Medical Review Accuracy Contractor (MRAC)   3

** Amendment 0004 ** This Amendment makes updates to Solicitation Section E.6 and E.9 to remove reference to the Phase 2 proposal submission date being July 14, 2023 and now references the submission date as to be determined (TBD) (These changes are highlighted in red text within the amended Solicitation). The Government is still performing their Phase 1 evaluation and has not yet released Advisory Notifications as reference in Solicitation Sections E.11. Upon completion of the Phase 1 evaluation, Offerors will receive an Advisory Notification via e-mail from the Contracting Officer, which will include the submission date for the Phase 2 proposals. In addition, an amendment to the Solicitation will be posted on SAM.gov with the revised submission date for the Phase 2 proposals, which will be due approximately two-weeks following the Advisory Notification.

** Amendment 0003 ** - This Amendment updates Solicitation Clause C.2, FAR 52.212-5 CONTRACTTERMS AND CONDITIONS REQUIRED TO IMPLEMENT STATUTES OR EXECUTIVE ORDERS COMMERCIAL PRODUCTS AND COMMERICAL SERVICES, to the JUNE 2023 version, which incorporates FAR 52.204-27, Prohibition on a ByteDance Covered Application (Jun 2023).

** Amendment 0002 ** - Provide Offeror's with Exhibit E.7, Medical Records Factor 1, which is required to complete Phase 1, Evaluation Factor 1, Medical Record Review.

** Amendment 0001 ** - Provides updates/ revisions to the Solicitation as described within the attached Solicitation Amendment 0001 and revised Exhibits E.2 and E.4.

The purpose of this contract is to support the Centers for Medicare & Medicaid Services (CMS) by monitoring the accuracy of CMS' Medicare and Medicaid Medical Review Contractors (MRCs) medical review (MR) decision making, their ability to implement Medicare and Medicaid coverage, coding, payment, and billing policies, and the identification of potential fraud, waste, or abuse (FWA) patterns and/or trends. MRCs are defined as the Medicare Administrative Contractors (MACs), Supplemental Medical Review Contractor (SMRC), with workstreams in Program Integrity (SMRC PI) and Healthcare Fraud Prevention Partnership (SMRC HFPP), Unified Program Integrity Contractors (UPICs), and the Railroad Retirement Board Specialty MAC (RRB SMAC).