Informal Request for Proposals (RFP) Centers for Medicare & Medicaid Services (CMS) Medicare Section 111 Reporting Services

The Orange County Transportation Authority is requesting proposals for Centers for Medicare & Medicaid Services Medicare Section 111 reporting services under an informal RFP, with proposals due October 14, 2026. The contract is valued at $36,000 for an initial three-year term with one two-year renewal option.

The scope requires the selected contractor to serve as OCTA's CMS reporting agent, managing compliance, technical submission, correction, and support services for non-group health plan liability claims only. The contractor must integrate with Origami Risk, OCTA's claims system of record, and migrate existing CMS Section 111 reporting data and available historical Insurance Services Office ClaimSearch results from the incumbent provider, Verisk, into Origami. The replacement service must be fully operational no later than January 1, 2027, following the end of Verisk's services on December 31, 2026. Key deliverables include project initiation within ten business days of Notice to Proceed, configuration and mapping within thirty calendar days, completion of data migration by December 15, 2026, and testing and readiness certification by December 15, 2026. Historical workload data shows low and variable claim volumes: 65 ISO Claim Searches and 13 Medicare-eligible claims over the five-year period from fiscal years 2021–22 through 2025–26.

Performance standards require 100 percent timeliness of CMS submissions within applicable windows, accurate and reconciled data, documented backup and recovery procedures, and SOC 2 Type II or equivalent security assurance including encryption, role-based access, and multi-factor authentication. All services, staffing, tools, testing, secure connectivity, and reporting-agent expertise are the contractor's responsibility. Excluded services include workers' compensation reporting, Medicare Set-Asides, and general claims administration. OCTA retains final responsibility for all reporting decisions.

Pricing must be submitted as firm-fixed prices for both an all-inclusive option and an implementation-plus-fixed-annual-pricing option, with all prices firm throughout the contract duration. Offers must remain valid for a minimum of 120 days from proposal submission. Offerors may submit technical or contractual exceptions or deviations using Exhibit D; those submitting no exceptions are deemed to accept all stated obligations and terms.