E.3_PPI_MEDIC_Workload_Assumptions.docx

This document provides workload projections for the Plan Program Integrity Medicare Drug Integrity Contractor solicitation. The Centers for Medicare and Medicaid Services will issue request for proposal 75FCMC19R0042 to provide proactive and reactive data analysis within Medicare Parts C and D to identify program vulnerabilities. The contractor will share findings with Medicare Advantage and Prescription Drug Plans to support fraud, waste and abuse monitoring efforts. The cost-plus-fixed-fee contract will have a one-year base period and four one-year option periods exercisable at the government's discretion. Workload projections over nine and twelve month periods include self-audits, national audits, program integrity audits, independent dispute resolution user group support, analytics and ad hoc projects, plan sponsor alerts, and requests for information. Offerors should use the projected workloads for proposals and disclose all assumptions.