Amendment 0003- Request for Proposals for Conducting Recovery Audit Services for the VHA Office of Finance, Department of Veterans Affairs (VA)

Closed Solicitation Posted

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Solicitation number
36C10X25R0021_0003
Agency
Responses due
Set-aside
No set-aside

Opportunity facts

NAICS code
541219 Other Accounting Services
Place of performance
Frederick, Maryland 21703, United States

Notice details come from SAM.gov. Updated .

About this opportunity

The Department of Veterans Affairs Strategic Acquisition Center Frederick is seeking up to three contractors to provide Recovery Audit Services for the VHA Office of Finance, focusing on healthcare claim payments across various VA Community Care programs including VA Community Care, CHAMPVA, Spina Bifida Program, and National Dialysis Contract. The primary objective is to identify and recover overpayments to healthcare providers through comprehensive audit activities, with contractors compensated based on a percentage of recovered funds. Amendment 0003 introduces a tiered pricing structure requiring offerors to provide unit price percentages for three distinct claims volume tiers: less than 10,000,000 claims annually, 10,000,001 to 25,000,000 claims annually, and more than 25,000,000 claims annually. The government will evaluate proposed prices using price analysis techniques prescribed in FAR 15.404-1(b), including competition analysis, historical pricing, and market research to ensure fair and reasonable pricing. Contractors must establish secure portals, customer service centers, maintain extensive VA security compliance including Authority to Operate certification, and provide comprehensive reporting capabilities. The proposal submission deadline has been extended to September 11, 2025, at 12:00 PM EDT.

This solicitation operates without any set-aside designation, making it available to all qualified contractors regardless of size or socioeconomic status. The contract structure includes a base period of one year with four optional one-year periods, and contractors will audit up to 25,000,000 claims annually across the VA's healthcare payment systems. While specific award values are not disclosed, compensation is structured as a percentage of successfully recovered overpayments, creating a performance-based payment model that aligns contractor incentives with government recovery objectives. The contract requires contractors to manage provider communications, conduct audits with qualified personnel, and maintain strict privacy and information security standards throughout the engagement period. Performance will take place in Frederick, Maryland, where contractors must coordinate with the VA Strategic Acquisition Center Frederick and maintain compliance with all federal healthcare data protection requirements.

Notice text

2 versions

Update #2 · Latest ·

The purpose of this amendment is to amend Section B.2 PRICE/COST SCHEDULE to include three Sub-Line Item Numbers (SLINs) for three distinct tiers of claims volume. Additionally, Section E.1 will detail the volume-based pricing requirements. Offerors must provide a Unit Price percentage for each tier based on the estimated volume of claims they expect to handle. The tiers are as follows:

Less than 10,000,000 claims annually

10,000,001 to 25,000,000 claims annually

More than 25,000,000 claims annually

This amendment ensures that pricing is adjusted according to the volume of claims managed, thereby promoting more accurate and fair pricing structures. The revised B.2 PRICE/COST SCHEDULE shall reflect these tiered pricing requirements.

The Government will evaluate the proposed prices to determine whether they are considered fair and reasonable. The Government will utilize price analysis techniques as prescribed in FAR 15.404-1(b) to evaluate price reasonableness. This may include the use of competition, historical prices, market research, or other resources necessary to ensure proposed prices are reasonable.

Amendment 3 also includes the updated Attachment D.1 Subcontracting Plan. The percentage of the contractor's recovered column has been updated from ($ <insert \text{value}>) to (<insert %\text{value}>).

The proposal due date has been extended to September 11, 2025, at 12:00 PM EDT.

Update #1 ·

The purpose of this amendment is to amend Section B.2 PRICE/COST SCHEDULE to include three Sub-Line Item Numbers (SLINs) for three distinct tiers of claims volume. Additionally, Section E.1 will detail the volume-based pricing requirements. Offerors must provide a Unit Price percentage for each tier based on the estimated volume of claims they expect to handle. The tiers are as follows:

Less than 10,000,000 claims annually

10,000,001 to 25,000,000 claims annually

More than 25,000,000 claims annually

This amendment ensures that pricing is adjusted according to the volume of claims managed, thereby promoting more accurate and fair pricing structures. The revised B.2 PRICE/COST SCHEDULE shall reflect these tiered pricing requirements.

The Government will evaluate the proposed prices to determine whether they are considered fair and reasonable. The Government will utilize price analysis techniques as prescribed in FAR 15.404-1(b) to evaluate price reasonableness. This may include the use of competition, historical prices, market research, or other resources necessary to ensure proposed prices are reasonable.

The proposal due date has been extended to September 11, 2025, at 12:00 PM EDT.

Files

File Type Posted
D.1 SUBCONTRACTING PLAN.docx DOCX document
RFP 36C10X25R0021_0003.pdf PDF
Amendment 36C10X25R0021 0003.pdf PDF

Notice history

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