Risk Adjustment Data Validation (RADV) Appeals Support Contractor / New
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
- Not on record
Forecast facts
- Incumbent contract
-
- GS10F0069X Federal IDV award held by A. Reddix & Associates Inc. Ordering ends Jan 11, 2031 · Ceiling $182,726,349
- Anticipated award
- Through
- Acquisition strategy
- Follow-on to Existing Contract
- NAICS code
- 541611 Administrative Management and General Management Consulting Services
- Forecast number
- 270287
- Points of contact
-
- Jennifer Kuhn jennifer.kuhn@cms.hhs.gov (410) 786-2299
- Crystal Southall-Norman crystal.southall-norman@cms.hhs.gov
Forecast details come from CMS's procurement forecast. Agencies' dates and values are estimates.
About this forecast
CMS is forecasting a recompete of its Risk Adjustment Data Validation (RADV) Appeals Support Contractor, with estimated solicitation release on February 26, 2027 and estimated award on June 26, 2027. The contractor functions as the RADV Appeals Subject Matter Expert for medical record review determination (MRRD) and payment error calculation (PEC) appeals at the first level, providing legal and regulatory support for RADV planning, processing, and reporting under the Medicare Part C program, with CPI. The contractor also supports CPI on appeals at level two (Office of Hearings) and level three (CMS Office of the Attorney Advisor). The forecast lists NAICS 541611, PSC R499, and a set-aside to be determined.
The estimated award value range is $20 million to $50 million for a five-year period of performance beginning June 26, 2027, with a forecast current fiscal year value of at least $5 million and less than $10 million. Points of contact are Jennifer Kuhn, Contracting Officer (jennifer.kuhn@cms.hhs.gov, +1 410-786-2299), and Crystal Southall-Norman, HHS.gov (crystal.southall-norman@cms.hhs.gov, +1 410-786-8708), with the forecast tied to contracting office 7500-7530-00500.
The recompeted award is Federal Supply Schedule contract GS10F0069X, a multiple-award Multiple Award Schedule vehicle held by A. Reddix & Associates Inc. (doing business as Ardx), an SBA-certified 8(a) small business, awarded January 12, 2011 with a ceiling of $182.7 million through January 11, 2031. The forecast references existing task or BPA call number 75FCMC19F0092, and the schedule includes a $36.5 million CMS order for Medicare Part C RADV activities and program integrity support, awarded August 26, 2019 and completing August 25, 2027. The schedule covers analytical, technical, program management, and consulting services, with place of performance listed as Norfolk, Virginia and nationwide ordering authority.
Forecast text
The purpose of the Appeals Support contractor is to provide legal and regulatory support for the Risk Adjustment Data Validation (RADV) activities for the Medicare Part C program with CPI. The Appeals Support contract provides support for RADV appeals planning processing and reporting. The contractor functions as the RADV Appeals Subject Matter Expert for medical record review determination (MRRD) and payment error calculation (PEC) appeals at the first level of appeal at the first level of appeal. Additionally, the contractor provides support to CPI for appeals for levels two (Office of Hearings) and three (CMS Office of the Attorney Advisor).
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