D03 Redacted JA A01 Posting_Redacted.pdf

DEFENSE HEALTH AGENCY

7700 ARLINGTON BOULEVARD, SUITE 5101

FALLS CHURCH, VIRGINIA 22042-5101

Control Number: FY26-0505-A01

Controlled by: Defense Health Agency (DHA) Controlled by: Professional Services Contracting Division CUI Category(ies): Source Selection Limited Dissemination Control: PROCUREMENT POC: Leslie Nelson

CUI

Source Selection Information - See FAR 2.101 and 3.104-4

1 OCT 2024

Justification and Approval (J&A) for Other than Full and Open Competition Federal Acquisition Regulation (FAR) Part 6

1. Identification of the Agency and Contracting Activity: Defense Health Agency (DHA), DHA Contracting Activity (DHACA), Professional Services Contracting Division (PS-CD)

2. Nature and/or Description of Action being Approved: The Government requires a new six-month bridge contract, with two (2) three (3)-month options, for continuation of services under Task Order HT001121F0082 to align existing Third-Party Collections (TPC) contracts with new, follow-on competitive action. The contract type is Firm Fixed Price, and this is an individual J&A.

3. Description of Supplies/Services and Estimated Value: The contract value is estimated at $12,259,961.99. This requirement requires the contractor to perform Other Health Insurance (OHI) billing and collection activities for the DHA Military Treatment Facilities (MTF), using a Government provided medical billing program (herein referred to as the Government Billing Solution or "GBS"). Billing and collection activities shall include identification and verification of OHI provided on the paper or electronic DD 2569, as well as update of collected OHI information in the GBS, direct billing of third-party payers, ongoing follow-up actions for unpaid claims to include denials management processes, posting payments, conducting valid write-offs and referral of delinquent claims. This task order covers all Air Force MTFs and an additional 52 Army and Navy MTFs.If applicable, state the proposed contractor’s name and describe the required supplies and/or services. Hamilton Enterprises, LLC was competitively awarded Task Order FA805220F0031 under GSA OASIS contract GS00Q14OADS206 as a 100% small business set aside by the 773rd Enterprising Sourcing Squadron/Air Force Installation Contracting Center in Joint Base San Antonio, Texas in September 2020. This Task Order was transferred to DHA in August 2021 for contract administration. This Task Order is now recognized as HT001121F0082. The Office of the Assistant Secretary of War (Health Affairs), Health Resources Management & Policy directed a modification to HT001121F0082 to expand the scope of the Third-Party Collections (TPC) task order to include coverage of an additional 52 Medical Treatment Facilities (MTFs) without contractor support with the intent to include MTFs with contractor support into the recompete contract. The modification was executed on 22 July 2025. A six-month extension was implemented through 8 March 2026 to allow sufficient time for full onboarding activities. To avoid a break in service, a Bridge effort is required to align

CUI

Source Selection Information - See FAR 2.101 and 3.104-4

OCT 2024

6. Efforts to Obtain Competition: A pre-solicitation notice was posted on 14 January 2026 to SAM.Gov. To date no responses have been received from the posting. The Government continues to conduct Market Research (see section eight (8) and is actively working on a Procurement Package for a follow-on competitive action with a projected award date of early quarter four (4) 2026.

7. Actions to Increase Competition/Remove or Overcome any Barriers to Competition: At present there is no feasible way to compete this requirement without the Program suffering a break in service without a Bridge effort being executed. The Program will simultaneously execute a follow-on competitive action for these services and award after the Bridge effort has expired. Market research shall determine the set-aside procedures and how this action will be solicited for future competition.

8. Market Research:

Market research was conducted in March 2025 for the re-compete effort of this task order utilizing the following methods:

Applying personal knowledge in three procurements for similar Third-Party billing and collection support contracts going back to 2010. This includes the current contract awarded to Hamilton Enterprises in 2020.

Contacted knowledgeable individuals in the Government and/or industry regarding market capabilities to meet requirement: Contacted Hamilton Enterprises, Inc., Nazim Hamilton on 9/6/2024. Contacted Benefit Recovery, Ann Migliaccio on 9/5/2024.

Contacted Signature Performance on 9/6/2024. Contacted I-Med Claims, Jay Campbell on 9/6/2024.

Published formal Request(s) for Information (RFI): RFI number HT0011-25-RFI-0223 (GSA eBuy ID: RFQ1739231) was issued between 23 January 2025 – 07 February 2025 to the following GSA MAS domains.

Contract NAICS

Code

SIN/POOL/DOMAIN

MAS 541219 541219

MAS 561440 561440

MAS 524292 524292INS

Five (5) companies (including 3 small businesses) submitted formal responses to the RFI. The three small businesses were: AGT Medical Billing Solutions LLC, BRSi, L.P. dba Benefit Recovery and GMG Management Consulting, Inc.

There are 379 GSA Multiple Award Schedule (MAS) contractors under the Budget and Financial Management Services category under NAICS code 541219. 303 of these GSA MAS contractors are small businesses. Seven out of the nine companies identified through market research have GSA MAS contracts and are eligible to provide responses under NAICS code 541219. Of those entities listed in the analysis, Hamilton Enterprises, Inc. is the incumbent under the current contract and has performed in a satisfactory manner. In addition to the incumbent, BRSi, LP, Tree Frog, and Signature Performance have also performed services previously or currently as prime or subcontractors and all four companies have extensive knowledge about this DHA Third Party Collection Program requirement. The remaining companies have experience in performing similar services for other Government Agencies and in the private sector but have no DHA experience.

9. Other Facts:

a. Procurement History:

(1) Is this a new requirement? No

(2) If 9.a.(1) is No, was the action just prior to this one competed? Yes

(3) If 9.a.(2) is Yes, what has changed where this action cannot be competed?

The Office of the Assistant Secretary of War (Health Affairs), Health Resources Management & Policy directed a modification to HT001121F0082 to expand the scope of the Third-Party Collections (TPC) task order to include coverage of an additional 52 Medical Treatment Facilities (MTFs) without contractor support with the intent to include MTFs with contractor support into the recompete contract. The modification was executed on 22 July 2025. A six-month extension was implemented through 8 March 2026 to allow sufficient time for full onboarding activities. Due to the requirement to align existing TPC contracts with the recompete and to complete a fully vetted competitive process, a six-month bridge contract, with an additional three-month extension option, is required.

10. Interested Sources: See Section Eight (8) Market Research for the list of companies who responded to the RFI. These vendors shall be considered in the follow-on action but are not suitable to fulfill the requirement of this bridge action for the reasons stated in the aforementioned sections above.

11. Technical Certification:

I certify the supporting data under my cognizance, which are included in the justification, are accurate and complete to the best of my knowledge and belief.

Uniform Business Office Revenue Cycle Management Branch Cost Accounting Division, Financial Operations J-8 Resources & Personnel Integration Directorate Defense Health Agency

12. Requirements Certification:

I certify the supporting data under my cognizance, which are included in the justification, are accurate and complete to the best of my knowledge and belief.

Uniform Business Office Revenue Cycle Management Branch Cost Accounting Division, Financial Operations J-8 Resources & Personnel Integration Directorate Defense Health Agency

13. Fair and Reasonable Cost Determination:

I hereby determine the anticipated cost to the Government for this contract action will be fair and reasonable.

Basis for Determination: Certified cost and pricing data is not required as this requirement is for commercial services. The Contracting Office will utilize price analysis techniques in accordance with FAR 15.404-1(b)(ii) and (v) in order to make a determination of a fair and reasonable price.

Approval

Based on the foregoing justification, I hereby approve the procurement of Third Party Collection Services in the amount of $12,259,961.99 on an other than full and open competition basis pursuant to the authority of 10 United States Code 3204(a)(1) as implemented in FAR 6.302-1, Only One Responsible Source subject to availability of funds, and provided that the supplies and/or services herein described have otherwise been authorized for acquisition.

Competition Advocate Defense Health Agency Contracting Activity