HHS Spends $38.8M on Medicare Advantage Plan Benefit Package Analysis by LMI Consulting
Contract Overview
Contract Amount: $38,762,592 ($38.8M)
Contractor: LMI Consulting, LLC
Awarding Agency: Department of Health and Human Services
Start Date: 2019-01-01
End Date: 2023-12-31
Contract Duration: 1,825 days
Daily Burn Rate: $21.2K/day
Competition Type: FULL AND OPEN COMPETITION
Number of Offers Received: 1
Pricing Type: TIME AND MATERIALS
Sector: Other
Official Description: IGF::OT::IGF REVIEW AND ANALYSIS OF PLAN BENEFIT PACKAGES SUBMITTED BY MEDICARE ADVANTAGE ORGANIZATIONS
Place of Performance
Location: WINDSOR MILL, BALTIMORE County, MARYLAND, 21244
State: Maryland Government Spending
Plain-Language Summary
Department of Health and Human Services obligated $38.8 million to LMI CONSULTING, LLC for work described as: IGF::OT::IGF REVIEW AND ANALYSIS OF PLAN BENEFIT PACKAGES SUBMITTED BY MEDICARE ADVANTAGE ORGANIZATIONS Key points: 1. Contract awarded to LMI Consulting, LLC for administrative management and general management consulting services. 2. The contract spans five years, from January 1, 2019, to December 31, 2023. 3. Services involve reviewing and analyzing plan benefit packages submitted by Medicare Advantage Organizations. 4. The contract was awarded under full and open competition. 5. The total award amount is $38,762,592.10.
Value Assessment
Rating: fair
The contract's value of $38.8M over five years for consulting services appears within a reasonable range for complex administrative and analytical tasks. However, without specific benchmarks for similar benefit package analysis contracts, a precise value assessment is difficult.
Cost Per Unit: N/A
Competition Analysis
Competition Level: full-and-open
The contract was awarded through full and open competition, suggesting a robust price discovery process. This method typically leads to more competitive pricing by allowing all eligible vendors to bid.
Taxpayer Impact: The competitive award process aims to ensure taxpayer funds are used efficiently for necessary services.
Public Impact
Ensures Medicare Advantage organizations comply with benefit package regulations. Supports the Centers for Medicare and Medicaid Services (CMS) in overseeing health plan offerings. Impacts the clarity and fairness of benefits offered to Medicare beneficiaries. Contributes to the integrity of the Medicare Advantage program.
Waste & Efficiency Indicators
Waste Risk Score: 50 / 10
Warning Flags
- Lack of specific performance metrics provided.
- Potential for scope creep in consulting services.
- Reliance on a single vendor for a critical analysis function.
Positive Signals
- Awarded through full and open competition.
- Long-term contract provides stability for analysis.
- Clear objective of reviewing benefit packages.
Sector Analysis
This contract falls under administrative management and general management consulting services, a broad category often supporting government agencies in operational efficiency and program oversight. Benchmarks for this sector vary widely based on specialization.
Small Business Impact
The data does not indicate any specific set-asides for small businesses. The contract was awarded to LMI Consulting, LLC, which may or may not be classified as a small business depending on its size standards.
Oversight & Accountability
The contract is managed by the Centers for Medicare and Medicaid Services (CMS), a key agency within HHS. Oversight would involve regular performance reviews and adherence to contract terms to ensure accountability.
Related Government Programs
- Administrative Management and General Management Consulting Services
- Department of Health and Human Services Contracting
- Centers for Medicare and Medicaid Services Programs
Risk Flags
- Potential for vendor lock-in.
- Dependence on contractor expertise.
- Limited transparency into specific analytical methodologies.
- Risk of analysis not keeping pace with evolving healthcare regulations.
Tags
administrative-management-and-general-ma, department-of-health-and-human-services, md, delivery-order, 10m-plus
Frequently Asked Questions
What is this federal contract paying for?
Department of Health and Human Services awarded $38.8 million to LMI CONSULTING, LLC. IGF::OT::IGF REVIEW AND ANALYSIS OF PLAN BENEFIT PACKAGES SUBMITTED BY MEDICARE ADVANTAGE ORGANIZATIONS
Who is the contractor on this award?
The obligated recipient is LMI CONSULTING, LLC.
Which agency awarded this contract?
Awarding agency: Department of Health and Human Services (Centers for Medicare and Medicaid Services).
What is the total obligated amount?
The obligated amount is $38.8 million.
What is the period of performance?
Start: 2019-01-01. End: 2023-12-31.
What specific criteria are used to evaluate the submitted plan benefit packages, and how does this analysis ensure value for money?
The evaluation likely focuses on compliance with Medicare regulations, adequacy of benefits offered, and clarity of presentation. Value for money is achieved by ensuring that Medicare Advantage Organizations provide comprehensive and compliant benefits to beneficiaries, preventing potential overcharges or inadequate service provision, and maintaining the integrity of the program.
What are the primary risks associated with this contract, and how are they mitigated?
Key risks include the potential for inaccurate analysis leading to non-compliant plans being approved, or conversely, overly stringent reviews hindering plan innovation. Mitigation involves robust quality assurance processes by CMS, clear performance standards for the contractor, and periodic reviews of the analytical methodologies employed by LMI Consulting.
How effective is this contract in ensuring the quality and fairness of benefits offered to Medicare beneficiaries?
The contract's effectiveness hinges on the thoroughness and accuracy of LMI Consulting's analysis and CMS's subsequent oversight. By ensuring benefit packages meet regulatory standards and are clearly communicated, the contract contributes to beneficiary protection and program integrity, promoting fair access to healthcare services.
Industry Classification
NAICS: Professional, Scientific, and Technical Services › Management, Scientific, and Technical Consulting Services › Administrative Management and General Management Consulting Services
Product/Service Code: SUPPORT SVCS (PROF, ADMIN, MGMT) › PROFESSIONAL SERVICES
Competition & Pricing
Extent Competed: FULL AND OPEN COMPETITION
Solicitation Procedures: SUBJECT TO MULTIPLE AWARD FAIR OPPORTUNITY
Offers Received: 1
Pricing Type: TIME AND MATERIALS (Y)
Evaluated Preference: NONE
Contractor Details
Address: 7940 JONES BRANCH DR, TYSONS CORNER, VA, 22102
Business Categories: Category Business, Corporate Entity Not Tax Exempt, Limited Liability Corporation, Not Designated a Small Business, Special Designations, U.S.-Owned Business
Financial Breakdown
Contract Ceiling: $38,762,592
Exercised Options: $38,762,592
Current Obligation: $38,762,592
Actual Outlays: $18,090,552
Contract Characteristics
Commercial Item: COMMERCIAL PRODUCTS/SERVICES
Parent Contract
Parent Award PIID: GS00F041GA
IDV Type: FSS
Timeline
Start Date: 2019-01-01
Current End Date: 2023-12-31
Potential End Date: 2023-12-31 00:00:00
Last Modified: 2025-03-26
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