Medical Record Review Contractor (MRRC)

Added: Jun 18, 2018 11:13 am
The Centers for Medicare and Medicaid Services (CMS) is seeking offerors having the ability for providing Medical Record Review Contractor (MRRC) services to conduct medical record reviews supporting various projects including the Risk Adjustment Data Validation (RADV) projects. The purpose of RADV is to measure the extent to which inaccurate diagnosis codes impact Hierarchal Condition Categories (HCC) assignments and the associated payment for Medicare Advantage (MA) beneficiaries. The validation process involves the evaluation and analysis of the risk adjustment data via medical record review.

CMS conducts two (2) major RADV projects: the National sample and the Contract-Level sample (the term sample is synonymous in this context with audit). The National sample is used to compute an error estimate for the Medicare Part C Program. The Contract-Level sample is used to estimate extrapolated payment adjustments at the MA Contract-Level based on medical record review findings. The Part C payment error estimate and the MA Contract-level extrapolated payment adjustments represent CMS's response to provisions set forth in the Improper Payments Information Act (IPIA) of 2002, as amended by the Improper Payments Elimination and Recovery Act (IPERA) of 2010 and the Improper Payments Elimination and Recovery Improvement Act (IPERIA) of 2012.

CMS requires two (2) independent MRRC (MRRC A and MRRC B) to conduct medical record review for various projects including the RADV projects and Ad Hoc Studies.

This competition will be limited to only eligible 8(a) participants. CMS anticipates awarding two (2) separate MRRC contracts (MRRC A and MRRC B) off of one solicitation. Both awards will be a cost-plus-fixed-fee (CPFF) type contract for five (5) years. Both awards will include one-year base period and four (4) twelve (12) month option periods.

The solicitation will be available on or about July 3rd, 2018, and it will be distributed solely through the Federal Business Opportunities (FBO) website at http://www.fbo.gov. Hard copies of the solicitation document will not be available. The site provides downloading instructions. All future information about this acquisition, including solicitation amendments, will also be distributed solely through this site. Interested parties are responsible for monitoring this site to ensure that they have the most up-to-date information about this acquisition. The estimated closing date of 75FCMC18R0017 on or about August 2nd, 2018. All responsible sources may submit a proposal which will be considered by this agency. No collect calls will be accepted. No telephone requests or written requests for the solicitation will be accepted.