TRICARE Claims Review Services (TCRS)
Contract Overview
Solicitation details, issuing organization, response deadlines, documents, and interested companies for this government contract opportunity.
AI Contract Overview
The Defense Health Agency awarded a Firm Fixed Price bridge extension to Concept Plus, LLC for TRICARE Claims Review Services (TCRS) under contract HT9402-17-D-0001. This sole-source award, issued under FAR 6.103-1(b), ensures continuity of mission-critical support from March 1, 2026, to February 28, 2027, while a competitive follow-on contract is finalized. The extension is valued between $5,230,151 and $6,001,310.90 and is managed by the DHA Managed Care Contracting Division in Aurora, Colorado. Concept Plus was identified as the only responsible source capable of preventing service gaps due to its existing NIST-compliant infrastructure, DoD Common Access Card compatibility, and specialized institutional knowledge. The primary objective of the TCRS contract is to assist the Improper Payment Evaluation Branch in identifying and reporting improper payments and recording discrepancies for the Military Health System. The contractor provides independent, impartial reviews of claims processing and reimbursement methodologies for MCSC, TMEP, TPharm, TOP, and ADDP contracts to ensure compliance with TRICARE policies. These activities are essential for meeting reporting requirements for the Office of Management and Budget and the Department of Defense Agency Financial Report, pursuant to the Payment Integrity and Information Act of 2019. Performance is conducted at the contractor's facilities, with deliverables including quarterly, semi-annual, and annual compliance reviews.
General Info
Contract Value
$5,230,151Place of Performance
Aurora, CO, 80011, USASet-Aside
Awardee
CONCEPT PLUS, LLCAward Issued Date
Timeline
Organization & Contact Information
Full Description
The Defense Health Agency (DHA) awarded a Firm Fixed Price (FFP) contract bridge extension for TRICARE Claims Review Services to Concept Plus on February 27, 2026 under contract HT9402-17-D-0001. The extension was issued sole-source in accordance with Federal Acquisition Regulation (RFO) 6.103-1(b), only one responsible source and no other supplies or services will satisfy agency requirements. The period of performance will be from March 01, 2026 - February 28, 2027. A bridge extension was necessary to prevent a gap in support to mission critical DHA requirements until a follow-on contract is awarded and the awardee completes transition-in.
The Defense Health Agency (DHA) supports health services for more than 9.4 million beneficiaries of the Military Health System (MHS). The purpose of the TCRS contract is to assist the DHA Improper Payment Evaluation Branch (IPEB) in identifying and reporting improper payments and discrepancies in payment recording for the MHS. TCRS support provides an independent impartial review of claims processing procedures and reimbursement methodologies utilized by purchased-care contractors and assesses purchased-care contractor compliance with TRICARE policies and directives by evaluating the accuracy of claims payment and payment record coding for the MCSC, TMEP, TPharm, TOP, and ADDP contracts. TCRS helps support IBEP’s requirement to assess the potential risk of improper payments and to identify and report improper payments to the Office of Management and Budget (OMB) for publication in the Department of Defense (DoD) Agency Financial Report (AFR) pursuant to Public Laws 107-300, and the Payment Integrity Act of 2019 (PIIA), Public Laws 116-117.
The total estimated value of the twelve (12) month extension is $5,230,151. Mr. Gregory Stephens is the Contracting Officer and the Defense Health Agency, Aurora, CO 80011, is the contracting activity (HT9402). Performance of this contract will be accomplished at the contractor’s facilities.
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