SAM #36C10G26D0030

VA justification for proposed sole-source community-care claims processing and customer-service support

The VA issued a justification for a proposed sole-source contract to maintain nationwide community-care claims and customer-service operations during transition to a long-term solution. - Contracting action: Firm-fixed-price indefinite-delivery/indefinite-quantity (FFP IDIQ) contract proposed for incumbent Signature Choice, LLC. - Purpose: Preserve continuity of Veterans Health Administration Office of Veterans Community Care services during the transition; the current contract ends November 7, 2026. - Services: Claims eligibility and authorization checks, community-care claims adjudication, provider billing support, claims-processing IT support, customer-service call centers, and a 24/7 emergency-care notification line. Coverage includes Veteran and Family Member Programs (VFMP), Centralized Authorizations for Emergency Care (CAEC), and non-network claims processing. - Additional requirement: Reissue approximately 2,000 PIV cards during the base period, with the cards required within the first 90 days. - Estimated value: $517 million. - Performance period: Base period November 1, 2026–October 31, 2027; two options covering November 1, 2027–October 31, 2028, and November 1, 2028–April 30, 2029. Exercising all options would provide up to 30 months of performance. - Products and OEMs: No commercial product part numbers or product quantities are identified; no OEM is specified.

Description

This Justification and Approval (J&A) will facilitate the award of an FFP IDIQ Contract that will prevent a lapse in critical services for the Veterans Health Administration (VHA) Office of Veterans Community Care (VCC) in support of Veteran and family member care in the community, while the follow-on transition is underway.

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