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Fraud Detection Analytics & OSINT Support

Active
Federal

Contract Overview

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

General Info

NAICS

541511 - Custom Computer Programming Services

Place of Performance

0, MD, 21244, USA

Set-Aside

NONE

Documents

This scope was carved out of 270536 .

The full solicitation package (2 documents), including the RFP, is on the prime solicitation, not on this scope.

View the prime solicitation

Request for Information - Fraud Defense Contracts

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Organization & Contact Information

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AgencyDepartment Of Health And Human Services → Ofc Of Acquisition And Grants Management
ContactsNo contacts available
OfficeN/A
Office AddressN/A
ContactsNo contact information available

Full Description

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Supplies advanced data analytics and intelligence gathering for prime contractors on CMS Program Integrity projects. Utilizes AI, predictive modeling, and SQL query methods to develop and vet fraud leads. Performs Open-Source Intelligence (OSINT) research and analyzes claims data to identify abuse patterns. Requires HIPAA compliance and data privacy certifications. Delivers vetted fraud leads and data analysis reports.

Similar Contracts

Same NAICS industry code

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

Same awarding agency

NAICS: 561611
New
Federal
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

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about 21 hours ago

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NAICS: 524114
Federal
Medicare Administrative Contractor (MAC) Jurisdiction 8 (J8) - Synopsis/Draft RFP / Presolicitation
Solicitation # 75FCMC27R0001
The Centers for Medicare & Medicaid Services is seeking a Medicare Administrative Contractor to provide health insurance benefit administration services for Jurisdiction 8, which covers Indiana and Michigan. The contractor will be responsible for Medicare claims processing and payment services for both institutional and professional providers across Part A and Part B. This procurement is being conducted as a full and open competition under FAR Part 15, utilizing a Cost Reimbursement contract with a Cost-Plus-Award-Fee pricing arrangement. The anticipated period of performance consists of a one-year base period followed by eight one-year options. Award will be determined using the FAR 15.103-1 trade-off process to identify the best overall value to the government. Technical evaluation factors, which are significantly more important than price, include the staffing plan, operations, past performance, small business utilization, and AbilityOne. Proposals are due by November 2, 2026, and must be submitted in separate volumes, with subcontracting plans required via the HHS Small Business Customer Experience system. Key requirements include strict adherence to cybersecurity and ePHI safeguards, the implementation of the TCEDI Gateway prior to contract start, and the maintenance of separate accounts for Medicare Integrity Program and Program Management functions.
Direct Health and Medical Insurance Carriers

POSTED

14 days ago

DEADLINE

in 27 days
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