Plan Management Compliance Review (PMCR)
Forecast Recompete Updated
- Agency
-
Centers for Medicare and Medicaid Services
Department of Health and Human Services
- Solicitation expected
- Estimated value
- $20,000,000 to $50,000,000
- Set-aside
- No set-aside
Forecast facts
- Incumbent contract
-
- 47QRAA19D006P Federal IDV award held by Strategygen Co Ordering ends Apr 3, 2029 · Ceiling $100,000
- Anticipated award
- NAICS code
- 541611 Administrative Management and General Management Consulting Services
- Points of contact
Forecast details come from HHS's procurement forecast. Agencies' dates and values are estimates.
About this forecast
The Centers for Medicare and Medicaid Services (CMS), Center for Consumer Information and Insurance Oversight (CCIIO) is procuring compliance review services for health insurance issuers operating Qualified Health Plans and Stand-Alone Dental Plans in the Federally-Facilitated Exchange, with solicitation release estimated for January 1, 2027 and award estimated for April 1, 2027. The services support ACS requirements under the Patient Protection and Affordable Care Act, with compliance reviews serving as a primary mechanism for CMS to ensure QHP issuer compliance, identify irregularities, validate self-reported data, and document effective FFE program management.
The estimated award value ranges from $20 million to $50 million. The work falls under NAICS 541611 (Administrative Management and General Management Consulting Services) and uses no set-aside. Inquiries should be directed to Lesa Paige (lesa.paige1@cms.hhs.gov) or Kelly Housein (kelly.housein@cms.hhs.gov, 410-786-2352) at CMS.
This recompete concerns a $24.1 million time-and-materials delivery order issued under Federal Supply Schedule contract 47QRAA19D006P held by Strategygen Co, awarded August 1, 2022 through July 31, 2027. Strategygen Co, a HUBZone-certified small disadvantaged business and 8(a) Program Participant, performed the marketplace plan management compliance reviews at Jacksonville, Florida.
Forecast text
Plan Management Compliance Review (PMCR): The purpose of this procurement is to obtain services to conduct various types of compliance reviews of health insurance issuers who operate Qualified Health Plans (QHHP)/Stand-Alone Dental Plans (SADP) in the Federally-Facilitated Exchange (FFE). These reviews are being procured by the Centers for Medicare & Medicaid Services' (CMS) Center for Consumer Information and Insurance Oversight's (CCIIO), in support of the health insurance Exchanges (Exchanges), as required under the Patient Protection and Affordable Care Act (PPACA). Compliance reviews serve as one of the primary mechanisms that CMS will use for ensuring and documenting QHP issuers' compliance with Affordable Care Act (ACA) requirements. Compliance reviews are necessary to identify irregularities, validate self-reported data, and to ensure that CCIIO is managing the FFE programs effectively.
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