At the recent CMS Industry event, one of the more well-attended sessions centered around the Center for Program Integrity (CPI) and the several significant contracts that will be competed in the near future in support of the Centers for Medicare & Medicaid Services CPI Fraud Waste and Abuse initiatives, ranging from the Fraud Prevention System FPS 2.0 and Advanced Provider Screening (APS) recompetes to Open Payments and One Program Integrity (One PI). Included below we cover some of the notes Orange Slices captured from the industry day, some high-level details about the procurements, and we help identify some of the potential partners (or competitors) you will want to consider if you are pursuing these important contracts.
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Fraud Prevention System (FPS) 2.0 Recompete
FPS is the primary tool for identifying potential fraud, waste, and abuse at the Center for Program Integrity with a specific focus on predictive analytics to identify leads of potentially fraudulent providers, claim editing algorithms to reject or deny claims, and business intelligence.
Peraton, by way of their acquisition of the Federal IT and Mission Support Services Business of Northrop Grumman, is the Prime incumbent on this contract.
This 5-year contract was last awarded in 2016 with a projected valued at the time of $91.5M, but spending to date has been closer to $156M.
Where will it be competed?
The draft solicitation for FPS dropped right days before the industry event and this information will help CMS determine the choice of contract vehicles/schedule to be used. The contract was competed the last time around as an unrestricted contract using the CMS SPARC IDIQ, drawing 8 bidders. We fully expect this to stay as full and open/unrestricted, but don’t be surprised to see this competed using GSA Alliant 2 or on CIO-SP3. Tonya Anderson is the contracting officer for this opportunity. You can find her contact details here in the HHS Employee Directory.
When will it be competed?
The latest information posted by CMS shows a late December release date, but with this size of a deal, there may be the need for some extra signatures which could slow this down a bit.
Who should I partner with on this effort?
The Orange Slices BOT leverages AI and ML tools to evaluate and recommend the top dozen or so Partner options to consider reaching out to, as a Prime or sub, on this contract, besides the obvious Peraton:
- IBM/Truven Health Analytics
- GDIT
- CGI Federal
- National Government Services (NGS)/Anthem
- Deloitte
- NCI
- GovernmentCIO/Salient CRGT
- CVP (Customer Value Partners)
- IntegrityM
- eSimplicity
- A Square Group
- Analytica
- SoftDev
- Federated IT
- Softrams
- Oddball
- Sparksoft
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Incumbent Recompete Win Percentile
The OrangeSlices.ai BOT (OS.aiBOT) places the odds of Peraton winning this recompete contract at 75%.
Related News
Northrop Grumman Wins Next Generation Contract for Fraud Solutions at CMS, May 2016
Advanced Provider Screening (APS) Recompete
The APS system is a fraud-prevention solution that leverages a variety of commercial and government data sources (such as provider licensing and criminal history) to systematically prevent ineligible providers from enrolling in the Medicare and Medicaid systems.
TISTA is the Prime incumbent for this 5-year contract which was awarded at the end of FY 2016 with an initial value of $76M, but spending shows that CMS has obligated more than $154M to date.
Where will it be competed?
The contract was competed the last time around as an 8(a) set-aside on CIO-SP3 SB, drawing 4 bids. After experiencing incredible growth over the past several years, TISTA is naturally losing their small business eligibility on a number of contract vehicles and schedules as the time comes for them to re-certify, but as for CIO-SP3 SB, NITAAC is still showing TISTA as an 8(a) SB. Given the size and level of interest, we would expect to see a lot of jockeying from competitors as they try and influence where this contract is competed this time around. Tonya Anderson is the contracting officer for this opportunity. You can find her contact details here in the HHS Employee Directory.
When will it be competed?
We can only speculate here, but with a September contract end date, CMS will need to begin the activity in early 2022.
Who should I partner with on this effort?
The Orange Slices BOT leverages AI and ML tools to evaluate and recommend the top dozen or so Partner options to consider reaching out to, as a Prime or sub, on this contract, besides the obvious TISTA:
- National Government Services (NGS)/Anthem
- Booz Allen Hamilton
- Leidos
- YOROSIS Technologies
- Moser Consulting
- TurningPoint Global Solutions
- Index Analytics
- Haplet
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Incumbent Recompete Win Percentile
The OrangeSlices.ai BOT (OS.aiBOT) places the odds of TISTA winning this recompete contract at 45% (as a Prime)
Recent Related News
Be forewarned: At the industry day, CMS leaders were quick to point that the APS requirement “will read easy”, but that respondents “need to do their due diligence” as the system is much more complex than it may look like on the surface due to the many connections APS needs to make into state/county level systems and data.
One Program Integrity (One PI) Recompete
The One PI system serves as “an enterprise resource to help identify, deter and prevent all fraud, waste, and abuse (FWA) activities across the agency.” The incumbent “maintains the One PI portal and continuously works toward improving access to data in support of advance analytics performed by its user base.” Development and maintenance activities include:” Ensuring that data available in the Integrated Data Repository (IDR) can be accessed by One PI users through a CPI-specific access layer; Implementing new data sources; Ensuring that portal users can access the One PI analytic tools; Enabling people to share information about program integrity through the portal; Providing training on advanced business intelligence tools in support of advanced data analytics; and Maintaining a One PI Help Desk.” Source: OPTUMServe (More Here)
OPTUMServe is the Prime incumbent for this 5-year contract which was awarded at the end of FY 2017 with an initial value of $69M, but spending shows that CMS has obligated more than $100M to date.
Where will it be competed?
The contract was competed the last time around as full and open competition on the CIO-SP3 contract vehicle. Part of the research will center around picking the right contract vehicle. OPTUMServe has Prime access to a number of key contract vehicles, as do most of the likely Prime competitors. Tonya Anderson is the contracting officer for this opportunity. You can find her contact details here in the HHS Employee Directory.
When will it be competed?
With a September contract end date, CMS will need to begin the activity in early 2022 and/or extend the contract to allow for more time to get this approved. CMS discussed an 18-month timeline for the four procurements to be complete.
Who should I partner with on this effort?
The Orange Slices BOT leverages AI and ML tools to evaluate and recommend the top dozen or so Partner options to consider reaching out to, as a Prime or sub, on this contract, besides the obvious OPTUMServe:
- GDIT
- IBM/Truven Health Analytics
- Leidos
- Next Phase
- SBS-Corp
- Sparksoft
- IntegrityM
- Signature Consulting Group (SCG)
- Teradata
- C-HIT
Did OS.aiBOT miss you? If so, comment below or contact us here to be added
Incumbent Recompete Win Percentile
The OrangeSlices.ai BOT (OS.aiBOT) places the odds of OPTUMServe winning this recompete contract at 60%
Open Payments System Support Services (OPS)
OrangeSlices.ai covered this item last week. You can read more about the $50M Centers for Medicare & Medicaid Services Open Payments System Support Services (OPS) requirement in this posting. Read the full piece here.
Additional Notes
A common theme and bit of advice we heard from CPI and other leaders is to be prepared for when meeting with CPI/CMS
- Know the CPI book of business before you come in – check the CMS Opportunity Forecast regularly (it is updated monthly) and CPI will share some information in advance of the meeting if you ask. As for the transparency page website.
- Know your audience – CMS does not just want to hear a general capabilities briefing about your company – they want to know what specific problems you are going to solve.
- Be prepared to share how CMS can get to you – contract vehicles, sole source options, etc
- Make good use of the QA period – this is the #1 time to get the information you will need
- If using subs in your RFI/sources sought responses, make sure to detail how much and where they will be used. Lack of details raises risk.
- Bring tech people to any meeting with CMS, not just Business Development people.
- Lastly, be prepared to run any meeting you get with CMS.
Do you have additional information to share? Comment below.
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