Request for Information for the Supplemental Medical Review Contractor (SMRC) Amendment 0001

The Centers for Medicare & Medicaid Services (CMS) has issued Request for Information (RFI) Amendment 0001 regarding the Supplemental Medical Review Contractor (SMRC) to solicit industry input on pricing strategies for this work. This Special Notice is not a binding solicitation but rather market research to determine the feasibility of implementing firm fixed-price or hybrid pricing structures for the SMRC Statement of Work. The RFI is open to all qualified contractors interested in providing input on whether fixed-price arrangements would be appropriate and achievable for performing the scope of work. Responses are voluntary and will not be compensated. The deadline for submission is April 23, 2026, at 5:00 PM Eastern Time, and responses should be submitted electronically to Tracy Amos (Contract Specialist) and Nicole Hoey (Contracting Officer). CMS explicitly states that this RFI imposes no obligation to issue a solicitation or make an award based on the responses received.

The SMRC SOW encompasses comprehensive medical review, program integrity, and administrative support activities supporting three CMS initiatives: Provider Compliance Group Specialty Reviews, Program Integrity Reviews, and internal data analysis programs including CERT, FATHOM, and PEPPER. The objective is to obtain contractor perspectives on feasible pricing approaches, including recommendations for hybrid pricing, unit or tiered pricing to address monthly volume variability (processing approximately 32,500 Medicare Part A claims and 117,000 Medicare Part B claims annually across multiple projects), labor category rates, performance incentives, and cost handling methodologies. Respondents must provide contractor information, feasibility assessments, proposed pricing structures by task area, recommended labor categories with hourly rates, performance standards and incentives, carryover cost methodologies, and Section 508 compliance cost integration. Responses are limited to 20 pages maximum (excluding cover page and attachments) in Microsoft Word or PDF format using Times New Roman or Arial 12-point font with 1-inch margins. There are no specific eligibility restrictions; all contractors are welcome to respond. The SMRC work is awarded under the Unified Program Integrity Contract (UPIC) Indefinite Delivery Indefinite Quantity (IDIQ) contract vehicle and requires compliance with FISMA/FedRAMP requirements, HIPAA compliance, and Authority to Operate (ATO) acquisition within 60 days of award.