Part D Transaction Facilitator
Closed Pre-Solicitation Posted
- Solicitation number
- 260108J
- Agency
-
Centers for Medicare and Medicaid Services
Department of Health and Human Services
- Responses due
- Set-aside
- No set-aside
Opportunity facts
- NAICS code
- 541519 Other Computer Related Services
- PSC
- R499 Support- Professional: Other
- Place of performance
- Baltimore, Maryland, United States
Notice details come from SAM.gov. Updated .
About this opportunity
The Centers for Medicare and Medicaid Services intends to solicit a contractor to provide Medicare Part D Transaction Facilitator services supporting coordination of benefits between Part D plans and other payers, with a Request for Information due May 7, 2026. No set-aside is anticipated.
Work is performed at contractor facilities and/or CMS-designated locations. The contractor must establish and operate a 24/7 real-time switching network for eligibility queries, BIN/PCN routing, and True Out-of-Pocket (TrOOP) balance transfers. Services include processing pharmacy eligibility (E1) queries using NCPDP standards, executing Business Associate Agreements with all Part D plan sponsors within 15 days of award (with no more than 10% amendment rate), maintaining disaster recovery and system architecture compliant with FIPS 199 and NIST standards at Moderate risk level, ensuring immediate security incident notification within one hour, and providing Section 508 accessibility compliance for all ICT deliverables.
The contract is structured as Firm-Fixed-Price with Time-and-Materials order-level materials, covering a base period plus four option periods. Performance requirements include monthly status reporting, bi-weekly management reviews, daily receipt and maintenance of Medicare eligibility indices, processing plan switches, submitting daily, monthly, quarterly, and annual reports to CMS, and responding to historical data and special reprocessing requests. The contractor must submit a detailed Performance Work Statement and Quality Assurance Surveillance Plan describing achievement of eight core objectives measured against 13 performance standards with Acceptable Quality Levels, surveillance methods, and remedies including corrective action plans and price reductions for sustained non-compliance.
CMS will provide the Medicare Part D Eligibility Index, standard BAA language, and technical specifications in Appendices A–I and the CMS Technical Reference Architecture. Potential three-month transition-in support is included if applicable.
Notice text
See attached Statement of Objectives and associated Request for Information documents.
Files
| File | Type | Posted |
|---|---|---|
| Appendix C_020526.pdf | ||
| Appendix H_020926.pdf | ||
| Appendix I_020926.pdf | ||
| Appendix F_020226.pdf | ||
| Appendix B_020226.pdf | ||
| Appendix G_020226.pdf | ||
| Appendix A_020526.pdf | ||
| Appendix E_020226.pdf | ||
| Appendix D_020226.pdf | ||
| Draft SOO - Part D Transaction Facilitator.pdf | ||
| RFI Memo - Part D Transaction Facilitation.pdf |
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