Financial Alignment Actuarial and Rate Review Services

The Centers for Medicare & Medicaid Services (CMS), under the Department of Health and Human Services, has awarded task order 75FCMC26F0116 for Financial Alignment Actuarial and Rate Review Services. With a total contract value of 2,799,412.30 dollars, this sole-source acquisition was executed as a logical follow-on under GSAR 538.7104-3(b)(iii) to ensure economy and efficiency. The contract spans a base year and two option years, with a total period of performance running from August 10, 2026, through August 9, 2029. While the primary place of performance is located in Annandale, Virginia, the services support demonstrations across multiple states. The scope of work focuses on the final phase of the Financial Alignment Initiative, providing critical actuarial support, rate review, and analytical services for Medicare-Medicaid financial alignment model demonstrations. The contractor is responsible for reviewing the Medicaid components of capitated payment rates for Medicare-Medicaid Plans and conducting ongoing financial analytics to monitor demonstration financing, specifically addressing delayed claims and encounter data. Key deliverables include actuarial analyses and technical assistance to support integrated, high-quality care for dually eligible beneficiaries. The contract is managed by the Office of Acquisition and Grants Management in Baltimore, Maryland, with Jeannine Bohlen serving as the primary point of contact.