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
- $50,000,000 to $100,000,000
- Set-aside
- Total Small Business
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 & Medicaid Services (CMS) Center for Consumer Information and Insurance Oversight is recompeting a procurement for Plan Management Compliance Review (PMCR) services, with an estimated solicitation release on January 1, 2027, and estimated award on April 1, 2027. The contract will support compliance reviews of health insurance issuers operating Qualified Health Plans and Stand-Alone Dental Plans in the Federally-Facilitated Exchange, as required under the Patient Protection and Affordable Care Act. These reviews identify irregularities, validate self-reported data, and ensure QHP issuers comply with ACA requirements.
The estimated award value ranges from $50 million to $100 million under NAICS 541611 (Administrative Management and General Management Consulting Services), designated as a Total Small Business set-aside. Place of performance is not specified in the forecast. Points of contact are Lesa Paige (lesa.paige1@cms.hhs.gov, 301-448-3760) and Kelly Housein, Contracting Officer (kelly.housein@cms.hhs.gov, 410-786-2352), both at CMS.
The incumbent awardee is Strategygen Co, a HUBZone-certified small disadvantaged business and 8(a) Program Participant, operating under GSA Federal Supply Schedule contract 47QRAA19D006P. The MAS contract issued on April 4, 2019, with a $100,000 ceiling and period of performance through April 3, 2029, has generated recent delivery orders including a $24.1 million time-and-materials order for marketplace plan management compliance reviews (awarded August 1, 2022, through July 31, 2027) performed in 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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