Fresh Squeezed Daily: $40M CMS Lead Analytical Contractor (LAC) for Risk Adjustment Data Validation (RADV) Opportunity

A research request was recently provided to OS AI from a large commercial Health IT and Program Integrity Specialist looking for details related to a potential FY 2023 recompete of this Centers for Medicare & Medicaid Services contract.  

The complete response from OS AI is not included here, but we at OrangeSlices AI do believe in the need for more and better-informed competition, so provided below are some of the competitive details. 

Opportunity Details Provided by Requestor:  

Scope: An overarching goal for the predecessor contract is “to validate payments made to States and Private Insurance Organizations”, to include undertaking “many activities to validate the inputs and outputs of payments made to Medicare, Medicaid, and Health Insurance Exchange private plans programs’ payments to assure payment accuracy, while providing the Centers for Medicare and Medicaid Services (CMS) and the Center for Program Integrity (CPI) with technical and analytical support with the following: Medicare Part-C Risk Adjustment Data Validation (RADV) activities, and Medicaid Medical Loss Ratio (MLR) audits.” 

Competitive Details (if known): 

  • Funding Agency: Department of Health and Human Services / Centers for Medicare & Medicaid Services 
  • Incumbent: Deloitte          
  • Contract Vehicle: This was last competed full and open on GSA FSS. 
  • Expected Competition Date: Fiscal Year 2023 – date tbd  
  • Contract Details and Spend to Date for Award ID 75FCMC19F0005 

** Please note that OS AI will not speculate here as to the accuracy of any scope details provided and/or any current plans related to the timing, details, and likelihood of any recompete.  

Related Data:  

Sample of Key Potential Points of Contact (current or past): 

  • Gina Romano, Contracts, CMS – Gina.Romano1@cms.hhs.gov 
  • Michelle Brown, Contracts, CMS  
  • William Wray, Project Delivery Manager, LAC RADV, Deloitte Consulting 
  • Marcus Henderson, Senior Advisory Consultant, LAC RADV, Deloitte Consulting 
  • Robert Brotzman, Managing Director, Deloitte 

Firms drawing the most attention: 

Included below is a list of the large and small companies we have noted as drawing the most views by Government and industry leaders on the OrangeSlices AI consultant directory over the past week and that bring direct past performance and/or related relationships in support of the Centers for Medicare & Medicaid Services.  

Please note that the research requestor for this item received a Premium OS AI Opp Segment report including 1) known details about how/if/when/where this contract will be competed; 2) a list of the top companies that are in position to win today (as well as those who have been making key investments and moves of late to position for a win); and 3) a detailed list of the top potential opportunity influencers any bidder will want to get to know. Whether it is current government leaders driving change, industry leaders, or recent former Federal officials 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.  

Want to see more of the top firms with direct past performance in support of the Centers for Medicare & Medicaid Services on similar consulting efforts? You can start here   

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 (it is free); or 2) Contacting us Here so we can add you.   

Additional 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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