HHS Awards $22.3M Medicaid Integrity Contract to Truven Health Analytics

Contract Overview

Contract Amount: $22,337,114 ($22.3M)

Contractor: Truven Health Analytics LLC

Awarding Agency: Department of Health and Human Services

Start Date: 2008-04-14

End Date: 2013-04-13

Contract Duration: 1,825 days

Daily Burn Rate: $12.2K/day

Competition Type: COMPETITIVE DELIVERY ORDER

Number of Offers Received: 1

Pricing Type: COST PLUS AWARD FEE

Sector: Other

Official Description: TAS::75 0516::TAS REVIEW OF PROVIDERMEDICAID INTEGRITY CONTRACT

Place of Performance

Location: ANN ARBOR, WASHTENAW County, MICHIGAN, 48103

State: Michigan Government Spending

Plain-Language Summary

Department of Health and Human Services obligated $22.3 million to TRUVEN HEALTH ANALYTICS LLC for work described as: TAS::75 0516::TAS REVIEW OF PROVIDERMEDICAID INTEGRITY CONTRACT Key points: 1. Contract awarded to Truven Health Analytics LLC for administrative management consulting. 2. The contract value is $22.3 million over a 5-year period. 3. Competition details are limited, but it was a competitive delivery order. 4. The sector is primarily administrative and management consulting services.

Value Assessment

Rating: fair

The contract type is Cost Plus Award Fee, which can lead to higher costs if not managed tightly. Benchmarking against similar contracts is difficult without more detailed cost breakdowns.

Cost Per Unit: N/A

Competition Analysis

Competition Level: unknown

This was a competitive delivery order, suggesting some level of competition existed. However, the specific details of the competition and how price was discovered are not fully detailed.

Taxpayer Impact: The cost-plus award fee structure necessitates careful oversight to ensure taxpayer funds are used efficiently and effectively.

Public Impact

Ensures integrity in provider payments within Medicaid. Supports the Centers for Medicare and Medicaid Services (CMS) in program integrity efforts. Aims to prevent fraud, waste, and abuse in the Medicaid program. Impacts healthcare providers and beneficiaries through improved program administration.

Waste & Efficiency Indicators

Waste Risk Score: 50 / 10

Warning Flags

Cost Plus Award Fee structure requires diligent oversight.
Limited detail on competition specifics.
Contract duration is substantial (5 years).

Positive Signals

Focus on program integrity is crucial for Medicaid.
Awarded to a known entity in health analytics.
Competitive delivery order indicates some market vetting.

Sector Analysis

This contract falls under administrative management and general management consulting services, a broad category. Benchmarks for similar large-scale program integrity contracts within government agencies are often specific to the agency's mission and scope.

Small Business Impact

The data does not indicate any specific set-asides or participation goals for small businesses in this contract.

Oversight & Accountability

The contract's success relies heavily on CMS's oversight of the Cost Plus Award Fee structure and the contractor's performance in ensuring Medicaid integrity.

Related Government Programs

Administrative Management and General Management Consulting Services
Department of Health and Human Services Contracting
Centers for Medicare and Medicaid Services Programs

Risk Flags

Cost Plus Award Fee structure can lead to cost overruns without strict oversight.
Limited transparency on the competitive process.
Potential for contractor performance to drift over a long contract duration.
Lack of explicit performance metrics in the provided data.

Frequently Asked Questions

What is this federal contract paying for?

Department of Health and Human Services awarded $22.3 million to TRUVEN HEALTH ANALYTICS LLC. TAS::75 0516::TAS REVIEW OF PROVIDERMEDICAID INTEGRITY CONTRACT

Who is the contractor on this award?

The obligated recipient is TRUVEN HEALTH ANALYTICS 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 $22.3 million.

What is the period of performance?

Start: 2008-04-14. End: 2013-04-13.

What specific metrics were used to determine the 'award fee' in this Cost Plus Award Fee contract, and how did they align with achieving Medicaid integrity goals?

The specific metrics for the award fee are not detailed in the provided data. Typically, for Medicaid integrity contracts, these metrics would focus on the effectiveness of fraud detection, recovery of improper payments, and improvements in program administration efficiency. A robust set of performance standards and measurable outcomes would be essential to justify the award fee and ensure it incentivizes the contractor to meet or exceed program integrity objectives.

Given the 5-year duration, what mechanisms were in place to ensure the contractor remained innovative and responsive to evolving threats in Medicaid fraud and abuse?

The provided data does not specify mechanisms for ensuring innovation over the contract's 5-year term. However, effective contracts often include clauses for regular performance reviews, potential contract modifications based on emerging threats, and requirements for the contractor to propose proactive solutions. The Cost Plus Award Fee structure could also incentivize innovation if award criteria included the development and implementation of novel integrity-enhancing strategies.

How does the $22.3 million expenditure compare to the estimated savings or recoveries achieved through the provider Medicaid integrity efforts under this contract?

The provided data does not include information on savings or recoveries. To assess the value for money, a comparison of the contract cost against the quantifiable benefits, such as identified fraud, waste, and abuse, and the amount of funds recovered or prevented from being improperly disbursed, would be necessary. This cost-benefit analysis is critical for evaluating the overall effectiveness of the contract.

Industry Classification

NAICS: Professional, Scientific, and Technical Services › Management, Scientific, and Technical Consulting Services › Administrative Management and General Management Consulting Services

Product/Service Code: SUPPORT SVCS (PROF, ADMIN, MGMT) › ADMINISTRATIVE SUPPORT SERVICES

Competition & Pricing

Extent Competed: COMPETITIVE DELIVERY ORDER

Solicitation Procedures: NEGOTIATED PROPOSAL/QUOTE

Solicitation ID: CMS2007DB2

Offers Received: 1

Pricing Type: COST PLUS AWARD FEE (R)

Evaluated Preference: NONE

Contractor Details

Parent Company: International Business Machines Corporation

Address: 777 E EISENHOWER PKWY, ANN ARBOR, MI, 48108

Business Categories: Category Business, Corporate Entity Not Tax Exempt, Manufacturer of Goods, Not Designated a Small Business, Special Designations, U.S.-Owned Business

Financial Breakdown

Contract Ceiling: $27,170,406

Exercised Options: $22,337,114

Current Obligation: $22,337,114

Contract Characteristics

Commercial Item: COMMERCIAL PRODUCTS/SERVICES PROCEDURES NOT USED

Parent Contract

Parent Award PIID: HHSM500200800008I

IDV Type: IDC

Timeline