This Award Notice opportunity from Department Of Health And Human Services was posted on June 1, 2026. The submission period has ended. Browse the details below for market research, or find similar active opportunities.

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ClaimsCore Combined Synopsis/Solicitation

Awarded

75FCMC26R0022Federal

Contract Overview

Solicitation details, issuing organization, response deadlines, documents, and interested companies for this government contract opportunity.

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Solicitation # AB-2026-07537

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Technology and Innovation

POSTED

1 day ago

DEADLINE

in about 1 month

AI Contract Overview

This Firm-Fixed-Price contract, awarded under solicitation number 75FCMC26R0022, was issued by the Centers for Medicare & Medicaid Services under the Department of Health and Human Services to acquire a Commercial-Off-The-Shelf claims processing platform to replace legacy Medicare Fee-for-Service adjudication systems. The contract spans multiple option periods from May 2026 through November 2033, with a focus on delivering a cloud-based, interoperable SaaS platform that supports sub-second adjudication, real-time fraud prevention, and integration via HIPAA X12 and FHIR/REST APIs. The Statement of Objectives emphasizes uninterrupted transition, improved beneficiary experience, enhanced policy agility, and seamless connectivity across CMS, Medicare Administrative Contractors, providers, and partners. Pricing for key service line items — CLINs 0004, 0006, 0008, 0010, 0012, and 0014 — is set at firm-fixed monthly unit prices per unique beneficiary (PMPM), with annual prospective true-up adjustments based on actual versus projected beneficiary volumes submitted by the contractor. Unit prices were not finalized at time of solicitation, making the total contract value contingent on future volume estimates and reconciliation. The evaluation process prioritizes non-price factors significantly over cost, assessing corporate experience, performance work statement, quality assurance surveillance plan, and past performance through a best-value tradeoff, with award decisions not limited to the lowest-priced offeror. Proposal submissions must adhere to strict formatting, electronic submission via email, page limits, and font requirements, with all submissions due by March 13, 2026. Contractors are required to comply with extensive cybersecurity, data handling, and procurement integrity standards including FedRAMP authorization, NIST SP 800-88 data sanitization, FIPS 140 and 201-2 encryption and identity verification, Section 508 accessibility, HHS electronic content standards, and prohibitions on covered telecommunications equipment. Compliance with FAR clauses covering code of ethics, whistleblower protections, small business utilization, labor standards, and anti-trafficking is mandatory. Contractor personnel require PIV credentials, and organizational conflicts of interest must be fully disclosed and mitigated. Invoicing is mandatory through the Invoice Processing Platform, with WAWF prohibited. The Contracting Officer and Contract Specialist, based in Baltimore, Maryland, are the primary points of contact for administration and

General Info

Firm-fixed-price SaaS contract for Medicare claims system replacement from 2026 to 2033 with sub-second adjudication, real-time fraud detection, and strict compliance requirements.

Agency

Department Of Health And Human Services → Ofc Of Acquisition And Grants Management

Contract Value

$9,150,543.66

NAICS

541512 - Computer Systems Design Services

Place of Performance

St James, MD, 21244, USA

Set-Aside

NONE

Awardee

PERATON INC.

Award Issued Date

05/29/2026, 12:00:00 AM UTC

Documents

62 pages · soo

High

13 pages · amendment

High

12 pages · amendment

High

3 pages · amendment

High

3 pages · amendment

High

amendment

High

13 pages · amendment

High

11 pages · amendment

High

amendment

High

14 pages · amendment

High

11 pages · amendment

High

amendment

High

2 pages · contract-document

High

13 pages · instructions-to-offerors

High

56 pages · q-and-a

High

62 pages · statement-of-objectives

High

3 pages · contractor-coi-submission-template

High

8 pages · contract-clauses

High

5 pages · past-performance

High

rfq

High

AI Contract Breakdown

Uniform Contract Format

View Full Breakdown

Timeline

3 updates

PhaseAwarded

PostedFeb 27

Combined Synopsis

Notice updatedMar 9

The notice description changed.

Notice updatedMar 10

The notice description changed.

Notice updatedMar 11

The notice description changed.

AwardedMay 29

Contract was awarded

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Organization & Contact Information

AgencyDepartment Of Health And Human Services → Ofc Of Acquisition And Grants Management

Contacts2 people available

OfficeBALTIMORE, MD, 21244, USA

Organization / AgencyDepartment Of Health And Human Services → Ofc Of Acquisition And Grants Management

Office AddressBALTIMORE, MD, 21244, USA

Contacts

Candace Straker

Lauren Holsey

Full Description

ClaimsCore Combined Synopsis/Solicitation Amendment 0003- The purpose of this amendment is to request offerors provide a copy of any CTA, as applicable in Phase 2 as stated in Amendment 3 - Attachment 3, ClaimsCore Instructions to Offerors.

ClaimsCore Combined Synopsis/Solicitation Amendment 0002- The purpose of this amendment is to correct the Phase 1 RFP submission due date as stated in Amendment 2 - Attachment 3, ClaimsCore Instructions to Offerors.

ClaimsCore Combined Synopsis/Solicitation Amendment 0001 - The purpose of this amendment is to 1) provide responses to RFP questions, 2) provide an Amended Solicitation - 75FCMC26R0022, 3) provide an amended Attachment 1 - ClaimsCore SOO, 4) provide an Amended Attachment 3 - ClaimsCore Instructions to Offerors, and 5) rename and provide an amended Attachment 6 - Beneficiary Quantities Claims and Unit Pricing.

This is a combined synopsis/solicitation for commercial products or commercial services prepared in accordance with FAR part 12. This announcement constitutes the only solicitation. Offers are being requested and a separate written solicitation will not be issued.

Solicitation number 75FCMC26R0022 is issued as a request for proposal (RFP) for ClaimsCore. The ClaimsCore program seeks to re-platform Medicare Fee for Service claims processing by replacing legacy “Shared Systems” including the Multi-Carrier System (MCS), Fiscal Intermediary Shared System (FISS) and Durable Medical Equipment Claims System (DME) as well as the Common Working File (CWF) with a flexible and interoperable platform that reduces administrative burden and sets improvement of the beneficiary experience as the program’s guiding objective. CMS intends to procure a Software as a Services (SaaS) Commercially-Available-Off-The-Shelf (COTS) product and complimentary configuration and integration services that will provide CMS with near real-time adjudication and claims status, policy agility, industry leading enterprise tools, improved fraud prevention capabilities, and tighter integration across CMS, Medicare Administrative Contractor (MACs), providers, and partners.

This acquisition is not set-aside for small business concerns. This solicitation incorporates provisions and clauses by reference. The full text of provisions and clauses may be accessed electronically at www.acquisition.gov.

Contract Line Item Number (CLIN) Structure:

See Attached Soliciation-75FCMC26R0022 for a full breakdown of the CLIN structure, items, quantities, and units of measure (including option(s)).

See Attachment 1 – ClaimsCore Statement of Objectives for full description of the requirements being acquired.

See the attached Solicitation - 75FCMC26R0022 and Attachment 5 - FAR 52.212-5 to find the full list of solicitation provisions and contract clauses that apply to the acquisition (see 12.205(a)).

Date, Response Times, Place for receipt of offer and Point of Contacts:

All questions regarding this solicitation shall be submitted via electronic mail (e-mail) no later than 11:00 am Eastern Time (ET) on March 6, 2026 to Contract Specialist, Lauren Holsey, at Sign up to see this detail and cc: Contracting Officer, Candace Straker, at Sign up to see this detail.

Offerors shall submit Phase One (1) proposals via electronic mail (e-mail) no later than 11:00 am Eastern Time (ET) on March 13, 2026 to Contract Specialist, Lauren Holsey, at Sign up to see this detail and cc: Contracting Officer, Candace Straker, at Sign up to see this detail.

See Attachment 3 - ClaimsCore Instructions to Offerors for full instructions.