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 ServicesManagement, Scientific, and Technical Consulting ServicesAdministrative 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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