RFI-Recovery Audit (RA) Services for the Department of Veterans Affairs (VA), Veterans Health Administration (VHA), Office of Finance (OF)
Closed Pre-Solicitation Posted
- Solicitation number
- VA-RFI-2024-001
- 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, United States
Notice details come from SAM.gov. Updated .
About this opportunity
The Department of Veterans Affairs (VA), specifically the Veterans Health Administration's Office of Finance, is seeking a Recovery Audit (RA) contractor to support the Payment Integrity Information Act of 2019 by identifying and recovering improper payments across VA healthcare claims. The contractor will be compensated solely through recovered funds, with no direct cost to the VA, and must review 100% of supplied paid claim data in accordance with an approved audit plan. Key requirements include establishing a Customer Service Center, developing an Audit Management Plan, creating public and secure web portals, and maintaining electronic case files with 95% accuracy in findings. The RFI requests vendors to submit electronic responses by January 17, 2025, with a 15-page limit, focusing on capabilities statements that address functionality, track record, scalability, and vendor considerations. Vendors are expected to demonstrate expertise in auditing healthcare claims, managing provider disputes, and coordinating recoupment activities.
The contract opportunity is not set aside for any specific business category and will be classified under NAICS code 541219 for Other Accounting Services. The contract structure includes a base year with four one-year option periods, covering fiscal year 2022-2029 claims data across multiple VA healthcare programs such as Community Care, CHAMPVA, Spina Bifida, Emergency Care, and National Dialysis Contract services. While no specific award value is mentioned, the contract requires contractors to have sufficient financial capability to support operations during a potential year-long Authority to Operate (ATO) certification process before recoveries can commence. The scope of work excludes claims from the Department of Defense, Indian Health Services, overseas care, and claims already under fraud investigation. Contractors must obtain VA system access and demonstrate experience with third-party administrators and complex recoupment processes, with particular interest in artificial intelligence capabilities and data handling methodologies.
Notice text
Recovery Audit (RA) Services for the Department of Veterans Affairs (VA), Veterans Health Administration (VHA), Office of Finance (OF)
INTRODUCTION
This notice is issued solely for information and planning purposes. There is no obligation for the Government to acquire any products or services described in this Request for Information (RFI). In accordance with the Federal Acquisition Regulations (FAR) Subpart 15.201(e), responses to this notice are not offers and cannot be accepted by the Government to form a binding contract. No funds have been authorized, appropriated, or received for this effort. The information provided may be used by VA in developing its acquisition strategy and refining the Performance Work Statement (PWS). Only electronic responses to this RFI will be accepted.
BACKGROUND
The Department of Veterans Affairs (VA), Veterans Health Administration (VHA), Office of Finance (OF) requires a contractor to conduct Recovery Audit (RA) activities in support of the Payment Integrity Information Act of 2019 (PIIA) (Public Law No. 116-117). The auditing will be organized into mandatory and optional tasks. The Office of Finance intends to award a no-cost task order, where the contractor is compensated solely from recovered funds. The contractor shall review 100% of supplied paid claim data in accordance with their approved audit plan and report results to the Office of Finance. The term “improper payment” refers specifically to overpayments. Situations where a provider submits a claim containing an error but does not alter the payment amount are not considered improper payments.
This RFI seeks information from potential contractors who possess the expertise to perform these Recovery Audit services effectively. Responses will help inform the VA's approach to this critical function. For further information or to submit responses, please contact the designated point of contact listed in this notice.
Thank you for your interest in supporting the Department of Veterans Affairs.
Files
| File | Type | Posted |
|---|---|---|
| PWS clean for RFI.docx | DOCX document | |
| RFI Recovery Audit.docx | DOCX document |
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