Plan Program Integrity Medicare Drug Integrity Contractor (PPI MEDIC)
Overview
Buyer
Place of Performance
NAICS
PSC
Set Aside
Original Source
Timeline
Qualification Details
Fit reasons
- NAICS alignment with historical contract wins in similar service areas.
- Scope strongly matches core technical capabilities and delivery model.
Risks
- Past performance thresholds may require one additional teaming partner.
- Potential clarification needed on staffing minimums before bid/no-bid.
Next steps
Validate eligibility requirements, assign capture owner, and schedule partner outreach to confirm teaming strategy before submission planning.
Quick Summary
The Centers for Medicare and Medicaid Services (CMS), under the Department of Health and Human Services, is seeking a contractor for the Plan Program Integrity Medicare Drug Integrity Contractor (PPI MEDIC). This presolicitation outlines the need for an external entity to provide oversight of Medicare Parts C and D programs, focusing on fraud, waste, and abuse prevention. This opportunity is designated as a Women-Owned Small Business (WOSB) Program Set-Aside.
Scope of Work
The PPI MEDIC contractor will be responsible for protecting the Medicare Trust Fund through various program integrity activities. Key tasks include:
- Data analysis related to Medicare Parts C and D.
- Audits and reviews of Medicare Advantage Organizations (MAOs), including Medicare Advantage Prescription Drug (MA-PD) plan sponsors and Prescription Drug Plan (PDP) sponsors.
- Outreach and education initiatives.
- Referrals to law enforcement for identified issues.
Contract & Timeline
- Contract Opportunity Type: Presolicitation
- Set-Aside: Women-Owned Small Business (WOSB) Program Set-Aside (FAR 19.15)
- Product Service Code: R499 (Other Professional Services)
- Published Date: March 18, 2026
- Place of Performance: St James, MD 21244, United States
Evaluation
All responsible sources may submit a quotation, bid, or proposal, which will be considered by the agency. Specific evaluation criteria are not detailed in this presolicitation notice.
Additional Notes
This presolicitation serves as an advance notice for the upcoming requirement. Interested parties should monitor SAM.gov for future solicitations and updates. Primary contact for this opportunity is Jennifer Kuhn (jennifer.kuhn@cms.hhs.gov) and secondary contact is Kyle Patton (kyle.patton@cms.hhs.gov).