JA - 3 month extension.pdf

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Attached to
Part D Formulary and Benefits Review Federal contract opportunity
Solicitation number
CMSFormulary2025
Issued by
Department of Health and Human Services Centers for Medicare and Medicaid Services

About this file

This is a Justification and Approval (J&A) document for a 3-month contract extension for a Part D Formulary and Benefits Review with the Centers for Medicare and Medicaid Services (CMS). The contract modification (number 75FCMC20C0027) is being awarded to Rainmakers Strategic Solutions under the Small Business Administration's (SBA) 8(a) program, which allows non-competitive awards to certified 8(a) contractors for contracts up to $4.5 million. The extension is designed to align the contract performance period from September 30th to December 31st to match the formulary review schedule, ensuring the business review occurs during the middle of the performance period rather than the end.

The total estimated value of the proposed action is $200,000, with funding coming from Program Ops and Medicare/Medicaid Financial Alignment. The contract will be extended at the same funding level and remain a Firm Fixed Price agreement. The modification is being processed to provide additional time for the subsequent contract, which is slated to begin market research on January 1, 2026. Key personnel include Mark Smolenski as the Contracting Officer, Jenna McLean as the Contracting Officer's Representative (COR), and Brian Martin as the COR Supervisor, who have all certified the accuracy and completeness of the justification.

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JUSTIFICATION AND APPROVAL

FOR OTHER THAN FULL AND OPEN COMPETITION

Acquisition Title:

Agency:

Acquisition Year (FY):

Author and Title:

2. Description of Action

Nature: New Requirement Follow-on Requirement

Modification to Existing Purchase Order/Contract Number:

Pricing: Firm-Fixed Price Time & Materials Cost

Other:

Funds: OMA Other Funds:

Name of Proposed Contractor(s):

Street Address:

City, State, Zip:

3. Description of Services or Supplies:

Basis for Approval (FAR 6.303-1(d)): Individual Basis Class Basis

The total estimated value of the proposed action, including all options is $ https://www.acquisition.gov/far/part-6#FAR_6_303_1

4. Authority and Rationale: Identify the statutory authority, FAR title and FAR citation permitting other than full and open competition. It may be one of the following most commonly used citations by the operating divisions of the Department of Health and Human Services (HHS), but other exceptions may apply per FAR Subpart 6.3.

Actions other than simplified acquisition procedures (select only one and provide an explanation):

FAR 6.302-1: Only one responsible source and no other supplies or services will satisfy agency requirements, 41 U.S.C.

3304(a)(1)

Explain why the intended contractor is the only responsible source who can provide the required supplies or s ervices.

Discuss the unique capabilities, expertise, etc. that support the lack of competition/why no other type of supplies or servic es will satisfy agency requirements. Explain factors/unique qualifications such as proprietary data or exclusive licensing rights, if applicable. When competition is limited to items particular to one manufacturer, this justification must explain why the particular brand name, product, or feature is essential to the Government's requirements, and that market research indicates other companies' similar products, or products lacking the particular feature, do not meet, or cannot be modified to meet the agency's needs in accordance with FAR 11.105. If in connection with a follow-on contract for continued development or production of highly specialized equipment, detail the substantial duplication of cost or unacceptable delays.

FAR 6.302-2: Unusual and compelling urgency, 41 U.S.C. 3304(a)(2)

If unusual and compelling urgency is the basis for the justification, explain the chronological events leading up to the requirement and explain why time constraints cannot permit even a limited competition. Describe the detrimental effects/ serious injury to the mission of the requiring activity or to the government, financial or otherwise, that will result if this justification is not approved. Describe impact of required delivery/performance date. Describe the detrimental effects/ serious injury to the mission of the requiring activity or to the government, financial or otherwise, that will result if this justification is not approved and the product or service cannot be provided by the intended sole source contractor. Failure to plan for expiring funds is not a valid reason for citing this exception. May not exceed one year, including all options, unless the head of the agency determines that exceptional circumstances apply.

FAR 6.302-5: Authorized or Required by Statute, 41 U.S.C. 3304(a)(5)

Provide a citation to the statutory authorization and a brief description of its content, or identify the specified source or other agency.

Other (See FAR Subpart 6.3 for additional authority)

Provide the authority and citation to the applicable section of FAR 6.3.

Provide a full explanation to justify use of the exception.

5. Agency Actions to Take or Remove Barriers That Led to Other Than Full and Open Competition (If applicable):

https://www.acquisition.gov/far/part-6#FAR_6_302_1 https://www.acquisition.gov/far/part-6#FAR_Subpart_6_3 https://www.acquisition.gov/far/part-11#FAR_11_105 https://www.acquisition.gov/far/part-6#FAR_6_302_2 https://www.acquisition.gov/far/part-6#FAR_6_302_5 https://www.acquisition.gov/far/part-6#FAR_Subpart_6_3 https://www.acquisition.gov/far/part-6#FAR_Subpart_6_3

6. Bridge Contracts:

For contract extensions or bridge contracts when a competitive follow-on is in the process of being developed, summarize history of current contract and explain the reasons for any delays in the acquisition. Include discussion of the milestones f or the follow-on action; the milestones should be as efficient as possible. Discuss why it would be neither cost effective nor realistic to expect another contractor to perform during the brief interim period; include issues such as start -up costs, phase-in, transfer of GFP, recruitment and staffing, etc. If the action is because of a protest, provide a brief discussion of the protest including the date the protest was filed and the basis of the protest. Explain that the action will provide the minimum quant ity or performance period.

7. Actions to Increase Competition:

8. Market Research:

9. Procurement History:

Purchase order or contract number:

Was action competed? Yes No

If action was not competed, state the cited authority, summarize rationale, and describe the actions that were supposed to be taken to increase competition and the results thereof:

https://www.acquisition.gov/far/part-5#FAR_Subpart_5_2

10.Additional Information to support the justification:

11. Technical / Requirements Certification: By my signature below, I certify that the supporting data included in this

J&A is accurate and complete.

Program Manager or Contracting Officer's Representative (COR)

Name:

Position Title:

Email address:

Phone:

Program Manager or COR Supervisor (or one level above Program Manager or COR)

Name:

Position Title:

Email address:

Signature:

Date:

12. Fair and Reasonable Price/Cost Determination: As Contracting Officer, by my signature below, I hereby determine that the anticipated price/cost to the Government for this contract action will be fair and reasonable.

Name: Phone:

Signature: Date:

13. Contracting Officer's Approval (Required for proposed contract not to exceed $700,000 (value calculated including all options)): I hereby certify that this justification is accurate and complete to the best of my knowledge. I approve this justification subject to availability of funds, and provided that the services and supplies herein described have otherwise been authorized for acquisition.

Name: Phone:

Signature: Date:

14. Legal Review:

15. OPDIV Competition Advocate Approval (Required for proposed contract over $700,000 but not exceeding $13.5 million (value calculated including all options)):

I have reviewed this justification and find that it adequately supports other than full and open competition.

Name: Phone:

Signature: Date:

16. Office of Small and Disadvantaged Business Utilization Review: (Required for contracts exceeding $68 million (value calculated including all options)):

Concur: Non-Concur:

Name: Phone:

Signature: Date:

17. OPDIV HCA Approval (Required for proposed contract over $13.5 million but not exceeding $68 million (value calculated including all options)):

Name: Phone:

Signature: Date:

18. Department Competition Advocate (Required for contracts exceeding $68 million (value calculated including all options)):

Concur: Non-Concur:

Name: Phone:

Signature: Date:

19. HHS Senior Procurement Executive (SPE) Approval:

Based on the foregoing justification, I hereby approve other than full and open competition for the above stated procurement, subject to the availability of funds, and provided that the services herein described have otherwise been authorized for acquisition.

State supplies/services being procured:

State the full statutory authority and FAR cite and title, consistent with paragraph 4, e.g. 41 U.S.C. 3304:

Name: Phone:

Signature: Date:

Modificationto Existing Purchase OrderContract Number: 75FCMC20C0027
Other:
Other Funds: Program Ops and Medicare/Medicaid Finan. Alignment Model
Name: Jenna McLean
Position Title: COR
Email address: jenna.mclean@cms.hhs.gov
Phone: 410-786-1822
Name_2: Brian Martin
Position Title_2: COR Supervisor
Email address_2: brian.martin@cms.hhs.gov
Date: 2/19/2025
Phone_2: 410-786-0175
Date_2: 05/22/2025
Phone_3: 410-786-0175
Date_3: 05/22/2025
Name_3: N/A
Phone_4:
Date_4:
Name_4: N/A
Phone_5:
Date_5:
Name_5: N/A
Phone_6:
Date_6:
Name_6: N/A
Phone_7:
Date_7:
Name_7: N/A
Phone_8:
Date_8:
Text51: Part D Formulary and Benefits Review
Text52: Mark Smolenski, Contracting Officer
Text53: 2025
Dropdown54: [CMS]
Check Box55: Off
Check Box56: Off
Check Box57: Yes
Check Box58: Yes
Check Box59: Off
Check Box60: Off
Check Box61: Off
Check Box62: Yes
Text63: Rainmakers Strategic Solutions
Text64: 3545 Ellicott Mills Drive
Text65: Ellicott City, MD 21043
Check Box66: Yes
Check Box67: Off
Text68: 200,000.
Text69: The purpose of this contract is to review prior authorizations and step therapy criteria that are submitted by plan sponsors to CMS via the Health Plan Management System to ensure they meet the standards outlined in Chapter 6 of the Medicare Prescription Drug Benefit Manual. The purpose of this justification is to extend Contract No. 75FCMC20C0027 for an additional three months at the same fixed price amount in accordance with FAR 52.217-8. At the time of award, an optional six month term was not evaluated to invoke FAR Clause 52.217-8 and per GAO case Major Contracting Services, Inc., B-401472 if the optional six month term was not evaluated at the time of award, a six month extension effectively constitutes a new procurement.
Text70:
Text71:
Check Box72: Off
Check Box73: Off
Check Box74: Yes
Check Box75: Off
Text76:

This contract was awarded in accordance with Section 8(a) of the Small Business Act (15 USC 637(a)(1)) and the Federal Acquisition Regulation (FAR) Part 19.8, and the executed Partnership Agreement between the U.S. Small Business Administration (SBA) and the Department of Health and Human Services.

Text77:
Text78:
Text79: This contract was awarded under the Small Business Administration (SBA) 8a program, which allows CMS to award a contract non-competitively to a certified SBA 8a company as long as the total cost is $4.5 million or less. Unless the work on the contract substantially changes, the contract is to remain within the 8a program.
Text80: N/A. This is not a bridge contract
Text81: As noted above, this contract was awarded under the 8a program, which allows CMS to award a contract non-competitively to a certified SBA 8a company as long as the total cost is $4.5 million or less. Unless the work on the contract substantially changes, the contract is to remain within the 8a program. If the total cost was to increase to more than $4.5 million, then the work would be competed amongst certified 8a contractors.
Check Box82: Off
Check Box83: Yes
Text84: As we are only extending this contract for 3 months, market research has not been done speficially for this modification. Market research will be conducted for the new contract which is slated to begin on January 1, 2026.
Text85: 75FCMC20C0027
Text86: This contract was not competed as it was awarded under the auspices of The Small Business Administrations 8a program which allows sole source awards to certified 8a contractor for contract values up to $4.5 million. CMS received SBA approval that this work was able to be successfully done by a certified 8a contractor.
Text87: This 3-month extension is being done to align the contract period of performance - currently running from September 30th to September 29th - to a calendar year basis, January 1st to December 31st to align with the formulary review schedule. Having the period of performance run from January 1st to December 31st for the subsequent contract benefits CMS by having the busiest time frame of the formulary review (which are the summer months) take place during the middle of the period of performance rather than the end of the period performance as it currently stands, which enables CMS to have additional time to assure the formulary reviews have been completed correctly. Additionally, this allows for the period of performance to encompass the entire formulary review process for that year rather than splitting the review process over two different periods of performance.
2025-02-19T12:23:32-0500
BRIAN R. MARTIN -S
Text89: Mark Smolenski
Text90: Mark Smolenski
2025-05-22T10:32:43-0400
Mark Smolenski -S
2025-05-22T10:33:41-0400
Mark Smolenski -S
Text93: N/A
Check Box96: Off
Check Box97: Off
Check Box98: Off
Check Box99: Off
Text102:
Text103:
Text105: The extension of the contract for three months will be at the some funding level for Option Period 4 of the contract which was determined to be fair and reasonable during the evaluation of the contract. The additional 3 months of performance will remain as Firm Fixed Price.
Text1:

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