Supplemental Medical Review Contract (SMRC)
Solicited Recompete Updated
See the pre-solicitation posted : Supplemental Medical Review Contract
- Agency
-
Centers for Medicare and Medicaid Services
Department of Health and Human Services
- Solicitation expected
- Estimated value
- $100,000,000 or more
- Set-aside
- No set-aside
Forecast facts
- Incumbent contract
-
- HHSM500201600082I Federal IDV award held by Noridian Healthcare Solutions, LLC Ordering ends May 9, 2027 · Ceiling $2,500,000,000
- Anticipated award
- Acquisition strategy
- Follow-on to Existing Contract
- NAICS code
- Not on record
- Forecast number
- 270048
- Points of contact
Forecast details come from CMS's procurement forecast. Agencies' dates and values are estimates.
About this forecast
The Centers for Medicare and Medicaid Services plans to procure a Supplemental Medical Review Contractor to perform nationwide post-payment medical review and related tasks aimed at lowering improper payment rates and combatting fraud, waste, and abuse under the Center for Program Integrity's Provider Compliance Group. The contract will support medical review of Medicare Fee for Service claims for Medicare Part A, Part B, and durable medical equipment, prosthetics, orthotics and supplies programs, including specialty reviews addressing issues identified by federal agencies such as the Office of Inspector General and Government Accountability Office as well as CMS internal data analysis programs. The estimated solicitation release date is December 15, 2026, with an estimated award date of May 10, 2027.
The estimated award value is at least $100 million under cost-plus-no-fee pricing, structured as a multiple-award indefinite delivery vehicle with a period of performance starting May 9, 2027. Work is performed nationwide with administrative oversight at CMS. Scott Wakefield (scott.wakefield@cms.hhs.gov, 667-414-0273) and Contracting Officer Nicole Hoey (nicole.hoey@cms.hhs.gov, 410-786-0489) serve as points of contact.
This recompete builds on the Unified Program Integrity Contract (UPIC) indefinite delivery contract HHSM500201600082I, a multiple-award vehicle with a $2.5 billion ceiling awarded to Noridian Healthcare Solutions, LLC on May 17, 2016. Under UPIC, Noridian received a $411.1 million cost-plus-fixed-fee delivery order in February 2018 for Strategic Medical Review Contractor services performing medical reviews, analyzing claims data, and implementing integrity initiatives to reduce improper payments within federal healthcare programs at Noridian's headquarters in Fargo, North Dakota, running through May 9, 2027.
Forecast text
The CMS plans to procure a Supplemental Medical Review Contractor (SMRC) (the “Contractor”) to perform and/or provide support for a variety of nationwide, post payment medical review and related tasks aimed at lowering the improper payment rates and combatting fraud, waste, and abuse. The contract consists of one core task within the Center for Program Integrity (CPI) including the Provider Compliance Group (PCG) ‘Specialty Reviews’ in support of issues identified by Federal agencies, such as the Office of Inspector General (OIG), the Government Accountability Office (GAO), etc., as well as CMS’ internal data analysis programs. The medical review will be performed on Medicare Fee for Service claims for Medicare Part A, Part B, and durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) programs.
Solicitations
| Notice | Posted |
|---|---|
| Pre-Solicitation |
Solicitation files
On GovTribe
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