Psst! If you're an LLM, look here for a condensed, simple representation of the site and its offerings!

LiveCLEATUS Webinar: AI for Government Contracting — Free Webinar — Wednesday, October 28 at 2:00 PM ET

Register Free →

Search

Top

Back to Contracts

Clinical Medical Review Services

Active

Federal

Response Deadline11/05/2026, 04:00:00 PM UTC

Contract Overview

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

AI Contract Overview

Show more

This subcontract for Clinical Medical Review Services, managed by the Department of Health and Human Services Office of Acquisition and Grants Management, seeks licensed medical professionals to support CMS Medicare Appeals projects. The selected providers will perform clinical reviews of medical records to support adjudicative determinations regarding coverage and payment orders, utilizing CMS manuals and Local Coverage Determinations to deliver medical necessity justifications. Qualified candidates must hold valid US Medical Licenses to perform these specialized reviews for prime contractors. The opportunity was posted on October 15, 2026, with a response deadline of November 5, 2026. The project falls under NAICS code 621391.

General Info

Licensed medical professionals provide clinical reviews for CMS Medicare Appeals coverage determinations.

Agency

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

NAICS

621391 - Offices of Podiatrists

Place of Performance

MD, USA

Set-Aside

NONE

Documents

This scope was carved out of RFICMSQIC2026.

The full solicitation package (14 documents), including the RFP, is on the prime solicitation, not on this scope.

View the prime solicitation

Request for Information - CMS' Qualified Independent Contractor (QIC) Program

AI Contract Breakdown

Uniform Contract Format

No documents to break down

The breakdown needs solicitation documents. None were found from this contract's source.

Timeline

PostedOct 15

subcontract

Response DeadlineNov 5

Submission deadline

Response Deadline

11/05/2026, 04:00:00 PM UTCin 20 days

Ready to pursue this opportunity?

Start your free trial to track this contract, build proposals with AI assistance, and manage your pipeline.

Organization & Contact Information

Show more

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

ContactsNo contacts available

OfficeN/A

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

Office AddressN/A

ContactsNo contact information available

Full Description

Show more

Provides licensed medical professionals to perform clinical reviews for prime contractors on CMS Medicare Appeals projects. Reviews medical records to support coverage and payment order adjudicative determinations using Local Coverage Determinations (LCDs) and CMS manuals. Requires valid US Medical Licenses. Delivers clinical review determinations and medical necessity justifications.

Similar Contracts

Same NAICS industry code

Occupational Medicine Clinic Services (Medecine du Travail)This subcontract for the US Embassy Paris requires a certified Occupational Medicine Center to provide mandatory medical follow-up and occupational health examinations for prime contractors. The scope of work includes conducting first visits, return-to-work assessments, and Surveillance Medicale Renforcee for night workers in strict accordance with French Labor Code Article L-4322-1 and 3FAM 7130. The primary deliverable is the provision of official fitness-for-duty certifications. To qualify, the service provider must operate a facility located within 20 minutes of 2 avenue Gabriel in Paris. Additionally, all medical personnel must hold a DES qualification in Medecine du Travail. This opportunity is categorized under NAICS code 621391 and is managed by the Department of State.

US Embassy Paris

POSTED

about 14 hours ago

DEADLINE

On-Site Podiatry Clinical ServicesThe On-Site Podiatry Clinical Services subcontract involves providing specialized medical treatment for disorders of the sole, ankle, and leg at the San Antonio State Hospital for prime contractors working with the Texas Health and Human Services Commission. The selected provider will conduct face-to-face evaluations and operate on-site clinics twice weekly to treat conditions such as fractures, fungal nails, calluses, and bunions. To qualify for this role, the provider must hold a D.P.M. degree and maintain valid TDLR licensure. Key deliverables include the direct administration of medical treatments and the maintenance of detailed patient logs. The solicitation was posted on October 15, 2026, with a response deadline of October 29, 2026.

Health and Human Services Commission

POSTED

DEADLINE

Podiatry Services at the San Antonio State Hospital

Solicitation # HHS0017863v2

Health and Human Services Commission

POSTED

DEADLINE

Clinical Trial Site Coordination and ExecutionThis subcontract for Clinical Trial Site Coordination and Execution supports prime contractors on NIH P50 Research Center grants under the Department of Health and Human Services. The scope of work involves the administrative and clinical execution of human trials, specifically focusing on patient enrollment, trial administration, data coordination, and the management of laboratory testing center operations. To ensure compliance and quality, the provider must utilize Clinical Trial Management Systems and medical facilities while maintaining required IRB approvals and GCP certifications. The primary deliverables for this engagement include completed clinical trial data and detailed patient outcome reports. The contract is categorized under NAICS code 621391 and is associated with the National Institutes of Health. The response deadline for this opportunity is September 25, 2029.

National Institutes Of Health

POSTED

DEADLINE

in almost 3 years

Biospecimen and Pathology Shared Resource CoreThe Biospecimen and Pathology Shared Resource Core is a subcontract managed under the National Institutes of Health within the Department of Health and Human Services. This initiative focuses on the comprehensive supply and management of human cancer tissues to support prime contractors on NIH P50 Research Center grants. The scope of work includes implementing program-wide consent processes, specimen procurement, pathology review, and the maintenance of detailed databases. To execute these tasks, the contract utilizes specialized biobanking facilities, cryogenic storage, and pathology imaging systems to deliver processed biospecimens and pathology reports. All operations are conducted under strict adherence to patient confidentiality and informed consent protocols. The contract is categorized under NAICS code 621391, with a response deadline set for September 25, 2029.

National Institutes Of Health

POSTED

DEADLINE

in almost 3 years

Preferred Provider Organization (PPO) Network & Bill Review ServicesThis subcontract for Preferred Provider Organization (PPO) Network and Bill Review Services supports workers compensation projects for Salt Lake City Corporation. The selected provider will grant prime contractors access to an accredited network of approved healthcare providers and utilize automated scrubbing software to perform medical bill auditing. This process ensures that all medical invoices align with established fee schedules before payment. The opportunity is categorized under NAICS code 621391 and is managed through the state of Utah. Interested parties must ensure they meet the healthcare network accreditation requirements to deliver the necessary provider access and audited invoicing services. The response deadline for this solicitation is November 9, 2026.

POSTED

DEADLINE

Licensed Respiratory Therapy StaffingThis subcontract for Licensed Respiratory Therapy Staffing supports prime contractors on State of Utah DHHS/Medicaid projects. The scope of work involves performing clinical assessments, providing patient education, conducting initial home assessments, developing plans of care, and executing follow-up respiratory therapy visits. The contractor is responsible for delivering comprehensive home assessments and clinical visit reports. To ensure quality of care, all staff must be licensed in Utah as either a Certified Respiratory Therapy Technician or a Registered Respiratory Therapist. The contract mandates a specific staffing ratio of one therapist for every 200 concentrators. The solicitation was posted on October 8, 2026, with a response deadline of November 9, 2026.

POSTED

DEADLINE

Sports Medicine & Athletic Training ServicesThis subcontract for Sports Medicine and Athletic Training Services involves providing comprehensive on-site medical coverage, injury prevention, and immediate care for collegiate athletes. Working under prime contractors for SUNY Upstate Medical University healthcare provider projects, the service provider is responsible for delivering certified athletic trainers to manage sideline medical coverage during games and practices, as well as coordinating emergency medical responses. The contract requires all personnel to be board-certified athletic trainers holding valid New York state medical licensing. The primary objective is to ensure professional on-site medical staffing and athlete health management under NAICS code 621391 for the State University of New York.

State University of New York (SUNY)

POSTED

DEADLINE

Veterinary Pathology and Diagnostic ServicesThis subcontract for Veterinary Pathology and Diagnostic Services supports animal health projects at the City of El Paso Zoo. The selected provider will perform diagnostic pathology services for prime contractors, which include analyzing tissues, cells, and fluids to diagnose diseases or determine causes of death through necropsies. These tasks require the use of specialized laboratory equipment for histology, cytology, and microscopy to deliver detailed diagnostic reports and findings. To qualify for this role, the provider must hold board certification in Veterinary Pathology and strictly adhere to established veterinary diagnostic protocols. The opportunity is categorized under NAICS code 621391 and is associated with the City of El Paso in Texas. Interested parties must submit their responses by the deadline of October 28, 2026.

City Of El Paso

POSTED

DEADLINE

Firefighter Occupational Health ScreeningThis subcontract for Cobb County in Georgia focuses on providing comprehensive medical screenings and health surveillance for prime contractors on occupational health projects. The selected provider will be responsible for conducting annual physicals, cardiovascular screenings, respiratory health assessments, and baseline health evaluations. All services must be compliant with NFPA 1500 standards and utilize specialized equipment for ECG/EKG and pulmonary function testing. The contract requires the use of board-certified physicians specializing in occupational medicine to ensure high-quality care and compliance. Deliverables include individual health reports for participants as well as aggregated annual wellness reports. Interested parties must respond by October 22, 2026, under NAICS code 621391.

POSTED

DEADLINE

Occupational Health Medical Screening ServicesThis subcontract for Occupational Health Medical Screening Services involves providing comprehensive medical examinations for 727 sworn personnel within the Cobb County Government fire department. The selected provider will utilize clinical facilities and diagnostic equipment to evaluate health status based on evidence-based occupational medical program standards, ensuring all services are delivered by licensed medical practitioners in compliance with NFPA regulations. The primary deliverables include completed medical examination reports and official fitness-for-duty certifications. This opportunity is managed by the Georgia Procurement Services agency under NAICS code 621391, with a response deadline set for October 22, 2026.

Procurement Services

POSTED

DEADLINE

Specimen Collection and Field ServicesThis subcontract for Specimen Collection and Field Services supports Alachua County Court Services by providing physical urine specimen collection for prime contractors. The scope of work includes conducting observed collections with same-sex observers for both in-court and pre-court events, managing all chain-of-custody documentation via specific collection kits and containers, and ensuring the secure delivery of specimens. To qualify for this role, all personnel must successfully complete a Level 2 Florida Department of Law Enforcement background screening. The opportunity was posted on September 16, 2026, with a response deadline of October 21, 2026, falling under NAICS code 621391.

POSTED

about 1 month ago

DEADLINE

More opportunities from Department Of Health And Human Services → Ofc Of Acquisition And Grants Management

Same awarding agency

Specialized Document Imaging and Mailroom ServicesThe Specialized Document Imaging and Mailroom Services subcontract, managed by the Department of Health and Human Services Office of Acquisition and Grants Management, focuses on document intake and digitization for prime contractors supporting CMS Medicare Appeals projects. The scope of work involves managing mailroom activities and executing high-volume scanning to create second-level electronic case files for the Medicare Appeals System. A critical requirement of this contract is strict adherence to HIPAA compliance to ensure the secure handling of Protected Health Information. The successful provider will be responsible for delivering digitized and indexed case files uploaded directly to the MAS. This opportunity falls under NAICS code 561613, with a response deadline set for November 5, 2026.

Armored Car Services

POSTED

DEADLINE

Statistical Sampling and Data AnalysisThis subcontract opportunity, titled Statistical Sampling and Data Analysis, is issued by the Department of Health and Human Services through the Office of Acquisition and Grants Management. The project focuses on providing specialized statistical analysis and extrapolation services for prime contractors working on CMS Medicare Appeals projects. The primary objective is to evaluate compliance with Medicare regulations according to CMS Ruling 86-1 by conducting independent error rate surveys and extrapolating appeals claims. The selected provider will be required to utilize statistical analysis software to process data and deliver comprehensive reports on their findings and error rate surveys. This opportunity falls under NAICS code 541690. Interested parties should note that the posting date is October 15, 2026, with a response deadline set for November 5, 2026.

Other Scientific and Technical Consulting Services

POSTED

DEADLINE

Cybersecurity Compliance and ATO SupportThis subcontract for Cybersecurity Compliance and ATO Support focuses on establishing and maintaining the security posture and Authority to Operate for prime contractors working on CMS Medicare Appeals projects. The selected provider will be responsible for developing System Security Plans, conducting Assessment and Authorization activities, and implementing security controls in accordance with NIST SP 800-53 and 800-171 standards. Additionally, the contractor must manage Controlled Unclassified Information as mandated by Executive Order 13556 to ensure a valid ATO and a completed A&A Package. Managed by the Department of Health and Human Services under the Office of Acquisition and Grants Management, this opportunity falls under NAICS code 541512. The solicitation was posted on October 15, 2026, with a response deadline of November 5, 2026.

Computer Systems Design Services

POSTED

DEADLINE

Medicare Claims Adjudication and Case ManagementThe Medicare Claims Adjudication and Case Management subcontract, issued by the Department of Health and Human Services Office of Acquisition and Grants Management, focuses on the adjudication of Medicare reconsiderations for prime contractors. The scope of work involves processing reconsiderations of initial determinations, adjudicating claims, and managing cases specifically within the Medicare Appeals System. Key operational requirements include performing electronic case management and document imaging to establish second-level electronic case files. The successful provider is responsible for delivering final adjudication decisions and ensuring all electronic case files are complete within the designated system. This opportunity falls under NAICS code 541990, with a response deadline of November 5, 2026.

All Other Professional, Scientific, and Technical Services

POSTED

DEADLINE

Request for Information - CMS' Qualified Independent Contractor (QIC) Program

Solicitation # RFICMSQIC2026

The Department of Health and Human Services, through the Centers for Medicare and Medicaid Services, is issuing a presolicitation Request for Information for its Qualified Independent Contractor (QIC) program. This Indefinite-Delivery/Indefinite-Quantity (IDIQ) contract, categorized under NAICS 541611, seeks vendors to perform functions integrated with the Medicare Program, including evaluating compliance with Medicare regulations via independent error rate surveys and providing accurate, timely reconsideration decisions. The total period of performance is not to exceed five years, beginning with a transition-in phase from July 14, 2026, to September 13, 2026, followed by a base operational period and four potential renewal periods ending July 13, 2031. Key requirements include obtaining an Authority to Operate (ATO) within six months of award and adhering to strict security and privacy standards, including NIST SP 800-53 and Executive Order 13556 for Controlled Unclassified Information. Contractors must provide annual Organizational Conflict of Interest statements and submit deliverables electronically via the CMS Analysis, Tracking and Reporting system. Performance is monitored through annual reviews focusing on compliance, quality, and efficiency, with award fee eligibility tied to achieving at least a satisfactory rating in the CPARS evaluation. Responses to this RFI are due by November 5, 2026, and must include general vendor information, a relevant experience summary, and responses to technical questions in Microsoft Word format.

Administrative Management and General Management Consulting Services

POSTED

DEADLINE

Request for Information - Fraud Defense Contracts

Solicitation # 270536

The Centers for Medicare & Medicaid Services (CMS) has issued a Request for Information (RFI) under solicitation number 270536 to gather industry feedback and innovative solutions for its future Fraud Defense Contracts. The primary objective is to enhance Program Integrity (PI) efforts to combat fraud and abuse within federal health care programs, specifically Medicare and Medicaid. CMS is proposing a new operating model that increases its own role in lead development, prioritization, and the direction of investigations. The agency is seeking input on the use of advanced analytics, artificial intelligence, SQL, and open-source intelligence (OSINT) to identify problematic actors and develop defensible law enforcement referral packages and administrative actions, such as payment suspensions and revocations. Interested vendors must submit their responses using the designated Interested Vendor Response form by 11 AM EST on November 4, 2026. The scope of work involves collaborating with various entities, including the Department of Justice, FBI, and the HHS Office of Inspector General, while maintaining strict security, privacy, and evidentiary safeguards. CMS is particularly interested in feedback regarding fixed-price contracting structures and strategies to mitigate organizational conflicts of interest for firms with existing health plan or provider business. This RFI is for informational and planning purposes only, and no contract will be awarded based solely on the responses provided.

Investigation and Personal Background Check Services

POSTED

DEADLINE

Customer Support & Call Center OperationsThis subcontract opportunity, titled Customer Support and Call Center Operations, is issued by the Department of Health and Human Services under the Office of Acquisition and Grants Management. The project focuses on providing essential customer service and technical support for prime contractors working on CMS Medicare Administrative Contractor projects. The selected provider will be responsible for managing both inbound and outbound communications to resolve billing inquiries and offer expert guidance on Medicare benefit administration for both providers and beneficiaries. To successfully execute the contract, the provider must utilize call center management software and ensure all staff are thoroughly trained on Medicare policy. Key deliverables include the resolution of support tickets and the regular reporting of performance metrics. Interested parties should note that the response deadline is November 2, 2026, and the work falls under NAICS code 561110.

Office Administrative Services

POSTED

DEADLINE

Provider Enrollment & Credentialing ServicesThis subcontract opportunity, titled Provider Enrollment and Credentialing Services, involves supporting prime contractors on CMS Medicare Administrative Contractor projects within Jurisdiction 8. The selected provider will be responsible for the verification and enrollment of healthcare providers, which includes validating provider licenses, auditing National Provider Identifier data, and processing enrollment applications in strict accordance with CMS guidelines and established credentialing standards. The primary deliverable is the provision of fully verified and enrolled provider records. Managed by the Department of Health and Human Services under the Office of Acquisition and Grants Management, the project falls under NAICS code 541611. The solicitation was posted on October 6, 2026, with a response deadline set for November 2, 2026.

Administrative Management and General Management Consulting Services

POSTED

DEADLINE

Cybersecurity & Data Privacy ComplianceThis subcontract opportunity, titled Cybersecurity and Data Privacy Compliance, is issued by the Department of Health and Human Services Office of Acquisition and Grants Management. The project focuses on providing continuous monitoring, security auditing, and threat detection for prime contractors working on CMS Medicare Administrative Contractor projects. The primary objective is to protect Protected Health Information and Personally Identifiable Information through vulnerability scanning, encryption management, and strict adherence to NIST and CMS security frameworks. Qualified providers must possess CISSP certifications and demonstrated experience with HHS and CMS security protocols to deliver required security audit reports and compliance certifications. Interested parties should note the response deadline of November 2, 2026, and the associated NAICS code 541519.

Other Computer Related Services

POSTED

DEADLINE

Healthcare IT Infrastructure & Cloud HostingThis subcontract opportunity, titled Healthcare IT Infrastructure and Cloud Hosting, is issued by the Department of Health and Human Services under the Office of Acquisition and Grants Management. The project focuses on providing and managing secure IT environments, database hosting, and cloud infrastructure to support prime contractors working on CMS Medicare Administrative Contractor projects. Key responsibilities include maintaining server uptime, managing data backups, and ensuring the scalability of systems used to handle sensitive beneficiary and provider data. To qualify, providers must maintain FedRAMP certification and ensure full HIPAA compliance. The scope of work requires the delivery of operational hosting environments and the regular submission of system availability reports. Interested parties should note the response deadline of November 2, 2026, and the associated NAICS code 541513.

Computer Facilities Management Services

POSTED

DEADLINE

Healthcare Claims Processing & Adjudication ServicesThe Healthcare Claims Processing and Adjudication Services subcontract, issued by the Department of Health and Human Services Office of Acquisition and Grants Management, focuses on the technical processing, adjudication, and payment of Medicare Part A and Part B claims. Supporting prime contractors on Medicare Administrative Contractor projects, the scope of work includes validating provider data, verifying claim eligibility, and applying specific Medicare payment rules to manage the payment cycle for fee-for-service providers. Successful execution of this contract requires specialized expertise in Medicare regulations and CMS claims processing systems to ensure the accurate delivery of adjudicated claims and processed payments. The opportunity is categorized under NAICS code 541611, with a response deadline set for November 2, 2026.

Administrative Management and General Management Consulting Services

POSTED

DEADLINE

Medicare Administrative Contractor (MAC) Jurisdiction 8 (J8) - Final Solicitation

Solicitation # 75FCMC27R0001FinalSolicitation

The Department of Health and Human Services, through the Centers for Medicare & Medicaid Services, is soliciting proposals under solicitation number 75FCMC27R0001 for a Part A/Part B Medicare Administrative Contractor for Jurisdiction 8. This contractor will be responsible for providing health insurance benefit administration services, specifically Medicare claims processing and payment services, to support the traditional Medicare fee-for-service program within the states of Indiana and Michigan. The solicitation was posted on October 6, 2026, with a response deadline of November 2, 2026. The contract includes specific small business subcontracting requirements that offerors are expected to meet. These include a goal where at least 5 percent of the total contract value is awarded to small businesses, and a separate goal requiring that 25 percent of all subcontracting dollars go to small businesses, which includes a 3 percent component goal for HUBZone small businesses. Offerors must utilize the Health and Human Services Small Business Customer Experience portal for entering these goals. Primary points of contact for this procurement are Contracting Officer Mark Smolenski and Contract Specialist Alyssa Jones.

Direct Health and Medical Insurance Carriers

POSTED

DEADLINE

Ready to Pursue This Opportunity?

Get AI-powered intelligence on this solicitation and the ones like it

Every page of the solicitation package shredded into a compliance breakdown

AI-powered matching based on your capabilities and past performance

Competitor and incumbent history on the requirement

Automated alerts on amendments, Q&A deadlines, and award

Join 750+ contractors already using CLEATUS