HHS Awards $23.6M for Medicare Appeals to Maximus Federal Services
Contract Overview
Contract Amount: $23,608,971 ($23.6M)
Contractor: Maximus Federal Services, Inc.
Awarding Agency: Department of Health and Human Services
Start Date: 2006-07-01
End Date: 2009-06-30
Contract Duration: 1,095 days
Daily Burn Rate: $21.6K/day
Competition Type: COMPETITIVE DELIVERY ORDER
Number of Offers Received: 2
Pricing Type: FIXED PRICE
Sector: Healthcare
Official Description: MEDICARE 2ND LEVEL OF APPEALS
Place of Performance
Location: RESTON, FAIRFAX County, VIRGINIA, 20190
State: Virginia Government Spending
Plain-Language Summary
Department of Health and Human Services obligated $23.6 million to MAXIMUS FEDERAL SERVICES, INC. for work described as: MEDICARE 2ND LEVEL OF APPEALS Key points: 1. Maximus Federal Services secured a significant contract for Medicare's second level of appeals. 2. The contract was awarded under a competitive delivery order, suggesting a degree of price discovery. 3. Potential risks include the long duration and the fixed-price nature of the contract. 4. The sector is primarily administrative and management consulting services within healthcare.
Value Assessment
Rating: good
The contract's fixed-price structure with a total award of $23.6 million over three years suggests a negotiated price. Benchmarking against similar administrative management contracts would be necessary for a precise value assessment, but the scale appears reasonable for the service scope.
Cost Per Unit: N/A
Competition Analysis
Competition Level: unknown
Awarded as a competitive delivery order, this indicates that multiple vendors likely had the opportunity to bid. The competitive process should have driven a more favorable price for the government compared to a sole-source award.
Taxpayer Impact: The competitive award aims to ensure taxpayer funds are used efficiently for essential Medicare appeals processing.
Public Impact
Ensures continued processing of Medicare beneficiary appeals, a critical function for healthcare access. Supports the administrative infrastructure of a major federal healthcare program. Impacts beneficiaries by providing a formal process for disputing Medicare coverage decisions.
Waste & Efficiency Indicators
Waste Risk Score: 75 / 10
Warning Flags
- Fixed-price contract risk for scope creep.
- Long-term contract duration may not reflect evolving needs.
Positive Signals
- Competitive award process.
- Established contractor with relevant experience.
Sector Analysis
This contract falls within administrative management and general management consulting services, specifically supporting the Centers for Medicare and Medicaid Services. Spending benchmarks for similar government-wide consulting contracts would provide further context.
Small Business Impact
The provided data does not indicate whether small businesses were involved as subcontractors or prime contractors in this award. Further investigation would be needed to assess small business participation.
Oversight & Accountability
The contract was awarded by the Department of Health and Human Services, indicating oversight by a major federal agency. The competitive delivery order process suggests a structured procurement with accountability measures in place.
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
- Potential for cost overruns if scope expands beyond initial estimates.
- Risk of contractor prioritizing speed over quality in a fixed-price environment.
- Dependency on a single contractor for a critical function.
- Long contract duration may not adapt to changing regulations or technology.
Tags
administrative-management-and-general-ma, department-of-health-and-human-services, va, delivery-order, 10m-plus
Frequently Asked Questions
What is this federal contract paying for?
Department of Health and Human Services awarded $23.6 million to MAXIMUS FEDERAL SERVICES, INC.. MEDICARE 2ND LEVEL OF APPEALS
Who is the contractor on this award?
The obligated recipient is MAXIMUS FEDERAL SERVICES, INC..
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 $23.6 million.
What is the period of performance?
Start: 2006-07-01. End: 2009-06-30.
What was the specific basis for the competitive award, and were there significant differences in proposed pricing among bidders?
The basis for the competitive award would typically involve a combination of technical merit, past performance, and price. Without access to the source selection decision document, it's impossible to know the exact weighting or the range of proposed prices. However, a competitive process generally implies that price was a significant factor, and differences among bidders likely existed.
How does the per-beneficiary cost of processing appeals under this contract compare to industry benchmarks or previous contracts?
Benchmarking the per-beneficiary cost is crucial for assessing value. While the total contract value is $23.6 million over three years, the number of appeals processed and the complexity of each case are key variables. Without this specific volume data and a comparison to similar contracts or industry standards, it's difficult to definitively state if the cost is optimal.
What mechanisms are in place to ensure the quality and timeliness of appeals processing under this fixed-price contract?
Fixed-price contracts can sometimes incentivize speed over quality if not managed carefully. CMS likely has performance standards, service level agreements (SLAs), and quality assurance reviews built into the contract. Regular monitoring and reporting by CMS would be essential to ensure Maximus Federal Services meets both timeliness and accuracy requirements for Medicare appeals.
Industry Classification
NAICS: Professional, Scientific, and Technical Services › Management, Scientific, and Technical Consulting Services › Administrative Management and General Management Consulting Services
Product/Service Code: MEDICAL SERVICES › GENERAL HEALTH CARE SERVICES
Competition & Pricing
Extent Competed: COMPETITIVE DELIVERY ORDER
Solicitation Procedures: NEGOTIATED PROPOSAL/QUOTE
Solicitation ID: RFPQIC04001
Offers Received: 2
Pricing Type: FIXED PRICE (J)
Evaluated Preference: NONE
Contractor Details
Parent Company: Maximus Inc (UEI: 082347477)
Address: 11419 SUNSET HILLS ROAD, RESTON, VA, 20190
Business Categories: Category Business, Corporate Entity Not Tax Exempt, Not Designated a Small Business
Financial Breakdown
Contract Ceiling: $25,853,337
Exercised Options: $23,608,971
Current Obligation: $23,608,971
Contract Characteristics
Commercial Item: COMMERCIAL ITEM PROCEDURES NOT USED
Parent Contract
Parent Award PIID: HHSM500200400007I
IDV Type: IDC
Timeline
Start Date: 2006-07-01
Current End Date: 2009-06-30
Potential End Date: 2009-06-30 00:00:00
Last Modified: 2018-10-18
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