Centers for Medicare & Medicaid Services (CMS) Medicare Section 111 Reporting Services

The Orange County Transportation Authority (OCTA) is requesting proposals for Centers for Medicare & Medicaid Services (CMS) Medicare Section 111 liability reporting agent services under RFP C260493, with proposals due September 2, 2026 at 2:00 p.m. Written questions are due August 24, 2026.

OCTA is a self-insured, self-administering transportation authority replacing its incumbent provider, Verisk (current PO A56213, ending December 31, 2026), with a qualified contractor who will integrate CMS Section 111 reporting with OCTA's Origami Risk claims system. The contractor must achieve full operational capability by January 1, 2027—a firm deadline driven by the incumbent's contract expiration.

The scope encompasses transition and implementation from Verisk; data migration and reconciliation of existing CMS Section 111 records and historical ISO ClaimSearch results into Origami; secure API or SFTP integration with Origami (which remains OCTA's claims system of record and will not be replaced); ongoing Medicare eligibility processing and quarterly CMS submissions; pre-submission edits and error resolution; compliance monitoring; audit and inquiry support; and transition-out assistance. Historical workload over five fiscal years (2021–22 through 2025–26) included 65 ISO claim searches and 13 Medicare-eligible claims; volumes do not guarantee future work or create minimum commitments. Key deliverables include project initiation within 10 business days of Notice to Proceed, configuration and mapping within 30 calendar days, incumbent data migration by December 15, 2026, testing and readiness certification by December 15, 2026, and production go-live no later than January 1, 2027.

The estimated contract value is $36,000 for an initial three-year firm-fixed-price term, with an optional two-year renewal term valued at $15,166. The all-inclusive firm-fixed price covers all labor, project management, systems, secure data exchange, implementation, data migration, Origami integration, Medicare queries, CMS submissions, corrections, account administration, training, and transition assistance—with no separate charges by claim, claimant, query, file, record, or support hour. Offerors submit pricing under Option A (one total three-year price with fixed annual installments) or Option B (separate implementation price plus fixed annual managed-service prices for each contract year). Prices must remain firm for 120 days from proposal date.

Minimum qualifications require at least three years of demonstrated NGHP Section 111 reporting-agent experience with liability or self-insured programs, current expertise in CMS registration and technical specifications, demonstrated integration experience with Origami Risk or comparable systems, and adequate staffing to meet the January 1, 2027 go-live deadline.

The evaluation committee (Gyromee Hatcher, Applications Analyst, Information Systems; Regie Peaslee, Senior Claims Representative, Risk Management; and Yamille Welch, Senior Workers Compensation Program Specialist, Risk Management) will score proposals on Qualifications of the Firm (25%), Staffing and Project Organization (20%), Work Plan (30%), and Cost (25%).

The contractor must maintain Commercial General Liability ($1,000,000 per occurrence / $2,000,000 aggregate), Automobile Liability ($1,000,000 combined single limit), Workers' Compensation as required by California, and Employers' Liability ($1,000,000 per accident / $1,000,000 per disease) with certificates provided within ten calendar days of agreement effectiveness and referenced to agreement number C260493. OCTA retains ownership of all claim data, configuration decisions, and submission histories. No certifications are required. A pre-evaluation meeting is scheduled for September 2, 2026 at 3:30 p.m., with proposal evaluation on September 16, 2026 at 10:00 a.m. and a Best and Final Offer opportunity on September 17, 2026. Contract execution is anticipated by September 30, 2026. OCTA's response to written questions will be issued August 26, 2026.