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Plan Management Compliance Review (PMCR)

Active
Federal

Contract Overview

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

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The Centers for Medicare and Medicaid Services, specifically the Center for Consumer Information and Insurance Oversight, is seeking services for Plan Management Compliance Reviews to monitor health insurance issuers operating Qualified Health Plans and Stand-Alone Dental Plans within the Federally-Facilitated Exchange. These reviews are mandated under the Patient Protection and Affordable Care Act to ensure that issuers adhere to federal requirements, validate self-reported data, and identify operational irregularities. This forecast falls under NAICS code 541611 and serves as a primary mechanism for the agency to document compliance and manage the effectiveness of the exchange programs. Key points of contact for this procurement include Lesa Paige as the Program Point of Contact and Kelly Housein as the Contracting Officer.

General Info

CMS seeks services for Plan Management Compliance Reviews of health insurance issuers.

NAICS

541611 - Administrative Management and General Management Consulting Services

Place of Performance

USA

Set-Aside

NONE

Documents

0

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Organization & Contact Information

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AgencyCenters for Medicare and Medicaid Services → Centers For Medicare And Medicaid Services
Contacts2 people available
OfficeN/A
Office AddressN/A
Contacts
Kelly HouseinContracting Officer

Full Description

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Plan Management Compliance Review (PMCR): The purpose of this procurement is to obtain services to conduct various types of compliance reviews of health insurance issuers who operate Qualified Health Plans (QHHP)/Stand-Alone Dental Plans (SADP) in the Federally-Facilitated Exchange (FFE). These reviews are being procured by the Centers for Medicare & Medicaid Services' (CMS) Center for Consumer Information and Insurance Oversight's (CCIIO), in support of the health insurance Exchanges (Exchanges), as required under the Patient Protection and Affordable Care Act (PPACA). Compliance reviews serve as one of the primary mechanisms that CMS will use for ensuring and documenting QHP issuers' compliance with Affordable Care Act (ACA) requirements. Compliance reviews are necessary to identify irregularities, validate self-reported data, and to ensure that CCIIO is managing the FFE programs effectively.

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