TRICARE Claims Review Services (TCRS)
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 Defense Health Agency (DHA) is issuing a Request for Information (RFI) for TRICARE Claims Review Services (TCRS). This RFI is for market research purposes, preceding a planned sole-source bridge action to Concept Plus to prevent a critical service gap. The bridge action will cover a 12-month period from March 1, 2026, to February 28, 2027, until a competitively awarded follow-on contract can be transitioned. Capabilities statements are due by February 13, 2026, at 2 PM MST.
Scope of Work
The TCRS contract supports the DHA Improper Payment Evaluation Branch (IPEB) in identifying and reporting improper payments and discrepancies within the Military Health System (MHS), which serves over 9.4 million beneficiaries. Services include independent, impartial review of claims processing procedures, reimbursement methodologies, and assessment of purchased-care contractor compliance with TRICARE policies. This support is crucial for IPEB's requirement to report improper payments to the Office of Management and Budget (OMB) for the DoD Agency Financial Report (AFR).
Contract & Timeline
- Type: Sources Sought / Request for Information (Market Research)
- Preceding Action: Sole-source bridge action to Concept Plus
- Bridge Duration: 12 months (March 1, 2026 – February 28, 2027)
- Set-Aside: None specified (market research for sole-source justification)
- Response Due: February 13, 2026, 2 PM MST
- Published: February 7, 2026
- PSC Code: R408 Program Management/Support Services
- NAICS Code: 541611 - Administrative Management and General Management Consulting Services
Evaluation
This notice is for market research only and is not a Request for Proposals. Responses will be used to determine industry capabilities and inform the justification for the sole-source bridge action, as well as future competitive solicitations. The Government will not acknowledge receipt or provide feedback on submissions.
Additional Notes
Interested parties must submit capabilities statements demonstrating experience with reviewing/auditing healthcare claims. A new contractor would require a minimum of 6 months for transition-in, which is why a bridge action is deemed necessary. No proprietary, classified, or sensitive information should be included in responses. Submissions and inquiries should be sent via email to Mr. Justin O’Hara at justin.a.ohara2.ctr@health.mil.