A14_MR_-_RFI_Notice_1.pdf

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RFI Comprehensive Medical Review & Audit Support
Solicitation number
140D0427Q0883
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This is a Request for Information (RFI) issued by the Department of the Interior's Interior Business Center for market research purposes regarding comprehensive medical review and audit support services.

The Government seeks industry feedback on its capability to provide medical review and audit support across five functional areas: audits for Medicare Parts A/B/D and Medicaid; audits for Medicare Part C; evaluations and inspections; expert consultant and witness services for the Office of Investigations; and support services for the Office of Counsel to the Inspector General. Respondents should provide high-level, non-price information addressing corporate capability and experience, including demonstration of core competencies across all five domains, geographic reach for nationwide or multi-jurisdictional medical claim reviews, maximum monthly claim review capacity with scalability approach, and teaming/subcontracting arrangements. Section 2 requires description of high-level technical methodology (limited to five pages), quality assurance frameworks, staffing structure with key qualifications (including physician specialties such as hospice, vascular surgery, nephrology, and physical medicine/rehabilitation), and risk mitigation strategies. Section 3 requests up to three examples each of similar Federal medical review contracts and Federal support services for medical expert consultants performed within the past five years, along with performance outcomes including timeliness, accuracy rates, and appeals overturn rates. Section 4 solicits industry feedback on the draft Performance Work Statement, including identification of ambiguous or infeasible requirements and recommendations for improvement. Responses must be submitted by email by November 13, 2026, at 12:00 PM Eastern Time to Contracting Officer Shavonda Jamison (Shavonda_Jamison@ibc.doi.gov) or Contracting Specialist Dorothy Royster (Dorothy_Royster@ibc.doi.gov). This is market research only; no proposals or quotes will be accepted, responses will not be reimbursed, and submission is not required to participate in any future solicitation.

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United States Department of the Interior

INTERIOR BUSINESS CENTER

Washington, DC 20240

REQUEST FOR INFORMATION

THIS IS A REQUEST FOR INFORMATION (RFI) NOTICE ONLY.

Title: Request for Information (RFI) Comprehensive Medical Review & Audit Support (Medicare Parts A/B/C/D and Medicaid; Evaluations & Inspections; Investigations; Office of Counsel to the Inspector General)

Notice Type: RFI (Market Research under Federal Acquisition Regulation (FAR) Part 10) This is not a solicitation. No proposals or quotes will be accepted.

Description:

This RFI is issued in accordance with FAR Part 10 to conduct market research. The Government’s purpose is planning only; this notice does not constitute a Request for Proposal (RFP)/Request for Quotation (RFQ) nor a promise to issue one in the future. The Government will not pay any costs for responding, and any submissions become Government property and will not be returned. Not responding to this RFI does not preclude participation in any future procurement. The Government is not seeking proposals or quotes at this time.

Scope of Interest / Functional Areas:

The Government is assessing the market’s capability to provide comprehensive support under the following disciplines:

• Audits for Medicare Parts A, B, D, and Medicaid medical record review and consultative services

• Audits for Medicare Part C medical record review and consultative services

• Evaluations and Inspections medical record review and consultative services

• Expert consultant and witness services in support of the Office of Investigations and/or Office of Counsel to the Inspector General

A draft Performance Work Statement (PWS) is provided for industry feedback; requirements may change prior to any future solicitation.

Requested Information (do not submit proposals or quotes):

Please provide high-level, non-price-specific information addressing the elements below. Do not include proprietary pricing, line-item estimates, or any proposal/quote content.

Section 1: Corporate Capability & Experience

• PWS Alignment: Demonstrate your organization's core capability to fulfill the functional areas outlined in the draft PWS.

• Medical Review Experience: Outline your firm's high-level experience in conducting large-volume medical claims reviews for audits and evaluations and inspections; and support services for medical expert consultants and witnesses specifically across the following five domains (as referenced in the attached PWS):

1. Audit – Medicare Parts A/B/D and Medicaid

2. Audit – Medicare Part C

3. Evaluations and Inspections

4. Office of Investigations

5. Office of Counsel to the Inspector General

• Geographic Reach: Describe your prior experience managing and executing nationwide or multi-jurisdictional medical claim reviews.

• Capacity & Scalability: State your organization's maximum monthly claim review capacity, including your approach to scaling operations between normal workloads and surge conditions.

• Teaming & Subcontracting: Identify potential subcontracting partners or specialized vendors you would anticipate utilizing, including an estimated percentage breakdown of work performed by the prime contractor versus subcontractors.

Section 2: High-Level Technical Approach & Operations

• High-Level Technical Methodology: Describe your conceptual approach to fulfilling the core tasks in PWS. Please limit this narrative to no more than 5 pages total, organized by the 5 PWS sections. Focus on your overarching claims review methodology, general sampling plan frameworks, documentation standards, and typical project timelines rather than a granular, step-by-step solution.

• Quality & Accuracy Frameworks: Outline your corporate quality assurance processes, internal review protocols, and standard strategies used to reduce error rates and ensure consistency across large volumes.

• Staffing & Key Qualifications: Provide a conceptual staffing structure or organizational chart.

Identify the typical roles, credentials (e.g., MD, RN, CPC), and qualifications of the key personnel required to successfully support a PWS of this nature. Please identify whether these staff will need to be hired or if they are current employees/contractors. Also, indicate staffing availability for physicians with specialties (i.e. hospice, vascular surgeon, nephrologist, physical medicine and rehabilitation or physiatrists).

• Risk & Mitigation: Identify the primary technical or operational challenges anticipated with a medical review scope of this size and outline your high-level mitigation strategies.

Section 3: Past Performance & Market Pricing

• Relevant Past Performance: Provide up to three examples of similar Federal medical review contracts performed within the last five years. Also, provide up to three examples of similar Federal support services for medical expert consultants and witnesses within the last five years.

• Performance Outcomes: Summarize the high-level outcomes of those past contracts, focusing on standard metrics such as timeliness, accuracy rates (including rate at which findings were overturned during the appeals process), and a history of successful audit findings.

• Cost Drivers & Efficiencies: Provide a general overview of your commercial pricing structure and the primary cost drivers (e.g., specific labor categories, specialized technology/AI tools, administrative overhead). Highlight any built-in efficiencies or innovative workflows in your approach that typically yield cost savings for the government.

Section 4: Industry Feedback & PWS Refinement

• Clarity & Feasibility Review: Identify any requirements, metrics, or tasks within the draft PWS that appear ambiguous, overly restrictive, or technologically infeasible based on current commercial market capabilities.

• Recommendations for Improvement: Suggest specific enhancements, industry standard metrics, or structural changes to the PWS that would improve the clarity, feasibility, and competitiveness of the final solicitation.

Submission Instructions:

Email responses by November 13, 2026, 12:00 PM Eastern Time to the Points of Contact below. Mark proprietary information clearly; the Government may use non-proprietary information to refine its acquisition approach.

Points of Contact:

• Contracting Officer: Shavonda Jamison — Shavonda_Jamison@ibc.doi.gov

• Contracting Specialist: Dorothy Royster — Dorothy_Royster@ibc.doi.gov

Attachments:

• Draft PWS (for market research and feedback only; subject to change).

Disclaimer:

This RFI is for market research; it does not commit the Government to any acquisition. The Government will not reimburse costs for responding. Not responding does not preclude participation in any future solicitation. No proposals or quotes will be accepted in response to this notice.

mailto:Shavonda_Jamison@ibc.doi.gov mailto:Dorothy_Royster@ibc.doi.gov

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