MAC Performance Compliance

The Medicare Access and CHIP Reauthorization Act of 2015 sets forth a provision in Section 509 that requires contractor performance transparency to the extent possible without compromising the process for entering into and renewing contracts with Medicare Administrative Contractors (MAC).  Under this section, the Secretary shall make available to the public the performance of each MAC with respect to such performance requirements and measurement standards.

As per FAR 46.401 Government contract quality assurance shall be performed at such times and places to determine that the supplies or services conform to contract requirements. Quality assurance surveillance plans (QASP) should be prepared in conjunction with the preparation of the Statement of Work (SOW). The QASP’s purpose is to measure the MAC's compliance with the SOW requirements (QASP reviews cover a major subset of the SOW requirements but does not cover an exhaustive list of SOW requirements for each MAC. The Overall Performance Compliance percentages below represent a cumulative value of contract standards considered to be met as part of the CMS QASP.

Please note that data only includes select QASP standards and metrics that are evaluated across all MAC contracts for a specific fiscal year, and metrics may vary from year to year for performance oversight purposes. In FY2019, FY2020 and FY2021 MACs were evaluated on approximately 80 performance metrics/requirements for Part A/B and 50 performance metrics/requirements for DME. For reporting purposes, the fiscal year is determined based on the MACs period of performance end date.