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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.
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
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%
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).

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
29.0% Complete

Obligations and Backlog
$5.9B
Total Obligated
$14.5B
Current Award
$70.9B
Potential Award
8% Funded
$8.6B
Funded Backlog
$65.0B
Total Backlog

Award Hierarchy

Definitive Contract

HT940223C0001

Subcontracts

-

Activity Timeline

Interactive chart of timeline of amendments to HT940223C0001

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
Representative
John McGarvey
Modified: 10/16/25