Amendment A0001 - Request for Proposals for Conducting Recovery Audit Services for the VHA Office of Finance, Department of Veterans Affairs (VA)
Closed Solicitation Posted
Not the latest version. See the latest solicitation from .
- Solicitation number
- 36C10X25R0021
- Agency
-
VA Strategic Acquisition Center Frederick
Headquarters, Department of Veterans Affairs
- Responses due
- Set-aside
- No set-aside
Opportunity facts
- NAICS code
- 541219 Other Accounting Services
- PSC
- R704 Support- Management: Auditing
- 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 contractors to conduct Recovery Audit (RA) services for healthcare claim payments made across various VHA Community Care programs, including pre-authorized claims, emergency care for veterans, ChampVA, Spina Bifida programs, and national dialysis services. The procurement requires contractors to perform both automated system-level reviews and complex individual medical record reviews to identify overpayments spanning fiscal years 2022-2029. Contractors must establish comprehensive infrastructure including a Customer Service Center, public website, secure data transmission portal, and maintain a 95% or higher audit accuracy rate. The contract structure is performance-based using a fixed percentage of recovery (FFP) model, where contractor compensation is contingent solely upon accurate identification and successful recovery of overpayments by the government, with contractors assuming all audit execution costs. Amendment A0001 has extended the proposal submission deadline to September 9, 2025 at 12:00 PM EST, with questions originally due by August 5, 2025.
The solicitation includes set-aside considerations for Service-Disabled Veteran-Owned Small Businesses (SDVOSB) and Veteran-Owned Small Businesses (VOSB) under NAICS code 541219 with a size standard of $25 million. The VA intends to award between one and three contracts with a total potential contract value up to $25 million. The contract includes a one-year base performance period followed by four optional one-year extension periods, all at the government's discretion. Performance will be evaluated across seven key tasks including audit management, reporting, website maintenance, data security, system access, customer service, and claims auditing. The place of performance is Frederick, Maryland, and contractors will receive compensation through a percentage of actual funds recovered, with financial incentives tied to performance metrics that can adjust contingency fees by 0.2% per percentage point above or below the required 95% accuracy threshold.
Notice text
2 versions
Update #2 · Latest ·
The purpose of this Amendment A0001 is to extend the proposals due date through September 09, 2025 @12:00 NOON EST.
The Department of Veterans Affairs (VA), VHA Office of Finance (OF) has a requirement for up to conduct Recovery Audit (RA) activities of healthcare claim payments made for a variety of VHA Community Care programs, as described below. Automated reviews occur at the system level while complex reviews require a qualified individual to review the medical record. Each program has specific payment methodologies as defined by VA regulations. In general, the audit will review various types of paid healthcare claim data with specific dates and criteria included in the description of each auditing scenario.
The VA intends to award one (1) but not more than three (3) FFP (fixed percentage of recovery) contract(s) to provide healthcare claims recovery auditing services. Contractor compensation under this contract will be contingent upon the accurate identification of valid overpayments and the successful recovery of those overpayments by the Government. The contractor shall assume all costs associated with the execution of RAC tasks and will only be reimbursed based on a fixed percentage of actual funds recovered.
The Period of Performance (POP) for the base period shall be from the date of award for a period of one (1) year base period, followed by four (4) year option periods to be awarded at the discretion of the Government.
Update #1 ·
The Department of Veterans Affairs (VA), VHA Office of Finance (OF) has a requirement for up to conduct Recovery Audit (RA) activities of healthcare claim payments made for a variety of VHA Community Care programs, as described below. Automated reviews occur at the system level while complex reviews require a qualified individual to review the medical record. Each program has specific payment methodologies as defined by VA regulations. In general, the audit will review various types of paid healthcare claim data with specific dates and criteria included in the description of each auditing scenario.
The VA intends to award one (1) but not more than three (3) FFP (fixed percentage of recovery) contract(s) to provide healthcare claims recovery auditing services. Contractor compensation under this contract will be contingent upon the accurate identification of valid overpayments and the successful recovery of those overpayments by the Government. The contractor shall assume all costs associated with the execution of RAC tasks and will only be reimbursed based on a fixed percentage of actual funds recovered.
The Period of Performance (POP) for the base period shall be from the date of award for a period of one (1) year base period, followed by four (4) year option periods to be awarded at the discretion of the Government.
Files
| File | Type | Posted |
|---|---|---|
| 36C10X25R0021 0001 - RAC.pdf | ||
| RFP 36C10X25R0021_Recovery Audit Services.pdf | ||
| D.4 APPENDIX C VA INFORMATION AND INFORMATION SYSTEM SECURITY AND PRIVACY LANGUAGE.docx | DOCX document | |
| D.2 BAA.docx | DOCX document | |
| D.7 QASP.docx | DOCX document | |
| D.6 OFFEROR ATTESTATION OF RESPONSIBILITY.docx | DOCX document | |
| RFP 36C10X25R0021_Recovery Audit Services.pdf | ||
| D.5 PAST PERFORMANCE QUESTIONAIRE.docx | DOCX document | |
| D.3 CONTRACTOR RULES OF BEHAVIOR.docx | DOCX document | |
| D.1 SUBCONTRACTING PLAN.docx | DOCX document | |
| D.8 RFP QUESTION SHEET.docx | DOCX document |
Show all 11
Notice history
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