CMS Shifts MA Plan IRE Contractor From Maximus: May 1 Start

The Centers for Medicare and Medicaid Services (CMS) is transitioning responsibility for second-level independent review of Medicare Advantage (MA) plan denials from its current independent review entity (IRE) contractor, Maximus.

In a March 31, 2026 announcement to MA plans, the agency said appeal requests of adverse MA reconsiderations and plan dismissals of appellant reconsideration requests will be handled by C2C Innovative Solutions, Inc. as of May 1.

Maximus will handle all appeals requests received before April 30.

Information for submitting appeals and other communication protocols will be available on C2C's website beginning April 1.

We are not aware of any actions that providers must take at this time, but want to communicate this change as they may begin receiving information from the new IRE in May. Providers who have been using the Maximus portal may wish to familiarize themselves with information on the C2C website prior to the May changeover.

While we know that some providers have expressed frustration with Maximus for frequently siding with the MA plans, it is unclear if those concerns factored into CMS's change of contractor decision.