Notice ID: HT9402-23-RFI-0178
Description:
INTRODUCTION: The Defense Health Agency (DHA), DHA Contracting Activity (DHACA), Managed Care Contracting Division (MC-CD), is issuing this Request for Information pursuant to Defense Federal Acquisition Regulation Supplement (DFARS) Procedures, Guidance, and Information (PGI) 206.302-1, only one responsible source and no other supplies or services will satisfy agency requirements. The DHA intends to issue a sole-source bridge action to continue the provision of services provided under the existing TCRS contract, HT9402-17-D-0001, to Concept Plus. This contract modification to extend performance is necessary to continue to meet mission critical requirements and to support the transition to a competitively awarded follow-on TCRS contract.
Background: The Defense Health Agency (DHA) supports health services for more than 9.4 million beneficiaries of the Military Health System (MHS). The purpose of the TCRS contract is to assist the DHA Improper Payment Evaluation Branch (IPEB) in identifying and reporting improper payments and discrepancies in payment recording for the MHS. TCRS support provides an independent impartial review of claims processing procedures and reimbursement methodologies utilized by purchased-care contractors and assesses purchased-care contractor compliance with TRICARE policies and directives by evaluating the accuracy of claims payment and payment record coding for the MCSC, TMEP, TPharm, TOP, and ADDP contracts. TCRS helps support IBEP’s requirement to assess the potential risk of improper payments and to identify and report improper payments to the Office of Management and Budget (OMB) for publication in the Department of Defense (DoD) Agency Financial Report (AFR) pursuant to Public Laws 107-300, and the Payment Integrity Act of 2019 (PIIA), Public Laws 116-117.
