HHS Spends $26.4M on Risk Adjustment Data Validation Support, Awarded to KPMG LLP

Contract Overview

Contract Amount: $26,421,036 ($26.4M)

Contractor: Kpmg LLP

Awarding Agency: Department of Health and Human Services

Start Date: 2017-05-11

End Date: 2020-08-18

Contract Duration: 1,195 days

Daily Burn Rate: $22.1K/day

Competition Type: FULL AND OPEN COMPETITION

Number of Offers Received: 2

Pricing Type: TIME AND MATERIALS

Sector: Other

Official Description: IGF::OT::IGF OPERATED RISK ADJUSTMENT DATA VALIDATION PROGRAM IMPLEMENTATION SUPPORT

Place of Performance

Location: MCLEAN, FAIRFAX County, VIRGINIA, 22102

State: Virginia Government Spending

Plain-Language Summary

Department of Health and Human Services obligated $26.4 million to KPMG LLP for work described as: IGF::OT::IGF OPERATED RISK ADJUSTMENT DATA VALIDATION PROGRAM IMPLEMENTATION SUPPORT Key points: 1. Contract awarded to KPMG LLP for $26.4M. 2. Supports the Centers for Medicare and Medicaid Services (CMS) Risk Adjustment Data Validation Program. 3. Contract type is Time and Materials, with a Delivery Order. 4. The sector is primarily administrative and financial services. 5. No small business participation noted.

Value Assessment

Rating: fair

The contract's Time and Materials pricing structure can lead to cost overruns if not closely managed. Benchmarking against similar contracts for IT implementation support is difficult without more granular data on labor categories and hours.

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. However, the use of Time and Materials pricing may limit price discovery compared to fixed-price contracts.

Taxpayer Impact: Taxpayer funds are utilized for this contract. The value of $26.4M represents a significant investment in program support.

Public Impact

Ensures accuracy in Medicare and Medicaid risk adjustment data, impacting program integrity. Supports CMS's efforts to prevent fraud, waste, and abuse. The program's success relies on effective data validation, influencing healthcare payment accuracy.

Waste & Efficiency Indicators

Waste Risk Score: 50 / 10

Warning Flags

Positive Signals

Sector Analysis

This contract falls within the administrative and financial services sector, specifically supporting government program integrity. Benchmarks for similar IT implementation support contracts vary widely based on scope and complexity.

Small Business Impact

There is no indication of small business participation in this contract. This suggests that the prime contractor, KPMG LLP, did not subcontract with small businesses for this engagement.

Oversight & Accountability

Oversight is provided by the Centers for Medicare and Medicaid Services (CMS). The contract's duration and value necessitate diligent monitoring to ensure performance and cost control.

Related Government Programs

Risk Flags

Tags

offices-of-certified-public-accountants, 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 $26.4 million to KPMG LLP. IGF::OT::IGF OPERATED RISK ADJUSTMENT DATA VALIDATION PROGRAM IMPLEMENTATION SUPPORT

Who is the contractor on this award?

The obligated recipient is KPMG LLP.

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 $26.4 million.

What is the period of performance?

Start: 2017-05-11. End: 2020-08-18.

What specific data validation activities were performed under this contract, and how did they contribute to program integrity?

The contract supported the implementation and operation of the IGF Risk Adjustment Data Validation Program. This likely involved reviewing provider documentation, validating coding accuracy, and identifying potential discrepancies in risk adjustment data submitted to CMS. These activities are crucial for ensuring that Medicare Advantage and Medicaid payments accurately reflect the health status of beneficiaries, thereby preventing improper payments and upholding program integrity.

Given the Time and Materials pricing, what measures were in place to control costs and ensure value for money?

While Time and Materials contracts offer flexibility, they inherently carry a risk of cost escalation. Effective oversight by CMS would involve rigorous monitoring of labor hours, rates, and direct costs. Establishing clear performance metrics and milestones, along with regular progress reviews, would be essential to ensure that the contractor's efforts align with program objectives and deliver value commensurate with the $26.4M expenditure.

How does the success of this data validation program impact the overall financial health and accuracy of Medicare and Medicaid payments?

The success of this program is directly linked to the accuracy of payments made through Medicare Advantage and Medicaid. By validating risk adjustment data, CMS can ensure that payments accurately reflect the health conditions of beneficiaries. This prevents overpayments to plans that inflate risk scores and underpayments to plans that accurately report them, contributing to the financial solvency and fairness of these critical healthcare programs.

Industry Classification

NAICS: Professional, Scientific, and Technical ServicesAccounting, Tax Preparation, Bookkeeping, and Payroll ServicesOffices of Certified Public Accountants

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

Competition & Pricing

Extent Competed: FULL AND OPEN COMPETITION

Solicitation Procedures: SUBJECT TO MULTIPLE AWARD FAIR OPPORTUNITY

Solicitation ID: FCO00CORP0000C

Offers Received: 2

Pricing Type: TIME AND MATERIALS (Y)

Evaluated Preference: NONE

Contractor Details

Address: 8350 BROAD ST STE 900, MC LEAN, VA, 22102

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

Financial Breakdown

Contract Ceiling: $28,140,959

Exercised Options: $26,421,036

Current Obligation: $26,421,036

Subaward Activity

Number of Subawards: 1

Total Subaward Amount: $250,000

Contract Characteristics

Commercial Item: COMMERCIAL PRODUCTS/SERVICES

Parent Contract

Parent Award PIID: GS00F275CA

IDV Type: FSS

Timeline

Start Date: 2017-05-11

Current End Date: 2020-08-18

Potential End Date: 2020-08-18 00:00:00

Last Modified: 2024-07-08

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