On March 30, 2026, the Centers for Medicare & Medicaid Services (CMS) announced that C2C Innovative Solutions will replace Maximus in reviewing and processing appeals of adverse organization determinations and reconsiderations made by Medicare Advantage plans, effective May 1. Coverage from AHA News and Washington Technology.
What Maximus loses
The Medicare Advantage appeals function — a discrete but visible piece of CMS work. Maximus had been the long-time incumbent. C2C takes over independent review of:
- Adverse organization determinations by MA plans
- Reconsiderations
- Related appeals processing
What Maximus keeps
The much larger $6.6B CMS Contact Center Operations (CCO) contract remains with Maximus through its base period plus 9 one-year options. Under that contract, Maximus continues supporting CMS contact center operations that help 75 million Americans navigate Medicare benefits and ACA Marketplace insurance programs.
Maximus also retained a 39-month task order as Qualified Independent Contractor for Medicare Part A West, securing $33M in continuing work.
What this signals
- CMS continues to use parallel/multi-vendor procurement for its work — even mature programs face recompete
- Long-tenured incumbents lose discrete program lines while retaining flagship contracts
- Specialty firms like C2C can grow by capturing well-defined functions away from generalist primes
What to do
- If you support Medicare appeals or related health-services work: C2C's expansion creates subcontract opportunity
- If you compete with Maximus elsewhere: incumbent vulnerability is real on discrete program lines
- Watch CMS's broader procurement portfolio — multiple recompetes are visible across CY26