Fraud, Waste and Abuse (FWA) Software (VA-25-00032490)

Background
The Department of Veterans Affairs (VA), specifically the Financial Services Center (FSC), is responsible for adjudicating and paying healthcare claims from private providers outside of VA medical facilities. The VA requires a software tool to identify and eliminate fraud, waste, and abuse (FWA) during the adjudication and processing of healthcare claims transactions. This initiative aims to improve the efficiency of claims processing and enhance the return on investment for the FWA program.

Work Details
The contractor shall provide commercial-off-the-shelf (COTS) software designed to detect Fraud, Waste, and Abuse (FWA) along with associated operational services. The software must include analytics capabilities to identify billing patterns indicative of potential fraud. Key deliverables include:
- A perpetual license for unlimited use of the software.
- Configuration, implementation, integration, testing, deployment, training, maintenance, and technical support.
- Real-time FWA detection capabilities within the claims adjudication process before payment.
- Post-payment auditing/reviews.

Specific tasks include:
1. Implementation and Configuration for Authentication and Real-Time FWA Software.
2. FWA Claim Pattern Review.
3. Application Maintenance.

The contractor must also provide a Contractor Project Management Plan (CPMP) detailing their approach, timeline, tools used for execution, and how they will coordinate data collection reporting requests as identified in the PWS.

Period of Performance
The configuration and implementation period shall not exceed 2 years from contract award, followed by option periods of 12 months each for a total contract duration not exceeding 5 years.

Place of Performance
The software may be delivered as a Software as a Service (SaaS) solution or installed at the VA-FSC facility in Austin, Texas. Configuration, implementation, integration, and testing will occur at this location.