Inactive

The scope of the resulting contract(s) will include medical review and consultative services associated with the oversight activities of the OIG primarily involving Medicare fee-for-service payments. ... The scope of the resulting contract(s) will include medical review and consultative services associated with the oversight activities of the OIG primarily involving Medicare fee-for-service payments. Occasionally it may include assessment of services and claims for Medicaid or Medicare Part D. Based on prior experience, the resulting contract(s) will require medical review of approximately 100-200 claims and associated medical records per audit and approximately 2,000-3,000 claims and associated medical records per annum, but actual workload under the resulting contract(s) could fluctuate based on potential future changes in OIG’s budget, shifts in OIG’s priorities, and other factors. The scope of the resulting contract(s) will not include determining OIG priorities; identifying auditees and subject matter of audits; claims sampling; and establishing audit objectives, scope and methodology; however, OIG may in its discretion ask for input on these matters as part of consultative services (see below). OIG will collect claims data, medical records and other supporting documents in accordance with each audit’s objectives. OIG will transmit those documents electronically through its secure file transfer system or occasionally in hard copy through the U.S. Postal Service or other parcel delivery service. The resulting contract(s) will not include responsibility for those functions.

Inactive

This Sources Sought Synopsis is seeking small business sources to determine the availability and capability on providing medical review and consultative services associated with the oversight activiti... This Sources Sought Synopsis is seeking small business sources to determine the availability and capability on providing medical review and consultative services associated with the oversight activities of the OIG primarily involving Medicare fee-for-service payments. The anticipated North American Industry Classification System Code (NAICS) for this requirement is 541611 Administrative Management and General Management Consulting Services, $16.5M. This Sources Sought Synopsis is requesting responses to the following criteria ONLY from all sources that can provide the required services under the NAICS Code 541611. To assist the AD Office in making a determination regarding the level of participation by small business in any subsequent procurement that may result from this Sources Sought, you are also encouraged to provide information regarding your plans to use joint venturing (JV) or partnering to meet the requirement. This includes responses from qualified and capable Small Businesses, Small Disadvantaged Businesses, Service Disabled-Veteran Owned Small Businesses, Women-owned Small Businesses, HUBZone Small Businesses, and 8(a) companies. You should provide information on how you would envision your company's areas of expertise and those of any proposed JV/partner would be combined to meet the specific requirements contained in this announcement. In order to make a determination for a small business set-aside, two or more qualified and capable small businesses must submit responses that demonstrate their qualifications. Responses must demonstrate the company’s ability to perform in accordance with the Limitations on Subcontracting clause (FAR 52.219-14).

Inactive

***THIS IS A DRAFT SOLICITATION*** ***ALL DATES POSTED ARE TENTATIVE WITH FINAL DATES TO BE PROVIDED BY COB 17 JULY 2020*** ***WHITE PAPERS ARE NOT DUE ON 20 JULY 2020*** The Office of Inspector Gener... ***THIS IS A DRAFT SOLICITATION*** ***ALL DATES POSTED ARE TENTATIVE WITH FINAL DATES TO BE PROVIDED BY COB 17 JULY 2020*** ***WHITE PAPERS ARE NOT DUE ON 20 JULY 2020*** The Office of Inspector General (OIG) will be hosting an Industry Day to pursue the acquisition of medical review (MR) and consultative services to assist the OIG in conducting its’ oversight responsibilities regarding the programs operated by the Department of Health and Human Services (HHS). The acquisition will primarily result in services that support the OIG’s auditing function and the production of audit reports. The resulting contract will include professional services to determine whether selected medical services and claims pertaining to beneficiaries of Medicare (and occasionally Medicaid) complied with coverage, coding, payment, and billing requirements and to provide medical consultative services to the OIG with respect to such services and claims. The acquisition is primarily to assess services and claims for Medicare fee-for-service payments for Part A and Part B. Other analyses on an infrequent basis may include assessment of services and claims for Medicaid or the Medicare Prescription Drug Plan (Part D). While individual reviews may comprise 100-200 claims, annual volume is expected to be 2,000-3,000 claims. In order to participate in the Industry Day event for this notice, please follow the dirctions in the documents labeled Medical Review Solicitation Number OIG260145, and OIG260145-SOO Medical Review.