HT940223C0001
Definitive Contract
Overview
Government Description
TRICARE MANAGED CARE SUPPORT SERVICES CONTRACT, 5TH GENERATION EAST REGION. PROVIDES MANAGED CARE SUPPORT TO THE DEPARTMENT OF DEFENSE, DEFENSE HEALTH AGENCY, TRICARE PROGRAM IN THE EAST REGION, ASSISTING IN OPERATING AN INTEGRATED HEALTH CARE DELIVERY SYSTEM THAT COMBINES CONTRACTOR RESOURCES WITH THE MILITARY’S DIRECT MEDICAL CARE SYSTEM TO DELIVER HEALTH, MEDICAL, AND ADMINISTRATIVE SUPPORT SERVICES TO ELIGIBLE UNIFORMED SERVICES MEMBERS, RETIREES, AND THEIR FAMILIES. WORK PERFORMED INCLUDES NETWORK APPOINTMENT AVAILABILITY DATA COLLECTION, HEDIS COMPLIANCE AUDITS, PROFESSIONAL CREDENTIALING AND PRIVILEGING, EVIDENCE-BASED MEDICINE SERVICES, HOSPITAL SAFETY GRADE DATA, PHYSICIAN PEER REVIEW FOR HEALTH CLAIMS, CUSTOMER ADVOCATE AND CONTACT CENTER OPERATIONS, BILLING AND ENROLLMENT SERVICES, NETWORK ADEQUACY MEASUREMENT, PROVIDER MANAGEMENT PLATFORM DEVELOPMENT, MEDICAL NECESSITY OPINIONS, CLAIMS PROCESSING, HEALTHCARE STAFFING, CARE MANAGEMENT PLATFORM INTEGRATION, PRINT/MAIL/FULFILLMENT, IT SUPPORT, AND QUALITY INTELLIGENCE APPLICATION SERVICES. THESE SERVICES ARE DELIVERED THROUGHOUT THE EAST REGION, INCLUDING WASHINGTON, D.C. AND 21 STATES, AT MILITARY SERVICE COMPONENT SITES, CONTRACTOR CALL CENTERS, AND WITHIN AN INTEGRATED HEALTHCARE PROVIDER NETWORK.
Awardee
Awarding / Funding Agency
Place of Performance
Louisville, KY 40222 United States
Pricing
Cost Plus Award Fee
Set Aside
None
Extent Competed
Full And Open Competition
Est. Average FTE
36186
Related Opportunity
Analysis Notes
Amendment Since initial award the Potential End Date has been extended from 01/31/33 to 06/30/33 and the Potential Award value has increased from $70,846,618,321 to $70,865,192,438.
Subcontracting Plan This Definitive Contract has an Individual Subcontract Plan. The Department of Defense has an overall small business subcontracting goal of 30%
Subcontracting Plan This Definitive Contract has an Individual Subcontract Plan. The Department of Defense has an overall small business subcontracting goal of 30%
Humana Government Business was awarded
Definitive Contract HT940223C0001 (HT9402-23-C-0001)
for Tricare Managed Care Support Services Contract, 5th Generation East Region
worth up to $70,865,192,438
by Defense Health Agency
in February 2023.
The contract
has a duration of 10 years 4 months and
was awarded
through solicitation Request For Proposals TRICARE Managed Care Support (T-5) HT9402-20-R-0005
full & open
with
NAICS 524114 and
PSC Q201
via direct negotiation acquisition procedures with 2 bids received.
As of today, the Definitive Contract has a total reported backlog of $64,975,065,340 and funded backlog of $8,574,794,885.
DOD Announcements
Dec 2022:
Humana Government Business Inc., Louisville, Kentucky, has been selected to provide managed care support to the Department of Defense, Defense Health Agency, TRICARE program in the East Region. The total potential contract value, including all transition and options periods, is estimated at $70,846,618,321. The contractor will assist the Defense Health Agency in operating an integrated health care delivery system combining the resources of the contractor and the military’s direct medical care system to provide health, medical and administrative support services to eligible members of the uniformed services, retirees and their eligible family members. The East Region includes Washington, D.C., and the states of Alabama, Connecticut, Delaware, Florida, Georgia, Indiana, Kentucky, Maine, Maryland, Massachusetts, Michigan, Mississippi, New Hampshire, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, South Carolina, Tennessee, Vermont, Virginia and West Virginia. The cost-plus-award-fee, firm-fixed-price, and fixed-price type contract has a 12-month base period (transition-in) and eight one-year option periods for health care delivery, plus a transition-out period. This contract also includes incentives and performance guarantees. The transition-in period begins Feb. 1, 2023. This contract was procured utilizing competitive source selection and two offers were received. The Defense Health Agency’s Managed Care Contracting Division, Aurora, Colorado, will administer the contract (HT940223C0001).
Jan 2023: Humana Government Business Inc., Louisville, Kentucky, was awarded a modification to a previously awarded cost-plus-fixed-fee T-2017 East Managed Care Service Contract (HT9402-16-C-0001) with a potential value of $16,259,562,586. The modification is to ensure continuity of healthcare delivered during the T-5 Managed Care Service Contract (HT940223C0001) transition-in period. This modification extends the current contract performance period by the addition of two one-year option periods beginning Jan. 1, 2023. Work will be performed throughout the eastern region of the continental U.S. at military service component sites, contractor call centers, and within an integrated healthcare provider network. Fiscal 2023 operation and maintenance funds for the first option period are being obligated at time of award. The Defense Health Agency, Managed Care Contracting Division, Aurora, Colorado, is the contracting activity. (Awarded Dec. 23, 2022)
Dec 2025: Humana Government Business Inc., Louisville, Kentucky, is awarded $7,342,637,605 to exercise Option Period Two under contract number HT9402-23-C-0001 (inclusive of adjustments to estimated health care costs, as a result of change orders accomplished during the implementation phase of contract performance) for health care and administrative support services in support of the Defense Health Agency (DHA) TRICARE program in the East Region. The contractor will assist DHA in operating an integrated health care delivery system combining the resources of the contractor and the military's direct medical care system to provide health, medical, and administrative support services to eligible members of the uniformed services, retirees, and their eligible family members. The East Region includes Washington, D.C., and the states of Alabama, Arkansas, Connecticut, Delaware, Florida, Georgia, Indiana, Kentucky, Maine, Maryland, Massachusetts, Michigan, Mississippi, Missouri, New Hampshire, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, South Carolina, Tennessee, Vermont, Virginia, and West Virginia. The cost-plus-award-fee, firm-fixed-price, and fixed-price type contract was awarded Dec. 22, 2022, with a 12-month base period (transition-in) and eight one-year option periods, plus a transition-out period. The option year period of performance is Jan. 1, 2026, to Dec. 31, 2026. The place of performance is Louisville, Kentucky. The Defense Health Agency's Managed Care Contracting Division, Aurora, Colorado, is the contracting activity. (Awarded Dec. 16, 2025.)
Jan 2023: Humana Government Business Inc., Louisville, Kentucky, was awarded a modification to a previously awarded cost-plus-fixed-fee T-2017 East Managed Care Service Contract (HT9402-16-C-0001) with a potential value of $16,259,562,586. The modification is to ensure continuity of healthcare delivered during the T-5 Managed Care Service Contract (HT940223C0001) transition-in period. This modification extends the current contract performance period by the addition of two one-year option periods beginning Jan. 1, 2023. Work will be performed throughout the eastern region of the continental U.S. at military service component sites, contractor call centers, and within an integrated healthcare provider network. Fiscal 2023 operation and maintenance funds for the first option period are being obligated at time of award. The Defense Health Agency, Managed Care Contracting Division, Aurora, Colorado, is the contracting activity. (Awarded Dec. 23, 2022)
Dec 2025: Humana Government Business Inc., Louisville, Kentucky, is awarded $7,342,637,605 to exercise Option Period Two under contract number HT9402-23-C-0001 (inclusive of adjustments to estimated health care costs, as a result of change orders accomplished during the implementation phase of contract performance) for health care and administrative support services in support of the Defense Health Agency (DHA) TRICARE program in the East Region. The contractor will assist DHA in operating an integrated health care delivery system combining the resources of the contractor and the military's direct medical care system to provide health, medical, and administrative support services to eligible members of the uniformed services, retirees, and their eligible family members. The East Region includes Washington, D.C., and the states of Alabama, Arkansas, Connecticut, Delaware, Florida, Georgia, Indiana, Kentucky, Maine, Maryland, Massachusetts, Michigan, Mississippi, Missouri, New Hampshire, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, South Carolina, Tennessee, Vermont, Virginia, and West Virginia. The cost-plus-award-fee, firm-fixed-price, and fixed-price type contract was awarded Dec. 22, 2022, with a 12-month base period (transition-in) and eight one-year option periods, plus a transition-out period. The option year period of performance is Jan. 1, 2026, to Dec. 31, 2026. The place of performance is Louisville, Kentucky. The Defense Health Agency's Managed Care Contracting Division, Aurora, Colorado, is the contracting activity. (Awarded Dec. 16, 2025.)
Status
(Open)
Last Modified 10/16/25
Period of Performance
2/1/23
Start Date
12/31/29
Current End Date
6/30/33
Potential End Date
Obligations and Backlog
$5.9B
Total Obligated
$14.5B
Current Award
$70.9B
Potential Award
$8.6B
Funded Backlog
$65.0B
Total Backlog
Award Hierarchy
Definitive Contract
HT940223C0001
Subcontracts
Activity Timeline
Subcontract Awards
Disclosed subcontracts for HT940223C0001
Opportunity Lifecycle
Procurement history for HT940223C0001
Transaction History
Modifications to HT940223C0001
People
Suggested agency contacts for HT940223C0001
Competition
Number of Bidders
2
Solicitation Procedures
Negotiated Proposal/Quote
Evaluated Preference
None
Performance Based Acquisition
Yes
Commercial Item Acquisition
Commercial Item Procedures Not Used
Simplified Procedures for Commercial Items
No
Other Categorizations
Subcontracting Plan
Individual Subcontract Plan
Cost Accounting Standards
Yes
Business Size Determination
Large Business
Defense Program
None
DoD Claimant Code
None
IT Commercial Item Category
Not Applicable
Awardee UEI
ZE6ZM6NKSV43
Awardee CAGE
050S0
Agency Detail
Awarding Office
HT9402 DEFENSE HEALTH AGENCY
Funding Office
HT0064
Created By
yannick.bongo@web97dh.dha
Last Modified By
mwebb@web97dh.dha
Approved By
mwebb@web97dh.dha
Legislative
Legislative Mandates
Labor Standards
Performance District
KY-03
Senators
Mitch McConnell
Rand Paul
Rand Paul
Representative
John McGarvey
Modified: 10/16/25