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This Subcontract opportunity from Department Of Health And Human Services was posted on March 11, 2026. The submission period has ended. Browse the details below for market research, or find similar active opportunities.

Software Development for Claims Adjudication

Closed
Federal

Contract Overview

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The Department of Health and Human Services, through the Office of Acquisition and Grants Management, is seeking a subcontractor for software development focused on Medicare claims adjudication. The scope of work involves the development and maintenance of critical software components, specifically emphasizing the integration of Durable Medical Equipment and the creation of interfaces for fraud detection. This opportunity is categorized under NAICS code 541511 and will be performed in St James. Interested parties must note the tight turnaround for submissions, as the response deadline is set for March 13, 2026, at 3:00 PM.

General Info

NAICS

541511 - Custom Computer Programming Services

Place of Performance

St James, MD, 21244, USA

Set-Aside

NONE

Documents

This scope was carved out of 75FCMC26R0022.

The full solicitation package (20 documents), including the RFP, is on the prime solicitation, not on this scope.

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ClaimsCore Combined Synopsis/Solicitation

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Timeline

PhaseClosed
Posted

subcontract

Response Deadline

Deadline has passed

Submission Closed

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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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Develop and maintain software components for Medicare claims adjudication, including DME integration and fraud detection interfaces.

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NAICS: 541512
New
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Computer Systems Design Services

POSTED

1 day ago

DEADLINE

in about 2 months
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NAICS: 541219
New
Federal
Accountable Care Organization Medicare Shared Savings Program (ACO MSSP)
Solicitation # 270195
The Centers for Medicare & Medicaid Services (CMS) is conducting market research via a Sources Sought Notice to identify qualified small businesses capable of providing financial services for the Accountable Care Organization Medicare Shared Savings Program (ACO MSSP). The primary objective of the resulting contract will be the disbursement of payments to ACOs, including annual shared savings payments typically issued between September and November, and quarterly Advance Investment Payments. The selected contractor will be responsible for establishing and managing a CMS-approved bank account, validating payees, monitoring transactions, and performing monthly reconciliations. Key operational requirements include the ability to process Electronic Funds Transfers (EFT) within 48 hours of receiving funds from the Treasury via the Healthcare Integrated General Ledger Accounting System (HIGLAS). The contractor must also handle ACH/wire transfers and paper checks through a designated CMS lockbox, perform TIN comparisons using the Treasury's TOP database, and issue IRS 1099-MISC forms by January 31st annually. All services must comply with government accounting principles, HIPAA privacy regulations, and Section 508 accessibility standards. Interested firms under NAICS code 541219 must submit capability statements by November 23, 2026, demonstrating expertise in EFT monitoring, funds control, and financial reporting.
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POSTED

6 days ago

DEADLINE

in 9 days
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