Healthcare Effectiveness Data Information Set (HEDIS®) Summary Level Data Collection for Medicare Advantage
Closed Pre-Solicitation Posted
A later notice was posted: the Limited / Sole Source Justification from .
- Solicitation number
- 250269J
- Agency
-
Centers for Medicare and Medicaid Services
Department of Health and Human Services
- Responses due
- Set-aside
- No set-aside
Opportunity facts
- NAICS code
- 541611 Administrative Management and General Management Consulting Services
- PSC
- R499 Support- Professional: Other
- Place of performance
- Windsor Mill, Maryland 21244, United States
Notice details come from SAM.gov. Updated .
About this opportunity
The Centers for Medicare and Medicaid Services (CMS) is seeking a contractor to collect and manage plan-level quality data for the Healthcare Effectiveness Data and Information Set (HEDIS) for Medicare Advantage Organizations. This task order is required under Section 1852(e) of the Social Security Act, which mandates MA organizations collect and report data measuring health outcomes and quality indices. The procurement is specifically focused on HEDIS Summary Level data, which are critical to the Medicare Advantage Star Ratings Program and publicly reported on the CMS website. Interested firms must demonstrate capability in summary-level data collection and management for HEDIS submissions. Capability statements must be emailed to Megan Famodu at Megan.Famodu@cms.hhs.gov by May 28, 2025, with the government retaining discretion to determine whether to conduct a competitive procurement based on received responses.
The pre-solicitation notice indicates no specific set-aside designation for this opportunity. The National Committee for Quality Assurance (NCQA) is currently positioned as the likely sole-source contractor, given its proprietary rights to the HEDIS data collection system and its history of developing performance measures for Medicare Advantage plans since 1997. While specific award values are not disclosed, the contract is structured with a base year and four option years. The procurement falls under NAICS Category 541611 for Administrative Management and General Management Consulting Services and PSC Category R499 for Professional Support Services. CMS will not reimburse costs associated with submitting capability information, and potential contractors should carefully review the requirements for collecting and managing summary-level HEDIS data for Medicare Advantage Organizations.
Notice text
The purpose of the task order is to secure a Contractor to collect and manage plan-level (i.e., “summary level”) quality data for the Healthcare Effectiveness Data and Information Set (HEDIS). Under 1852 (e) of the Social Security Act, MA organizations are required to collect, analyze, and report data that permit measurement of health outcomes and other quality indices.
HEDIS Summary Level data are an integral part of the Medicare Advantage Star Ratings Program, which is codified in federal regulation (2018). HEDIS quality of care measures are described in the methodology in the Rule. The Medicare Star Ratings are publicly reported on the CMS website and they are displayed in the HPMS.
Files
| File | Type | Posted |
|---|---|---|
| NCQA_Synopsis_HEDIS Summary.pdf |
Notice history
| Notice | Type | Posted |
|---|---|---|
| Healthcare Effectiveness Data Information Set (HEDIS®) Summary Level Data Collection for Medicare Advantage | Limited / Sole Source Justification | |
| This notice | Pre-Solicitation |
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