Fresh Squeezed Daily: $45M+ CMS Drug Data Processing System (DDPS) & Payment Reconciliation System (PRS)

We will sound like a bit of a broken record here when we say that typically any contract recompete whereby the incumbent has a two-decade history of supporting the program passes with little attention. The continued trend by the Centers for Medicare and Medicaid Services however, to follow the rule of two, which requires contracting officials to set aside any acquisition when there is a reasonable expectation that offers will be obtained from at least two responsible small business concerns, means that CMS-focused small businesses will be taking an extra-long look at this opportunity to support these two established systems.  

In 2003, the Medicare Modernization Act was enacted by Congress, introducing the Medicare Part D prescription drug benefit as part of the Federal Medicare program. This crucial benefit provided financial support for the expenses of prescription drugs for numerous Medicare beneficiaries, a group that included a substantial number of Baby Boomers progressively joining the program each year. 

Nearly two decades ago, and preceding the implementation of this program, GDIT, a now multiple-time incumbent, was selected to undertake the design, development, validation, and implementation of an extensive Drug Data Processing System (DDPS). The primary objective of this system was to efficiently process all prescription drug events (PDEs) covered by Medicare, as well as non-covered events, along with the associated data. The significance of this data lies in its role in verifying and authenticating billions of dollars in Medicare payments related to prescription drugs. 

Moreover, GDIT was also entrusted with the responsibility of creating the Payment Reconciliation System (PRS), which functioned as a companion system to the DDPS. Its crucial role involved comparing prospective drug payment information with the actual costs incurred, thereby facilitating various types of payment reconciliations. 

The most recent and current contract, a 5-year task awarded to GDIT in 2019, was competed as unrestricted on the CMS SPARC IDIQ, drawing 4 bids. Contract Details and Spend to date for the predecessor contract can be found here. Saxon Infotech is a known subcontractor on this effort.  

An RFP competing the next iteration of the DDPS & PRS support contract is expected out as early as February of 2024. CMS has not stated which vehicle they will use to compete the next generation of this contract, but they do currently expect it to be unrestricted once again. While the acquisition strategy is not completely baked yet, what we do know is that small firms will be actively working to influence the direction of this procurement.   

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Related Data:    

Key Points of Contact (current or past) Sample 

Pro Tip 1: When viewing relevant Federal staff on LinkedIn – mutual connections you have can be an indicator of a potential partner or competitor 

Partnering    

Looking for an IT and consulting firm to partner with at CMS? Click Here   You can filter the list by several key indicators, including socio-economic status, NAICS, Contract vehicle, etc.  

Firms drawing the most attention:  

Below is a list of more than three dozen 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 eight weeks and that bring direct past performance and/or related relationships in support of CMS.  

** An Elev8 GovCon Honoree, noted for a corporate culture that demonstrates excellence, making the company a beacon for talent, for partners, and for clients.             

We cannot and will not speculate here as to the reasons for the increased interest, but whether it is a company evaluating them as a potential partner; a federal acquisition leader doing their due diligence; or a consultant weighing their next job move, this group of companies has been receiving increased interest.     

Pro Tip 2 – If you are a small business with capabilities and socio-economic status that might support this or any related effort, comment below and let others know you are interested. Comments are some of the most viewed portions of any article.  

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.    

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