Medicare DME MAC Jurisdiction A Contract Awarded to NHIC Corp for $105M

Contract Overview

Contract Amount: $105,226,239 ($105.2M)

Contractor: Nhic, Corp

Awarding Agency: Department of Health and Human Services

Start Date: 2011-04-01

End Date: 2016-08-31

Contract Duration: 1,979 days

Daily Burn Rate: $53.2K/day

Competition Type: FULL AND OPEN COMPETITION

Number of Offers Received: 5

Pricing Type: COST PLUS AWARD FEE

Sector: Healthcare

Official Description: DURABLE MEDICAL EQUIPMENT MEDICARE ADMINISTRATIVE CONTRACT JURISDICTION A

Place of Performance

Location: HINGHAM, PLYMOUTH County, MASSACHUSETTS, 02043

State: Massachusetts Government Spending

Plain-Language Summary

Department of Health and Human Services obligated $105.2 million to NHIC, CORP for work described as: DURABLE MEDICAL EQUIPMENT MEDICARE ADMINISTRATIVE CONTRACT JURISDICTION A Key points: 1. Contract value of $105.2M over 5 years. 2. Awarded under full and open competition. 3. Potential risk in cost-plus award fee structure. 4. Sector: Healthcare administration and insurance.

Value Assessment

Rating: fair

The contract's Cost Plus Award Fee (CPAF) structure can incentivize performance but may also lead to higher costs if not managed carefully. Benchmarking against similar administrative contracts is difficult without detailed performance data.

Cost Per Unit: N/A

Competition Analysis

Competition Level: full-and-open

The contract was awarded through full and open competition, suggesting a robust price discovery process. However, the CPAF structure requires careful monitoring to ensure cost-effectiveness.

Taxpayer Impact: Taxpayer funds are used for Medicare administration. The efficiency of this contract directly impacts the cost of healthcare services for beneficiaries.

Public Impact

Impacts Medicare beneficiaries' access to durable medical equipment. Ensures proper administration and claims processing for a critical healthcare service. Affects the operational efficiency of the Centers for Medicare and Medicaid Services (CMS).

Waste & Efficiency Indicators

Waste Risk Score: 50 / 10

Warning Flags

Positive Signals

Sector Analysis

This contract falls within the healthcare sector, specifically Medicare administrative services. Spending benchmarks for similar administrative contracts are highly variable based on scope and complexity.

Small Business Impact

The data does not indicate any specific provisions or awards to small businesses under this contract.

Oversight & Accountability

CMS is responsible for oversight. The CPAF structure necessitates diligent performance monitoring and auditing to ensure value for money and prevent cost overruns.

Related Government Programs

Risk Flags

Tags

direct-health-and-medical-insurance-carr, department-of-health-and-human-services, ma, definitive-contract, 100m-plus

Frequently Asked Questions

What is this federal contract paying for?

Department of Health and Human Services awarded $105.2 million to NHIC, CORP. DURABLE MEDICAL EQUIPMENT MEDICARE ADMINISTRATIVE CONTRACT JURISDICTION A

Who is the contractor on this award?

The obligated recipient is NHIC, CORP.

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 $105.2 million.

What is the period of performance?

Start: 2011-04-01. End: 2016-08-31.

How effectively did the CPAF structure incentivize NHIC, Corp to control costs while maintaining service quality?

The effectiveness of the CPAF structure hinges on the specific award fee criteria and CMS's oversight. Without detailed performance metrics and award fee payouts, it's difficult to definitively assess cost control effectiveness. A well-defined criteria set should reward efficiency and quality, but poorly managed CPAF can lead to inflated costs if the government's evaluation process is not rigorous.

What were the primary risks associated with the full and open competition for this contract?

While full and open competition generally promotes a competitive environment, risks can include the complexity of evaluating multiple proposals, potential for protests, and ensuring that the chosen contractor possesses the specialized expertise required for Medicare administration. The government must ensure the evaluation criteria accurately reflect the needs of the program and that the winning bid represents the best value.

How did this contract contribute to the overall efficiency and effectiveness of Medicare's durable medical equipment program?

This contract's effectiveness is measured by its ability to ensure timely and accurate processing of DME claims, manage provider networks, and maintain program integrity. Success would be reflected in beneficiary satisfaction, reduced fraud and abuse, and efficient operational costs for CMS. The CPAF structure suggests an intent to link contractor performance directly to these outcomes.

Industry Classification

NAICS: Finance and InsuranceInsurance CarriersDirect Health and Medical Insurance Carriers

Product/Service Code: SOCIAL SERVICESSOCIAL SERVICES

Competition & Pricing

Extent Competed: FULL AND OPEN COMPETITION

Solicitation Procedures: NEGOTIATED PROPOSAL/QUOTE

Solicitation ID: RFPCMS20100004

Offers Received: 5

Pricing Type: COST PLUS AWARD FEE (R)

Evaluated Preference: NONE

Contractor Details

Parent Company: DXC Technology Company

Address: 402 OTTERSON DR, CHICO, CA, 95928

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

Financial Breakdown

Contract Ceiling: $105,226,239

Exercised Options: $105,226,239

Current Obligation: $105,226,239

Contract Characteristics

Commercial Item: COMMERCIAL PRODUCTS/SERVICES PROCEDURES NOT USED

Cost or Pricing Data: NO

Timeline

Start Date: 2011-04-01

Current End Date: 2016-08-31

Potential End Date: 2016-08-31 00:00:00

Last Modified: 2023-09-28

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