Case Management and Bill Auditing Services

ID: 75D301-24-Q-78141 • Type: Synopsis Solicitation

Description

This is a non-personal service(s) contract to perform client case management services and audits of
hospital and physician invoices for services rendered to clients enrolled in the Tuskegee Health
Benefit Program (THBP). The Contractor shall review claims and conduct audits to ensure the
THBP clients have received healthcare that is clinically appropriate and medically necessary.

The resulting contract from this solicitation will be a Firm Fixed Price, Single Award Purchase
Order. No work shall begin prior to a Purchase Order being issued.

Dates and Location of Contract Performance:
Period of Performance includes a one-year base period with two 12-month option periods. See table
below:
Base Period September 30, 2024 to September 29, 2025
Option Period 1 September 30, 2025 to September 29, 2026
Option Period 2 September 30, 2026 to September 29, 2027

Location of Performance will occur at multiple locations in accordance with the Statement of Work Tasks
and Subtasks. Performance for Tasks 1, 2, 4: Subtasks 3.1, 3.2.2, 3.3, and 3.4 will occur at the
Contractor's facility. Performance for Subtask 3.2.1 will occur at the THBP client's residence.
Performance for Subtask 3.5 will occur at the inpatient treatment facility.

The Government will award a contract resulting from this solicitation to the reponsible offeror
whose offer conforms to the solicitation and will be the most advantageous to the Government,
price and other factors considered. The following factors shall be used to evaluate the offers:
Technical Requirements Offeror shall meet the following:
Certified Case Manager (CCM). CCM certification is through The Commission for Case
Manager Certification
Certified Medical and/or Provider Bill Review Services. Certification through Certified Clinical
Financial Auditor (CCFA)
Shall be a member with the Case Management Society of America (CMSA)
75D301-24-Q-78141
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Shall be a current member of the American Association of Medical Audit Specialists (AAMAS)

Past Performace Provide a description of any and all projects performed within the past three years that
clearly demonstrates the offeror's experience in performing projects of similar scope, size, and
complexity to the requirements described in the RFQ.

Price: Quote shall be inclusive of all costs, base year and all options, to perfom the tasks specified in the
Statement of Work.

Background
The Tuskegee Health Benefit Program (THBP) is a congressionally mandated initiative providing comprehensive lifetime medical and health benefits to the affected wives/widows and offspring of participants in the Tuskegee Syphilis Study. Currently, there are 7 THBP clients located in five states (Alabama, Georgia, Illinois, New York, and Ohio) participating in the program.

The program has previously engaged in contractual agreements for case management and auditing services that have yielded significant savings and high-quality services for clients. The need to reestablish a contract for services arises as the current contract's final period of performance ends on September 29, 2024.

Work Details
The contractor will perform client case management services and audits of hospital and physician invoices for services rendered to clients enrolled in the THBP. Key tasks include:
1. **Kick-off Meeting**: Conducted within two weeks of award via teleconference, with minutes provided within two days.
2. **Quarterly Meetings**: Participation in quarterly calls with the CDC Project Officer to discuss activities, problems encountered, and procedures.
3. **Case Management Services**:
- Provide health benefit program cards for each client with embossed information including CDC logo, client name, contact information, coverage statement, and claim submission instructions.
- Conduct monthly telephone calls with each client and provide written summaries of treatment plans and progress.
- Annual visits to each client to update biopsychosocial assessments and provide trip reports summarizing visits.
- Maintain a toll-free number for clients and healthcare providers to contact case managers.

Period of Performance
The contract will have a base period from September 30, 2024 to September 29, 2025, followed by two option periods from September 30, 2025 to September 29, 2026 and from September 30, 2026 to September 29, 2027.

Place of Performance
Performance will occur at multiple locations including the contractor’s facility for certain tasks and at THBP clients’ residences or inpatient treatment facilities as specified.

Overview

Agency

Centers for Disease Control and Prevention (CDC) [HHS]

Response Deadline

Aug. 15, 2024, 2:00 p.m. EDT Past Due

Posted

Aug. 7, 2024, 9:24 a.m. EDT

Set Aside

Small Business (SBA)

NAICS

541618 - Other Management Consulting Services

PSC

R426 - Support- Professional: Communications

Place of Performance

United States

Source

SAM

Current SBA Size Standard

$19 Million

Pricing

Fixed Price

Est. Level of Competition

Low

Est. Value Range

Experimental

<$250,000 (solicitation indicates Simplified Acquisition Procedures, which in most cases, applies to contracts expected to be less than $250K in value)

Signs of Shaping

The solicitation is open for 8 days, below average for the Centers for Disease Control and Prevention.

On 8/7/24 Centers for Disease Control and Prevention issued Synopsis Solicitation 75D301-24-Q-78141 for Case Management and Bill Auditing Services due 8/15/24. The opportunity was issued with a Small Business (SBA) set aside with NAICS 541618 (SBA Size Standard $19 Million) and PSC R426.

Primary Contact

Name

Kathleen Waits Profile

zrh1@cdc.gov

Phone

None

Question & Answer

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Additional Details

Source Agency Hierarchy

HEALTH AND HUMAN SERVICES, DEPARTMENT OF > CENTERS FOR DISEASE CONTROL AND PREVENTION > CDC OFFICE OF ACQUISITION SERVICES

FPDS Organization Code

7523-00254

Source Organization Code

100188028

Last Updated

Aug. 30, 2024

Last Updated By