Plan Program Integrity Medicare Drug Integrity Contractor (PPI MEDIC)

The contract pertains to supporting the Centers for Medicare & Medicaid Services (CMS) through the PPI MEDIC initiative, which aims to enhance program integrity for Medicare Parts C and D by detecting and preventing fraud, waste, and abuse. The scope involves extensive data analysis, audits of Medicare Advantage Organizations and Prescription Drug Plans, outreach, education, and law enforcement referrals to safeguard the Medicare Trust Fund. The effort emphasizes collaboration with stakeholders, timely audits, and comprehensive reporting, guided by detailed statements of work, security, and accessibility standards, including CMS-specific security requirements and Section 508 compliance. The contract is anticipated as a cost-plus-fixed-fee type, with performance expected at a site in St James, Maryland, and involves a three-month transition period. Deliverables include analytic reports, audit materials, vulnerability assessments, and lessons learned, all to be submitted electronically into CMS-approved systems, with acceptance contingent upon adherence to quality, security, and performance standards. The procurement process is in the market research phase via a Sources Sought Notice (SSN 260656J), seeking small businesses across various socioeconomic categories, including 8(a), service-disabled veteran-owned, HUBZone, disadvantaged, veteran-owned, and woman-owned firms. Respondents must provide capability statements limited to ten pages, demonstrating experience in Medicare data analysis, FWA detection, healthcare audits, outreach, and stakeholder collaboration. Business information, including Unique Entity ID, size status under NAICS 541990, and teaming arrangements, must be included. Submission is via email by November 24, 2025, with instructions emphasizing no proprietary information and standard PDF formatting. The contract emphasizes strict adherence to federal security, privacy, and personnel qualification requirements, including background investigations, HSPD-12 compliance, and confidentiality protocols, with key personnel approval and detailed documentation of efforts. While specific pricing, contract type, and detailed evaluation criteria are not provided at this stage, future solicitations will likely include comprehensive award factors based on technical capability and experience.