Regenstreif (LOINC) J-and-A-Other-Than-Full-and-Open Competition.pdf
PDF 870 KB Posted
- Attached to
- Logical Observation Identifiers Names and Codes (LOINC) for Assessment Data Elements Federal contract opportunity
- Solicitation number
- 75FCMC26R0050
About this file
This is a Justification and Approval (J&A) for Other Than Full and Open Competition for a federal contract procurement by the Centers for Medicare & Medicaid Services (CMS).
The acquisition is for "Logical Observation Identifiers Names and Codes (LOINC) for Assessment Data Elements," a follow-on requirement to create and update standardized identifiers in the Data Element Library. The proposed contractor is Regenstrief Institute, located at 1101 W. 10th Street, Indianapolis, IN 46202. The total estimated contract value is $2,130,654.00 (base plus 4 option periods) on a firm-fixed-price basis, with a performance period spanning fiscal years 2027-2031. The justification cites FAR 6.302-1 (only one responsible source) as the authority for sole source procurement, based on Regenstrief's proprietary ownership and development of LOINC codes and the LOINC Committee, which directs broad industry input and participation. Regenstrief holds the copyright for LOINC and is the only organization capable of maintaining and extending LOINC and SNOMED codes to meet HHS and federal agency requirements. Market research confirmed no other entity can perform this work, and previous contracts (75FCMC21C0032 and HHSM-500-2016-00040C) established Regenstrief as the incumbent. The fair and reasonable price determination was based on independent cost estimate analysis comparing current Bureau of Labor Statistics labor rates and historical invoices. No bridge contract discussion applies, and limited actions exist to increase competition given the proprietary nature of LOINC code development and maintenance. The OPDIV Competition Advocate approved the justification on 5/22/2026.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Letter of Intent.pdf |
On GovTribe
Work with this file on GovTribe
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
JUSTIFICATION AND APPROVAL
FOR OTHER THAN FULL AND OPEN COMPETITION
Completion Instructions: The Department of Health and Human Services (HHS) has established a standard template for the preparation of a J&A for Other Than Full and Open Competition. If this is an 8(a) set-aside, please note this form is not required unless the acquisition is valued (including all options) at greater than $22 million. This template is NOT applicable for actions using simplified acquisition procedures (FAR Part 13), Federal Supply Schedule orders (FAR 8.4) or task or delivery orders subject to fair opportunity (FAR 16.505).
Tailor all aspects of this template to the individual acquisition. Consult FAR Subpart 6.3 for guidance. An addendum may be added in case additional space is needed.
When this document is printed, the blue italic instructions are automatically deleted on the printed version.
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 $
As applicable, briefly describe the services or supplies required to meet the agency's needs, including make & model number where appropriate. Include quantities of supplies or period of performance for services. Provide information for any options included. If the action is a modification to an existing contract, distinguish clearly between the work covered by the original contract and the work to be obtained by the proposed modification.
https://www.acquisition.gov/far/part-8#FAR_Subpart_8_4 https://www.acquisition.gov/far/part-13 https://www.acquisition.gov/far/part-16#FAR_16_505 https://www.acquisition.gov/far/part-6#FAR_Subpart_6_3 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):
Describe the actions, if any, the agency may take to remove or overcome any barriers that led to the restricted consideration prior to any subsequent acquisition for the supplies of services is made. If no such actions have been taken, explain why.
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
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:
Describe efforts made to compete the action, including whether a notice was or will be publicized as required by FAR Subpart
5.2 or which exception under FAR 5.202 applies. If a notice was publicized, discuss the number of written responses to the synopsis and the results of the assessment of the written responses. List sources, if any, that expressed, in writing, an interest in the acquisition. Provide rationale if interested sources were rejected. If applicable, state that no other sources have expressed interest, but all offers received shall be considered. Describe what actions will be taken to increase competition before subsequent acquisition of the supplies or services is required. You may state that an action is a one-time requirement, but if a similar requirement arises, every effort will be made to compete it to the maximum extent possible. If action is sole source because of proprietary data or licensing rights and there will be a continuing need for the requirement, there must be evidence that advanced planning has been initiated to overcome the barriers to competition, or there should be documentation to support an analysis that replacement costs/licensing purchase costs outweigh the benefits of competition. If the action is a contract extension or bridge, explain actions to compete the follow-on. If action is an urgent new requirement and a competitive follow-on is anticipated, explain that efforts are underway to facilitate a full and open competition.
8. Market Research:
Describe the extent of the market research conducted to identify all qualified sources and the results thereof. “Market Research” is defined as those attempts you made to ascertain whether other qualified sources exist, and can include contact with knowledgeable experts regarding similar or duplicate requirements, contact with industry, results of a sources sought synopsis, or draft solicitations. Research of the marketplace may consist of written, electronic (i.e. email) telephonic, or world wide web inquiries. Lack of advanced planning is not an acceptable reason for the lack of market research, but true urgency may necessitate abbreviated market research that is limited to readily available historical and commercial information. If ac tion is a contract extension or bridge contract, describe the market research efforts underway or completed for the follow-on. See FAR 10.002(b)(2).
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 https://www.acquisition.gov/far/part-5#FAR_Subpart_5_2 https://www.acquisition.gov/far/part-5#FAR_5_202 https://www.acquisition.gov/far/part-10#FAR_10_002
10.Additional Information to support the justification:
If applicable, explain why technical packages or specifications to facilitate competition were not developed or available;
describe actions taken to remedy the situation.
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
Name:
Position Title:
Email address:
Phone:
Program Manager Supervisor (or one level above Program Manager)
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.
Provide the basis for this determination, e.g., describe techniques to be used to determine fair and reasonable price (FAR Subpart 15.402), such as price analysis, cost analysis, cost realism. Per FAR Subpart 15.403-4(a)(1), the threshold for obtaining cost or pricing data is $750,000.
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:
https://www.acquisition.gov/far/part-15#FAR_15_402 https://www.acquisition.gov/far/part-15#FAR_15_402 https://www.acquisition.gov/far/part-15#FAR_15_403_4
14. Legal Review:
All J&As greater than $68 million must have a legal review from the General Law Division of the Office of the General Counsel prior to sending it to the Department.
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:
All J&As greater than $68 million must have a review from the Office of Small & Disadvantaged Business Utilization (OSDBU) prior to sending it to the Department. The OSDBU at their discretion may review any J&A.
16. Office of Small and Disadvantaged Business Utilization Review: (Required for contracts exceeding $68 million (value calculated including all options)):
Concur:
Non-Concur:
17. OPDIV HCA Approval (Required for proposed contract over $13.5 million but not exceeding $68 million (value calculated including all options)):
18. Department Competition Advocate (Required for contracts exceeding $68 million (value calculated including all options)):
Concur:
Non-Concur:
(The below approval paragraph is required if the cumulative contract value, including all options, exceeds $68 million.)
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:
| Modificationto Existing Purchase OrderContract Number: |
| Other: |
| Other Funds: |
| Name: Shelly Coyle, RN, MS, MBA,CPHQ, COR III, Sr FAC-P/PM |
| Position Title: Nurse, Contracting Officer's Representative |
| Email address: Shelly.coyle@cms.hhs.gov |
| Phone: 410-786-7394 |
| Name_2: Elizabeth Palena-Hall |
| Position Title_2: Division Director, Division of Digital Quality Measurement |
| Email address_2: Elizabeth.palenahall@cms.hhs.gov |
| Date: 05/15/2026 |
| Phone_2: 410-786-5779 |
| Date_2: 5/19/2026 |
| Phone_3: 410-786-5779 |
| Date_3: 5/20/2026 |
| Name_3: Lyandra Emmanuel |
| Phone_4: 410-786-5130 |
| Date_4: 5/22/2026 |
| Name_4: |
| Phone_5: |
| Date_5: |
| Name_5: |
| Phone_6: |
| Date_6: |
| Name_6: |
| Phone_7: |
| Date_7: |
| Name_7: |
| Phone_8: |
| Date_8: |
| Text51: Logical Observation Identifiers Names and Codes (LOINC) for Assessment Data Elements |
| Text52: Shelly Coyle, Nurse, COR, FAC-P/PM Division of Digital Quality Measurement (CMS/CCSQ/QMVIG/DDQM) |
| Text53: 2027-2031 |
| Dropdown54: [CMS] |
| Check Box55: Off |
| Check Box56: Yes |
| Check Box57: Off |
| Check Box58: Yes |
| Check Box59: Off |
| Check Box60: Off |
| Check Box61: Off |
| Check Box62: Off |
| Text63: Regenstrief Institute |
| Text64: 1101 W. 10th Street |
| Text65: Indianapolis, IN 46202 |
| Check Box66: Yes |
| Check Box67: Off |
| Text68: 2,130,654.00 |
| Text69: This purpose of this request is for a new Sole Source contract entitled “Logical Observation Identifiers Names and Codes (LOINC) for Assessment Data Elements” to create and update standardized identifiers in the Data Element Library. Developed and copyrighted by the Regenstrief Institute, LOINC codes enable consistent naming and identification of clinical observations, document types, and assessment data in electronic health records for interoperability. In making data elements interoperable, CMS links assessment data elements to widely available and commonly used health IT standards, including but not limited to LOINC and SNOMED-CT vocabulary standards, that are part of the United States Core Data for Interoperability (USCDI). USCDI is a federally recognized, standardized set of health data classes and constituent data elements that the Office of the National Coordinator for Health Information Technology (ONC) maintains and updates through a transparent, open process. It establishes a minimum baseline of structured health data required to support nationwide interoperable health information exchange across all care settings and a broad range of clinical and administrative use cases. By aligning CMS assessment data elements to USCDI-conformant standards, CMS helps ensure that health information can be consistently captured, shared, and used across the healthcare ecosystem. This initiative aligns with Section 1899B of Title XVIII of the Social Security Act and the Improving Medicare Post-Acute Care Transformation Act of 2014 (the IMPACT Act) of 2014, which mandate standardized, inter-operable post-acute care (PAC) assessment data elements to facilitate coordinated care and improved outcomes. Most recently, Section 4125(b)(1) of the Consolidated Appropriations Act, 2023 (CAA, 2023) amended section 1886(s)(4) of the Social Security Act to require Inpatient Psychiatric Facilities (IPFs) participating in the IPF Quality Reporting Program to collect and submit standardized patient assessment data, using a standardized patient assessment instrument. The IPF Patient Assessment Instrument (IPF-PAI) has been developed and intended to be implemented in a way to support interoperable exchange of data. The assessment items will be managed centrally in the CMS Data Element Library (DEL), enabling consistency in usage across versions or updates. Each assessment item is represented as a machine-readable data element with a stable identifier and metadata, such as definition, datatype, and permissible values such as LOINC and SNOMED codes, as applicable. The services to be provided include the following: |
• Assign LOINC, SNOMED and other HIT codes to CMS identified assessment data elements as needed; and
• Resolve issues regarding how CMS PAC or other program’s assessment data elements have been represented in the Regenstrief database.
• Maintenance and updates to HIT codes regarding PAC and other setting’s quality reporting assessment instruments in addition to standardizing elements of data exchange in support of facilitating inter-operable data exchange across settings.
• Provide Subject Matter Expertise in assisting CMS in evaluating the presence of health IT codes from standardized sets of data elements (e.g, LOINC, SNOMED-CT, RxNorm, ICD-10, and possibly others) available in support of nationwide, interoperable health information exchange.
The current contract is anticipated to come to its natural end September 13, 2026; therefore, an updated contract and period of performance shall be required. This sole source acquisition is Firm Fixed Price (FFP) with a period of performance of September 13, 2026, through September 12, 2031. The base twelve (12) month period of performance is planned to be awarded by September 2026 followed by 4 twelve month option periods.
| Text70: Regenstrief has unique knowledge and capabilities regarding the development and ongoing maintenance and distribution of LOINC and SNOMED. LOINC is a proprietary nomenclature developed and maintained by Regenstrief and the LOINC Committee (which Regenstrief directs with broad industry input and participation). Regenstrief holds the copyright for LOINC. Therefore, Regenstrief is the only organization capable of maintaining and extending LOINC and SNOMED in order to meet HHS and other federal agency requirements, including CMS requirements to link LOINC and other HIT standards to assessment data elements in support of interoperability across systems and care provider settings. There are no other acquisition sources or in-house alternatives. Any other solution would result in substantial duplication costs and unacceptable delays. As a result, small business participation cannot be applied. It has been noted that there may be follow-on procurements beyond the current period of performance if, (i) CMS continues to update assessment data elements; and (ii) Regenstrief continues to hold the copyright for LOINC and LOINC maintains its designation as a standard for use in US systems for the electronic exchange of clinical health information. As of this date, these factors remain unchanged. Of note, the Office of the National Coordinator for Health Information Technology (ONC) in HHS has identified LOINC as one of the vocabulary standards that must be supported by certified EHR technologies used by providers in the Medicare and Medicaid EHR Incentive Programs. Additionally, beginning in 1999, the National Library of Medicine in HHS contracted with Regenstrief for the continued development and free public distribution of LOINC on behalf of HHS, the Veterans’ Administration (VA), and the Department of Defense (DOD). Incorporation and access to development of these codes supports movement toward interoperability within the healthcare environment. | |
| Text71: | |
| Check Box72: Yes | |
| Check Box73: Off | |
| Check Box74: Off | |
| Check Box75: Off | |
| Text76: | |
| Text77: | |
| Text78: | |
| Text79: Given the limitations set forth by the proprietary nature of the services supporting the provision and maintenance of LOINC codes by the Regenstrief Institute, very few options have been available for consideration to overcome the barriers existing requiring a sole source acquisition. A review of the existing other service arrangements was completed to determine if opportunities exist for collaboration across work streams to yield the same results. This was not shown to be an option. Consideration of facilitating a subcontracting arrangement with another support contractor was assessed as well. This was identified to create other risks associated with indirect oversight of a limited resource in striving toward facilitating interoperability objectives of CMS. Revisions to the Statement of Work and Schedule of Deliverables have been made in an effort to facilitate desired outcomes and high quality services from this sole source vendor. | |
| Text80: N/A | |
| Text81: No alternative actions to increase competition exist given that Regenstrief holds the copyright, and hence, proprietary rights to the development and maintenance of the LOINC codes. It is expected that a continuing need will exist, as use of LOINC codes have been supported through the Interoperability Standards Platform (ISP) is the Office of the National Coordinator for Health IT’s (ONC) repository for standards initiatives that advance health data interoperability nationwide. LOINC is a proprietary nomenclature developed by the Regenstrief Institute (Regenstrief) as a source of standard identifiers, names and codes for clinical observations, clinical document types, claims attachment sets, and questions and answers in assessment instruments. SNOMED-CT is one of a suite of designated standards for use in U.S. Federal Government systems for the electronic exchange of clinical health information such as clinical findings, procedures and observable entities. Interoperability standards and implementation specifications continue to evolve to be used by the healthcare industry to address specific interoperability needs including, but not limited to, interoperability for clinical, public health, research and administrative purposes. Progress continues toward normalization of these codes as interoperability efforts continue in support of facilitating information flow across care settings. The use of LOINC codes at this time is among a variety of code sets (e.g., LOINC: observations, RxNorm: medications SNOMED CT: findings, organisms, problems, ICD, and others). This also supports CMS movement in the direction of facilitating the adoption of FAST Healthcare Interoperability Resources (FHIR) and the HL7 standards utilized by providers to support electronic clinical systems with the goal of enhanced quality of care, efficiency and outcomes. By aligning CMS assessment data elements to USCDI-conformant standards, CMS helps ensure that health information can be consistently captured, shared, and used across the healthcare ecosystem. | |
| Check Box82: Off | |
| Check Box83: Yes | |
| Text84: Market Research has been conducted for current contract by evaluating history of required Logical Observation Identifiers Names and Codes (LOINC) which resulted in the determination no other entity was able to perform this work as LOINC is a proprietary nomenclature developed and maintained by Regenstrief. This included discussions with other the Office of the National Coordinator, exploration of SAM.gov in addition to other websites to ascertain the potential availability of the services provided by Regenstrief by another vendor/agency. At this time, Regenstrief holds the copyright for LOINC currently. Therefore, Regenstrief is still the only organization capable of maintaining and extending LOINC in order to meet HHS and other Federal agency requirements, including CMS requirements to link LOINC to assessment data elements. There are no other acquisition sources or in-house alternatives. | |
| Text85: 75FCMC21C0032 (9/2021-9/2026) and HHSM-500-2016-00040C (8/2016-8/2021) | |
| Text86: The incumbent for this requirement is the Regenstrief Institute, who has held two contracts since initiation in 2016. The most recent contract number is 75FCMC21C0032 was awarded with a period of performance beginning with a base period on 9/13/2021 and is expected to come to its natural end on 9/12/2026 after 4 option periods. This contract was proceeded with contract number HHSM-500-2016-00040C, awarded August 8, 2016. This sole source acquisition is Firm Fixed Price (FFP) with a period of performance of August 15, 2016, through August 14, 2021. | |
| Text87: The utilization of LOINC codes traverses a number of entities in support of facilitating interoperability. CMS, HL7, NCQA, CDC, VA and DoD are among the organizations embracing these codes to normalize lab results and clinical observations in support of patient care. These codes are provided by Regenstrief free of charge to the public for use in electronic health record systems. LOINC is considered a universal coding system, enabling health care organizations to map (or link) their local codes to LOINC codes for transmission in clinical messages to payers, regulators, and other health care organizations. Contracting with Regenstrief provides CMS with the ability to directly influence the development of necessary codes, with a particular focus on post-acute care facilities to seek care efficiency through reducing waste and harm (through uninformed care), providing information for care coordination and ultimately fostering trust and confidence for patients and their caregivers. | |
| 2026-05-15T10:25:39-0400 | |
| ELIZABETH M. PALENA HALL -S |
| Text89: Scott Filipovits | |
| Text90: Scott Filipovits | |
| 2026-05-19T14:40:03-0400 | |
| Scott A. Filipovits -S |
| 2026-05-20T10:11:37-0400 | |
| Scott A. Filipovits -S |
| Text93: N/A | |
| 2026-05-22T13:40:20-0400 | |
| Lyandra Emmanuel -S |
| Check Box96: Off |
| Check Box97: Off |
| Check Box98: Off |
| Check Box99: Off |
| Text102: |
| Text103: |
| Text105: CMS has evaluated the cost by formulating an independent cost estimate. Our analysis compared current Bureau of Labor Statistics (BLS) labor rates for comparable position and other direct costs as well as historical invoices from current LOINC contract. CMS anticipates the cost to be fair and reasonable. |
| Text1: $2,130,654.00 (base + 4 OPs) |
File details come from the government source that posted it. Updated .