HHS Awards $158.5M Medicare Claims Processing Contract to Peraton Enterprise Solutions

Contract Overview

Contract Amount: $158,509,771 ($158.5M)

Contractor: Peraton Enterprise Solutions LLC

Awarding Agency: Department of Health and Human Services

Start Date: 2018-05-31

End Date: 2023-05-31

Contract Duration: 1,826 days

Daily Burn Rate: $86.8K/day

Competition Type: FULL AND OPEN COMPETITION

Number of Offers Received: 3

Pricing Type: FIRM FIXED PRICE

Sector: IT

Official Description: MEDICARE FEE-FOR-SERVICE CLAIMS PROCESSING - WORKLOAD A

Place of Performance

Location: PLANO, COLLIN County, TEXAS, 75024

State: Texas Government Spending

Plain-Language Summary

Department of Health and Human Services obligated $158.5 million to PERATON ENTERPRISE SOLUTIONS LLC for work described as: MEDICARE FEE-FOR-SERVICE CLAIMS PROCESSING - WORKLOAD A Key points: 1. Contract value of $158.5 million over five years. 2. Peraton Enterprise Solutions is the sole awardee. 3. Potential risks include vendor lock-in and performance issues. 4. Spending falls within the IT infrastructure and data processing sector.

Value Assessment

Rating: good

The contract value appears reasonable for a five-year period supporting critical Medicare operations. Benchmarking against similar large-scale IT service contracts would provide further validation.

Cost Per Unit: N/A

Competition Analysis

Competition Level: full-and-open

The contract was awarded under full and open competition, suggesting a robust price discovery process. However, as a single delivery order, it implies a specific task within a broader framework.

Taxpayer Impact: Taxpayer funds are being used to ensure the efficient processing of Medicare claims, a vital public service.

Public Impact

Ensures continued processing of Medicare fee-for-service claims. Supports the operational integrity of a major federal healthcare program. Impacts millions of Medicare beneficiaries and healthcare providers.

Waste & Efficiency Indicators

Waste Risk Score: 75 / 10

Warning Flags

Positive Signals

Sector Analysis

This contract falls under the IT sector, specifically focusing on computing infrastructure and data processing for healthcare services. Spending benchmarks for similar government IT contracts vary widely based on scope and complexity.

Small Business Impact

The data does not indicate specific provisions or set-asides for small businesses in this particular award. Further analysis would be needed to determine the extent of small business participation.

Oversight & Accountability

The Centers for Medicare and Medicaid Services (CMS) is responsible for overseeing this contract. Robust performance metrics and regular reviews are crucial for ensuring accountability and effective service delivery.

Related Government Programs

Risk Flags

Tags

computing-infrastructure-providers-data-, department-of-health-and-human-services, tx, delivery-order, 100m-plus

Frequently Asked Questions

What is this federal contract paying for?

Department of Health and Human Services awarded $158.5 million to PERATON ENTERPRISE SOLUTIONS LLC. MEDICARE FEE-FOR-SERVICE CLAIMS PROCESSING - WORKLOAD A

Who is the contractor on this award?

The obligated recipient is PERATON ENTERPRISE SOLUTIONS LLC.

Which agency awarded this contract?

Awarding agency: Department of Health and Human Services (Centers for Medicare and Medicaid Services).

What is the total obligated amount?

The obligated amount is $158.5 million.

What is the period of performance?

Start: 2018-05-31. End: 2023-05-31.

What is the specific scope of 'workload' covered by this contract and how is it measured?

The contract covers the workload associated with Medicare Fee-For-Service claims processing. While specific metrics aren't detailed here, this typically involves the volume of claims submitted, processed, and adjudicated. The 'workload' is likely defined by service level agreements (SLAs) within the contract, measuring factors like processing time, accuracy rates, and system uptime to ensure efficient operation of the Medicare program.

What are the key performance indicators (KPIs) used to assess Peraton's performance and ensure value for money?

Key performance indicators likely include metrics related to claims processing accuracy, turnaround time, system availability, data security, and compliance with regulations. CMS would monitor these KPIs against established benchmarks and contractually agreed-upon service levels. Consistent achievement of these KPIs is essential for demonstrating value for money and ensuring the continued effective operation of Medicare's claims processing.

How does this contract align with CMS's broader IT modernization strategy and long-term goals?

This contract supports the ongoing operational needs of Medicare claims processing, a foundational element of CMS's mission. Its alignment with broader modernization strategies would depend on whether the awarded services contribute to or hinder initiatives like cloud migration, data analytics enhancement, or the adoption of newer technologies. Ensuring the contract allows for flexibility and future integration is key to its long-term strategic value.

Industry Classification

NAICS: InformationComputing Infrastructure Providers, Data Processing, Web Hosting, and Related ServicesComputing Infrastructure Providers, Data Processing, Web Hosting, and Related Services

Product/Service Code: IT AND TELECOM - INFORMATION TECHNOLOGY AND TELECOMMUNICATIONSADP AND TELECOMMUNICATIONS

Competition & Pricing

Extent Competed: FULL AND OPEN COMPETITION

Solicitation Procedures: SUBJECT TO MULTIPLE AWARD FAIR OPPORTUNITY

Solicitation ID: RFPCMS20120007

Offers Received: 3

Pricing Type: FIRM FIXED PRICE (J)

Evaluated Preference: NONE

Contractor Details

Address: 15050 CONFERENCE CENTER DR, CHANTILLY, VA, 20151

Business Categories: Category Business, Limited Liability Corporation, Not Designated a Small Business, Special Designations, U.S.-Owned Business

Financial Breakdown

Contract Ceiling: $161,154,164

Exercised Options: $158,509,771

Current Obligation: $158,509,771

Actual Outlays: $53,218,993

Subaward Activity

Number of Subawards: 29

Total Subaward Amount: $3,260,893

Contract Characteristics

Commercial Item: COMMERCIAL PRODUCTS/SERVICES PROCEDURES NOT USED

Cost or Pricing Data: NO

Parent Contract

Parent Award PIID: HHSM500201300014I

IDV Type: IDC

Timeline

Start Date: 2018-05-31

Current End Date: 2023-05-31

Potential End Date: 2023-09-22 00:00:00

Last Modified: 2024-05-29

More Contracts from Peraton Enterprise Solutions LLC

View all Peraton Enterprise Solutions LLC federal contracts →

Other Department of Health and Human Services Contracts

View all Department of Health and Human Services contracts →

Explore Related Government Spending