HHS Awards $42.6M for Health Coverage Verification to Cotiviti Gov Services
Contract Overview
Contract Amount: $42,608,976 ($42.6M)
Contractor: Cotiviti GOV Services, LLC
Awarding Agency: Department of Health and Human Services
Start Date: 2023-02-15
End Date: 2027-02-14
Contract Duration: 1,460 days
Daily Burn Rate: $29.2K/day
Competition Type: FULL AND OPEN COMPETITION
Number of Offers Received: 2
Pricing Type: FIRM FIXED PRICE
Sector: Healthcare
Official Description: HEALTH COVERAGE VERIFICATION (HCV), FOR AUTOMATED VERIFICATION OF CRITICAL DATA SUPPLIED BY CONSUMERS DURING INTERACTIONS WITH CMS ON VARIOUS EXCHANGE PROGRAMS.
Place of Performance
Location: WINDSOR MILL, BALTIMORE County, MARYLAND, 21244
State: Maryland Government Spending
Plain-Language Summary
Department of Health and Human Services obligated $42.6 million to COTIVITI GOV SERVICES, LLC for work described as: HEALTH COVERAGE VERIFICATION (HCV), FOR AUTOMATED VERIFICATION OF CRITICAL DATA SUPPLIED BY CONSUMERS DURING INTERACTIONS WITH CMS ON VARIOUS EXCHANGE PROGRAMS. Key points: 1. Contract awarded to Cotiviti Gov Services, LLC for automated verification of critical consumer data. 2. The contract has a base value of $29.18M with options bringing the total to $42.6M. 3. This is a delivery order under a larger contract, indicating potential for future task orders. 4. The service falls under 'Other Accounting Services' (NAICS 541219).
Value Assessment
Rating: good
The contract's value of $42.6M over four years appears reasonable for a specialized IT service like automated data verification. Benchmarking against similar contracts for data processing and verification services would provide a more precise assessment.
Cost Per Unit: N/A
Competition Analysis
Competition Level: full-and-open
The contract was awarded under full and open competition, suggesting a competitive bidding process that likely resulted in fair pricing. The use of a delivery order under an existing contract implies that the initial competition was robust.
Taxpayer Impact: The use of automated verification aims to improve efficiency and accuracy in health coverage determination, potentially leading to cost savings and better resource allocation for taxpayers.
Public Impact
Ensures accuracy of critical data for consumers interacting with CMS exchange programs. Supports automated verification processes, potentially reducing manual effort and errors. Aims to streamline interactions with CMS for individuals seeking health coverage. Contributes to the integrity of health insurance marketplaces.
Waste & Efficiency Indicators
Waste Risk Score: 50 / 10
Warning Flags
- Potential for scope creep if additional verification needs arise.
- Reliance on a single vendor for critical data verification.
Positive Signals
- Awarded through full and open competition.
- Utilizes a firm-fixed-price contract type.
- Automated process likely increases efficiency.
Sector Analysis
This contract falls within the IT and Healthcare sectors, specifically focusing on data verification services for health insurance exchanges. Spending in this area is driven by the need for accurate eligibility determination and program integrity.
Small Business Impact
The data does not indicate whether small businesses were involved in this specific delivery order or the parent contract. Further analysis would be needed to determine small business participation.
Oversight & Accountability
The Centers for Medicare and Medicaid Services (CMS) is responsible for overseeing this contract. The firm-fixed-price structure provides some cost control, but ongoing monitoring of performance and deliverables is crucial.
Related Government Programs
- Other Accounting Services
- Department of Health and Human Services Contracting
- Centers for Medicare and Medicaid Services Programs
Risk Flags
- Potential for vendor lock-in.
- Data security and privacy concerns.
- System performance and reliability.
- Accuracy of automated verification algorithms.
Tags
other-accounting-services, department-of-health-and-human-services, md, delivery-order, 10m-plus
Frequently Asked Questions
What is this federal contract paying for?
Department of Health and Human Services awarded $42.6 million to COTIVITI GOV SERVICES, LLC. HEALTH COVERAGE VERIFICATION (HCV), FOR AUTOMATED VERIFICATION OF CRITICAL DATA SUPPLIED BY CONSUMERS DURING INTERACTIONS WITH CMS ON VARIOUS EXCHANGE PROGRAMS.
Who is the contractor on this award?
The obligated recipient is COTIVITI GOV SERVICES, 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 $42.6 million.
What is the period of performance?
Start: 2023-02-15. End: 2027-02-14.
What is the expected impact of this automated verification system on the accuracy and speed of health coverage determinations?
The automated Health Coverage Verification (HCV) system is designed to significantly improve the accuracy and speed of processing critical data supplied by consumers. By automating checks against various data sources, it aims to reduce manual errors, expedite eligibility assessments, and ensure that individuals receive appropriate health coverage benefits more efficiently, thereby enhancing the overall user experience with CMS exchange programs.
What are the primary risks associated with relying on Cotiviti Gov Services for this critical data verification function?
Key risks include potential data security breaches if the vendor's systems are compromised, vendor lock-in due to the specialized nature of the service, and performance issues if the automated system fails to accurately verify data or experiences downtime. Ensuring robust data protection measures, clear performance metrics, and contingency plans are vital to mitigate these risks.
How does this contract contribute to the overall effectiveness of CMS exchange programs?
This contract enhances the effectiveness of CMS exchange programs by ensuring the integrity of eligibility data. Accurate verification helps prevent improper payments, reduces administrative burden, and streamlines the enrollment process for consumers. This leads to a more efficient and trustworthy marketplace, ultimately supporting the program's mission of providing accessible health coverage.
Industry Classification
NAICS: Professional, Scientific, and Technical Services › Accounting, Tax Preparation, Bookkeeping, and Payroll Services › Other Accounting Services
Product/Service Code: SUPPORT SVCS (PROF, ADMIN, MGMT) › MANAGEMENT SUPPORT SERVICES
Competition & Pricing
Extent Competed: FULL AND OPEN COMPETITION
Solicitation Procedures: SUBJECT TO MULTIPLE AWARD FAIR OPPORTUNITY
Offers Received: 2
Pricing Type: FIRM FIXED PRICE (J)
Evaluated Preference: NONE
Contractor Details
Address: 10701 S RIVER FRONT PKWY, SOUTH JORDAN, UT, 84095
Business Categories: Category Business, Limited Liability Corporation, Not Designated a Small Business, Special Designations, U.S.-Owned Business
Financial Breakdown
Contract Ceiling: $53,373,935
Exercised Options: $42,608,976
Current Obligation: $42,608,976
Actual Outlays: $25,383,970
Contract Characteristics
Commercial Item: COMMERCIAL PRODUCTS/SERVICES
Parent Contract
Parent Award PIID: GS00F277CA
IDV Type: FSS
Timeline
Start Date: 2023-02-15
Current End Date: 2027-02-14
Potential End Date: 2028-02-14 00:00:00
Last Modified: 2026-02-10
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