04-25-0030 TPS Medical Claims Adjudication Services.pdf

This document is a Justification for Other Than Full and Open Competition for a Medical Claims Adjudication (MCA) services contract with Aprio Inc. The U.S. Department of Justice, Federal Bureau of Prisons is seeking a firm-fixed-price contract for a 12-month period valued at $5,930,000.00. The MCA system is a hybrid design leveraging the FLEXIS QC core administrative processing platform, which enables Aprio to customize a system for fraud monitoring and detection. The system will include real-time tracking of database elements, fraud alerts, customized Explanation of Benefits reports, and analytic tools to analyze system data.

The procurement is being justified under 41 U.S.C. 3304(a)(2) as an unusual and compelling urgency that precludes full and open competition. Aprio is identified as the only responsible source capable of providing a custom BOP system without duplicating existing costs. The company has developed a custom interface allowing BOP systems to transmit and receive information using Amazon Web Services AppStream. The agency will publish the unusual and compelling justification within 30 days of contract entry, as required by federal procurement regulations.