Fresh Squeezed Daily: $240M Centers for Medicare & Medicaid Services Eligibility Appeals Operations Support (EAOS) contract

A research request was sent to OS AI earlier this month from a small business CEO looking for a list of some of the top partner [and/or competitor] options related to the potential FY 2023 recompete of a 5-year Centers for Medicare & Medicaid Services Eligibility Appeals Operations Support (EAOS) contract.  

Please note that as this was requested research, only a high-level view is provided here. The research requester received the complete report and list of partner options.  

Provided below are some of the competitive details shared with us by the requestor, followed by some high-level research, and what we call our Six Four One. 

Details Provided by Requestor 

Scope: Eligibility Appeals Operations Support (EAOS) – support the appeals process established for consumers and employers appealing eligibility determinations made by the Federally Facilitated Exchanges (FFEs) and State-based Exchanges (SBEs), to include supporting maintenance and management of the Eligibility Appeals Case Management System (EACMS) and leading Call Center related aspects of Operations for the EAOS Project. EAOS was established to develop and operate the Federal Marketplace eligibility appeals process, specifically to facilitate data collection, provide an initial determination, review appeal requests, provide general case management for the exchanges, provide recommendations to federal employees, and to provide hearing support required for these appeals. 

Competitive Details (if known):  

  • Funding Agency: Department of Health and Human Services / CMS 
  • Incumbent: Maximus 
  • Contract Vehicle: This was last competed on CIO-SP3. 
  • NAICS Series: 541512 
  • Expected Competition Date: Fiscal Year 2023 – date tbd 

Supporting Data: 

Key Points of Contact: 

  • Kevin Simpson, Director, Marketplace Appeals Group, CMS 
  • Ellen Kuhn, Acting Deputy Group Director, Marketplace Appeals Group, CMS 
  • Aleah Williamson, Marketplace Appeals Group Division Deputy Director of Technology and Operations, CMS 
  • Amberly Kovalick, CMS 

The Top Partners and Competitors and the Six Four One 

A list of 25 large and small companies who were well positioned to win this contract, as well as 14 key influencers, was generated and provided to the research requestor. The full list will not be published publicly, but we are including here is what we call our Six Four One.   

Six emerging small businesses to know

Four large firms making strategic investments in support of the agency

Note: This group of 10 companies is a subset of the 25 companies we identified and provided as part of the broader partners and competitors list. Whether it is key hires, key investments, or a proven ability to win, the list highlighted companies positioned to bid and win this contract, as a sub or Prime. Investments do not guarantee success, but they do signify intent.  

One agency opportunity influencer  

  • Cynthia Moreno, Marketplace Appeals Group Division Director of Technology and Operations, CMS 

Note: OS AI provided a list of 14 key opportunity influencers to the requester. Whether it is a current government leader driving change, an industry leader, or a recent former Federal official who can support capture, serve as key personnel, or ensure delivery upon award, this is a group of leaders any bidder will want to get to know.  

Is your company pursuing this effort or similar opportunities?  

Let others know you are interested in joining a team by either 1) Logging In and Commenting Below; or 2) Contacting us Here so we can add you to the list.  

Resources 

About OrangeSlices AI 

Developed by a team of government and industry contracting subject matter experts, the OrangeSlices AI data driven platform is a publicly available searchable listing of the top information technology and consulting services contractors doing business with the Federal government today. Driven by a robust and comprehensive set of authoritative and trusted data sources, the OS.ai tool is intended to help government and industry leaders find the right partner to help deliver on the important missions of the Federal government. Learn more about how you can engage with OS AI here.  

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