Centers for Medicare & Medicaid Services #261595

Medical Record Review Services for Medicare RADV Program

The Centers for Medicare and Medicaid Services (CMS), through the Center for Program Integrity (CPI) and the ASG - DPIFMC division, is seeking a contractor to provide medical record review services for the Medicare Contract-level Risk Adjustment Data Validation (RADV) program. - Government Buyer: - Centers for Medicare and Medicaid Services (CMS) - Center for Program Integrity (CPI), ASG - DPIFMC division - Scope of Work: - Medical Record Review Contractor (MRRC) services to support RADV audits - Focus on ensuring accuracy of payments to Medicare Advantage plans - No specific OEMs or product manufacturers required - Contract Details: - Firm Fixed Price order - Competed under the 8(a) program - Estimated total value: $50 million to $100 million over five years - Notable Requirements: - Specialized expertise in medical record review and audit processes - Supports CMS's ongoing efforts to improve Medicare payment accuracy - No specific products or part numbers requested; requirement is for professional services only

Description

The Centers for Medicare and Medicaid Services (CMS) Center for Program Integrity (CPI) is seeking a Medical Record Review Contractor (MRRC) for the Medicare Contract-level Risk Adjustment Data Validation (RADV) program. The contract aims to ensure the accuracy of payments to Medicare Advantage plans through RADV audits. The contract duration is 5 years with an estimated total value between $50 million and $100 million, including options. The acquisition method is 8(a) competed with a firm fixed price contract type.

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