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Centers for Medicare & Medicaid Services (CMS)

★ Member

Administers Medicare, Medicaid, ACA marketplaces, and CHIP. Largest single payer in the US healthcare system.

MMT's Current Read

CMS is executing the ClaimsCore RFP (the largest claims processing modernization in CMS history) and advancing data modernization across its systems. AI fraud detection and payment integrity are growth areas. CMS procurement is large-scale and long-cycle, with multi-year IDIQs as the dominant vehicle type.

Updated: April 2026

Budget Posture
FY2026 Enacted
$1.1T (mandatory + discretionary)
FY2027 Request
$1.15T
Key Funded Programs
  • ClaimsCore modernization
  • Data modernization
  • AI fraud detection
  • Payment integrity
Programs at Risk
  • ACA marketplace IT funding (policy-dependent)
Upcoming Procurement Signals
  • • ClaimsCore RFP evaluation (ongoing)
  • • Data modernization Phase 2 RFI
Key Program Offices
  • OIT (Office of Information Technology)
  • CCIIO (Center for Consumer Information and Insurance Oversight)
  • OAGM (Office of Acquisition and Grants Management)

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