 am Eastern Time (ET) on March 6, 2026 to Contract Specialist, Lauren Holsey, at Lauren.Holsey@cms.hhs.gov and cc: Contracting Officer, Candace Straker, at Candace.Straker@cms.hhs.gov. Offerors shall submit Phase One (1) proposals via electronic mail (e-mail) no later than 11:00 am Eastern Time (ET) on March 13, 2026 to Contract Specialist, Lauren Holsey, at Lauren.Holsey@cms.hhs.gov and cc: Contracting Officer, Candace Straker, at Candace.Straker@cms.hhs.gov. See Attachment 3 - ClaimsCore Instructions to Offerors for full instructions.

ClaimsCore Combined Synopsis/Solicitation Amendment 0002- The purpose of this amendment is to correct the Phase 1 RFP submission due date as stated in Amendment 2 - Attachment 3, ClaimsCore Instructions to Offerors. ClaimsCore Combined Synopsis/Solicitation Amendment 0001 - The purpose of this amendment is to 1) provide responses to RFP questions, 2) provide an Amended Solicitation - 75FCMC26R0022, 3) provide an amended Attachment 1 - ClaimsCore SOO, 4) provide an Amended Attachment 3 - ClaimsCore Instructions to Offerors, and 5) rename and provide an amended Attachment 6 - Beneficiary Quantities Claims and Unit Pricing. This is a combined synopsis/solicitation for commercial products or commercial services prepared in accordance with FAR part 12. This announcement constitutes the only solicitation. Offers are being requested and a separate written solicitation will not be issued. Solicitation number 75FCMC26R0022 is issued as a request for proposal (RFP) for ClaimsCore. The ClaimsCore program seeks to re-platform Medicare Fee for Service claims processing by replacing legacy Shared Systems including the Multi-Carrier System (MCS), Fiscal Intermediary Shared System (FISS) and Durable Medical Equipment Claims System (DME) as well as the Common Working File (CWF) with a flexible and interoperable platform that reduces administrative burden and sets improvement of the beneficiary experience as the program s guiding objective. CMS intends to procure a Software as a Services (SaaS) Commercially-Available-Off-The-Shelf (COTS) product and complimentary configuration and integration services that will provide CMS with near real-time adjudication and claims status, policy agility, industry leading enterprise tools, improved fraud prevention capabilities, and tighter integration across CMS, Medicare Administrative Contractor (MACs), providers, and partners. This acquisition is not set-aside for small business concerns. This solicitation incorporates provisions and clauses by reference. The full text of provisions and clauses may be accessed electronically at www.acquisition.gov. Contract Line Item Number (CLIN) Structure: See Attached Soliciation-75FCMC26R0022 for a full breakdown of the CLIN structure, items, quantities, and units of measure (including option(s)). See Attachment 1 ClaimsCore Statement of Objectives for full description of the requirements being acquired. See the attached Solicitation - 75FCMC26R0022 and Attachment 5 - FAR 52.212-5 to find the full list of solicitation provisions and contract clauses that apply to the acquisition (see 12.205(a)). Date, Response Times, Place for receipt of offer and Point of Contacts: All questions regarding this solicitation shall be submitted via electronic mail (e-mail) no later than 11:00 am Eastern Time (ET) on March 6, 2026 to Contract Specialist, Lauren Holsey, at Lauren.Holsey@cms.hhs.gov and cc: Contracting Officer, Candace Straker, at Candace.Straker@cms.hhs.gov. Offerors shall submit Phase One (1) proposals via electronic mail (e-mail) no later than 11:00 am Eastern Time (ET) on March 13, 2026 to Contract Specialist, Lauren Holsey, at Lauren.Holsey@cms.hhs.gov and cc: Contracting Officer, Candace Straker, at Candace.Straker@cms.hhs.gov. See Attachment 3 - ClaimsCore Instructions to Offerors for full instructions.

ClaimsCore Combined Synopsis/Solicitation Amendment 0003- The purpose of this amendment is to request offerors provide a copy of any CTA, as applicable in Phase 2 as stated in Amendment 3 - Attachment 3, ClaimsCore Instructions to Offerors. ClaimsCore Combined Synopsis/Solicitation Amendment 0002- The purpose of this amendment is to correct the Phase 1 RFP submission due date as stated in Amendment 2 - Attachment 3, ClaimsCore Instructions to Offerors. ClaimsCore Combined Synopsis/Solicitation Amendment 0001 - The purpose of this amendment is to 1) provide responses to RFP questions, 2) provide an Amended Solicitation - 75FCMC26R0022, 3) provide an amended Attachment 1 - ClaimsCore SOO, 4) provide an Amended Attachment 3 - ClaimsCore Instructions to Offerors, and 5) rename and provide an amended Attachment 6 - Beneficiary Quantities Claims and Unit Pricing. This is a combined synopsis/solicitation for commercial products or commercial services prepared in accordance with FAR part 12. This announcement constitutes the only solicitation. Offers are being requested and a separate written solicitation will not be issued. Solicitation number 75FCMC26R0022 is issued as a request for proposal (RFP) for ClaimsCore. The ClaimsCore program seeks to re-platform Medicare Fee for Service claims processing by replacing legacy Shared Systems including the Multi-Carrier System (MCS), Fiscal Intermediary Shared System (FISS) and Durable Medical Equipment Claims System (DME) as well as the Common Working File (CWF) with a flexible and interoperable platform that reduces administrative burden and sets improvement of the beneficiary experience as the program s guiding objective. CMS intends to procure a Software as a Services (SaaS) Commercially-Available-Off-The-Shelf (COTS) product and complimentary configuration and integration services that will provide CMS with near real-time adjudication and claims status, policy agility, industry leading enterprise tools, improved fraud prevention capabilities, and tighter integration across CMS, Medicare Administrative Contractor (MACs), providers, and partners. This acquisition is not set-aside for small business concerns. This solicitation incorporates provisions and clauses by reference. The full text of provisions and clauses may be accessed electronically at www.acquisition.gov. Contract Line Item Number (CLIN) Structure: See Attached Soliciation-75FCMC26R0022 for a full breakdown of the CLIN structure, items, quantities, and units of measure (including option(s)). See Attachment 1 ClaimsCore Statement of Objectives for full description of the requirements being acquired. See the attached Solicitation - 75FCMC26R0022 and Attachment 5 - FAR 52.212-5 to find the full list of solicitation provisions and contract clauses that apply to the acquisition (see 12.205(a)). Date, Response Times, Place for receipt of offer and Point of Contacts: All questions regarding this solicitation shall be submitted via electronic mail (e-mail) no later than 11:00 am Eastern Time (ET) on March 6, 2026 to Contract Specialist, Lauren Holsey, at Lauren.Holsey@cms.hhs.gov and cc: Contracting Officer, Candace Straker, at Candace.Straker@cms.hhs.gov. Offerors shall submit Phase One (1) proposals via electronic mail (e-mail) no later than 11:00 am Eastern Time (ET) on March 13, 2026 to Contract Specialist, Lauren Holsey, at Lauren.Holsey@cms.hhs.gov and cc: Contracting Officer, Candace Straker, at Candace.Straker@cms.hhs.gov. See Attachment 3 - ClaimsCore Instructions to Offerors for full instructions.

This Firm-Fixed-Price (FFP) contract was awarded as the result of a competitive procurement.