Maximus Medicare Advantage Adverse-Determination Appeals Contract Lost to C2C Innovative Solutions (May 2026)

Pre-registered Phoenix-Cycle falsification (BST III paper protocol, Report #86 May 8 2026). The original Maximus single-point-of-control thesis at the CMS layer was strictly tested by tracking ALL Medicare-related contract activity, not just the keystone 1-800-MEDICARE contact-center contract. Empirical falsification: April-May 2026, CMS announced that C2C Innovative Solutions won the contract for reviewing and processing appeals of Medicare Advantage adverse organization determinations and reconsiderations — REPLACING Maximus, which had previously held this work. Engine framing: this falsification proves that the federal layer retains operational alternatives in specific Medicare sub-domains. Maximus's CMS dominance is confined to the 1-800-MEDICARE + Healthcare.gov contact center keystone (where federal lawsuit forced 2024 CMS capitulation on early rebid) — it does NOT extend to every CMS contract category by default. The structural-insulation mechanism (H3 confirmed) operates through entitlement-mandatory-spending function, not through reflexive incumbent renewal. Falsifiability discipline: divergence resolves if Maximus reclaims the MA appeals contract or any equivalent CMS sub-contract within 24 months, or if the loss generalizes — i.e., if 2+ additional CMS sub-contracts also pivot to non-Maximus operators within the same window, signaling a broader CMS-deconcentration trajectory that would compress the H1-CMS-keystone-confirmation.