SAM #7571MN26F80050

Award for Risk Scoring Proof of Concept Pilot with Verato Software for HHS ASFR

This opportunity involves a sole-source award by the Department of Health and Human Services (HHS), Assistant Secretary for Financial Resources (ASFR) Immediate Office, for a Risk Scoring Proof of Concept (Phase 1 Pilot): - Government Buyer: - Department of Health and Human Services (HHS) - Assistant Secretary for Financial Resources (ASFR) - Office of Mission Acquisition Solutions (OMAS), Office of Acquisitions (OA) - Awardee and Key Vendors: - MORPHWORKS INC. (prime contractor) - Verato (OEM for referential matching software, provided via subcontractor Euclidian Trust) - Euclidian Trust (subcontractor for Verato software) - Services Requested: - Risk Scoring Proof of Concept (Phase 1 Pilot) - Design and execution of a standardized, explainable provider risk-scoring capability - Referential matching using Verato software - Data preparation, scoring, anomaly detection, validation support, and executive reporting - Pilot covers six states - Includes validation support and documentation - Notable Requirements: - Use of Verato referential matching software is specified - Focus on improving provider risk scoring to enhance oversight and program integrity - Deliverables include executive-ready reporting and validation support - 90-day period of performance - Estimated contract value: $223,140

Description

The HHS ASFR Immediate Office requires an improved capability to identify, assess, and prioritize health care service providers that may present elevated improper payment risk or related program integrity concerns. ASFR already tracks state-level findings associated with Single Audits and needs a more effective means of leveraging those findings, together with other authoritative reference data, to strengthen oversight, improve accountability, and support more informed communication with states regarding questioned costs, improper payments, and related provider risk indicators.

This requirement is focused on service-provider analysis and provider record quality. It is not intended to involve patient data processing. Phase 1 is a six-state, 90-day proof of concept intended to determine whether a standardized risk-scoring and referential matching approach can generate useful, explainable, and operationally relevant results for ASFR and, as appropriate, support coordination with the Office of Inspector General (OIG).

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