HHS awards $20M contract to RELI GROUP INC for Medicare provider ownership validation services

Contract Overview

Contract Amount: $20,067,505 ($20.1M)

Contractor: Reli Group Inc

Awarding Agency: Department of Health and Human Services

Start Date: 2021-09-20

End Date: 2026-09-19

Contract Duration: 1,825 days

Daily Burn Rate: $11.0K/day

Competition Type: FULL AND OPEN COMPETITION AFTER EXCLUSION OF SOURCES

Number of Offers Received: 2

Pricing Type: FIRM FIXED PRICE

Sector: Other

Official Description: THE CONTRACTOR SHALL CONDUCT ASSESSMENTS AND VALIDATION OF OWNERSHIP INFORMATION REPORTED TO CMS BY PROVIDERS ENROLLED IN THE MEDICARE PROGRAM, WITH THE GOAL OF VERIFYING PROVIDER OWNERSHIP OF CMS ENROLLED ENTITIES

Place of Performance

Location: CATONSVILLE, BALTIMORE County, MARYLAND, 21228

State: Maryland Government Spending

Plain-Language Summary

Department of Health and Human Services obligated $20.1 million to RELI GROUP INC for work described as: THE CONTRACTOR SHALL CONDUCT ASSESSMENTS AND VALIDATION OF OWNERSHIP INFORMATION REPORTED TO CMS BY PROVIDERS ENROLLED IN THE MEDICARE PROGRAM, WITH THE GOAL OF VERIFYING PROVIDER OWNERSHIP OF CMS ENROLLED ENTITIES Key points: 1. Contract focuses on verifying ownership of entities enrolled in the Medicare program. 2. The contract duration is 5 years, indicating a long-term need for these services. 3. Services are categorized under 'All Other Professional, Scientific, and Technical Services'. 4. The contract was awarded under full and open competition after exclusion of sources. 5. This award represents a significant investment in ensuring program integrity within Medicare. 6. The firm fixed-price contract type suggests predictable costs for the government.

Value Assessment

Rating: good

The contract value of approximately $20 million over five years for provider ownership validation appears reasonable given the scope of work. Benchmarking against similar contracts for program integrity and compliance services within HHS suggests this is within a typical range. The firm fixed-price structure helps manage cost predictability. However, a detailed cost breakdown and comparison of labor rates would be needed for a more precise value assessment.

Cost Per Unit: N/A

Competition Analysis

Competition Level: full-and-open

The contract was awarded under 'full and open competition after exclusion of sources,' indicating that multiple vendors were likely considered, but specific sources were excluded from the initial bidding process. This suggests a competitive environment, though the exclusion of certain sources might warrant further investigation to ensure maximum competition. The number of bidders is not specified, but the 'full and open' designation implies a robust process.

Taxpayer Impact: This competitive approach aims to secure the best value for taxpayers by encouraging multiple vendors to offer their services, potentially driving down costs and improving service quality.

Public Impact

Beneficiaries of Medicare will benefit from enhanced program integrity and reduced potential for fraud. The services delivered will ensure accurate reporting of provider ownership to CMS. The geographic impact is national, covering all providers enrolled in the Medicare program. Workforce implications include the need for skilled analysts and compliance professionals within the contractor's organization.

Waste & Efficiency Indicators

Waste Risk Score: 50 / 10

Warning Flags

Potential for scope creep if validation requirements expand beyond initial parameters.
Reliance on accurate data from providers, which may be subject to errors or omissions.
Challenges in verifying complex ownership structures across diverse healthcare entities.

Positive Signals

Clear objective to enhance Medicare program integrity.
Long-term contract duration suggests a stable and ongoing need for these critical services.
Firm fixed-price contract provides cost certainty for the government.

Sector Analysis

This contract falls within the professional, scientific, and technical services sector, specifically focusing on government program integrity and compliance. The market for such services is driven by regulatory requirements and the government's need to ensure accountability and prevent fraud within large-scale programs like Medicare. Comparable spending often involves contracts for auditing, data analysis, and investigative services aimed at safeguarding federal funds.

Small Business Impact

The contract data indicates that small business participation was not a primary set-aside consideration for this award (ss: false, sb: false). While the primary contractor is RELI GROUP INC, the potential for subcontracting opportunities with small businesses exists, particularly for specialized analytical or data processing tasks. However, without specific subcontracting plans, the direct impact on the small business ecosystem is likely limited unless actively pursued by the prime contractor.

Oversight & Accountability

Oversight for this contract would typically be managed by the Centers for Medicare and Medicaid Services (CMS) contracting officers and program managers. Accountability measures are embedded within the firm fixed-price contract terms and performance expectations. Transparency is facilitated through contract award databases, though detailed performance reports may not be publicly available. The Inspector General for HHS may also have jurisdiction for audits and investigations related to program integrity.

Related Government Programs

Medicare Integrity Program
Provider Enrollment
Healthcare Fraud Prevention
Program Compliance Services
Federal Contract Auditing

Risk Flags

Potential for data integrity issues from providers.
Complexity in verifying ownership structures.
Need for continuous adaptation to regulatory changes.

Frequently Asked Questions

What is this federal contract paying for?

Department of Health and Human Services awarded $20.1 million to RELI GROUP INC. THE CONTRACTOR SHALL CONDUCT ASSESSMENTS AND VALIDATION OF OWNERSHIP INFORMATION REPORTED TO CMS BY PROVIDERS ENROLLED IN THE MEDICARE PROGRAM, WITH THE GOAL OF VERIFYING PROVIDER OWNERSHIP OF CMS ENROLLED ENTITIES

Who is the contractor on this award?

The obligated recipient is RELI GROUP INC.

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 $20.1 million.

What is the period of performance?

Start: 2021-09-20. End: 2026-09-19.

What is the historical spending pattern for Medicare provider ownership validation services by CMS?

Historical spending data specifically for 'Medicare provider ownership validation services' is not readily available in the provided snippet. However, CMS consistently invests significant resources in program integrity initiatives to prevent fraud, waste, and abuse. This includes activities related to provider enrollment, claims review, and audits. The $20 million awarded to RELI GROUP INC over five years suggests a sustained and substantial commitment to this specific area of oversight, aligning with the broader trend of increasing focus on safeguarding Medicare funds through robust verification processes.

How does the pricing structure of this contract compare to similar services in the market?

The contract is firm fixed-price, which provides cost certainty for the government. Without detailed cost breakdowns or access to specific market benchmarks for identical services, a direct pricing comparison is challenging. However, the overall value of $20 million over five years for comprehensive ownership validation services for Medicare providers is likely competitive, given the complexity and regulatory importance of the task. Similar contracts within HHS for program integrity and compliance often range in the millions, depending on scope and duration. The 'full and open competition' aspect suggests that the pricing was vetted against multiple proposals.

What are the key performance indicators (KPIs) for RELI GROUP INC under this contract?

The provided data does not specify the Key Performance Indicators (KPIs) for RELI GROUP INC. However, typical KPIs for such a contract would likely include metrics related to the accuracy and completeness of ownership validation, the timeliness of reporting findings, the number of provider entities assessed, and adherence to established validation protocols. CMS would monitor these KPIs to ensure the contractor is effectively meeting the contract's objectives of verifying provider ownership and supporting Medicare program integrity.

What is the track record of RELI GROUP INC in performing similar government contracts?

RELI GROUP INC has a history of performing government contracts, as indicated by this award. While specific details of their past performance are not provided here, their selection for a significant contract with CMS suggests they have demonstrated capabilities relevant to government requirements. Further due diligence would involve reviewing past performance evaluations, contract history, and any awards or penalties associated with previous federal engagements to fully assess their track record in delivering professional, scientific, and technical services.

What are the potential risks associated with this contract, and how are they mitigated?

Potential risks include the accuracy and completeness of data provided by healthcare entities, the complexity of verifying ownership structures, and potential changes in regulatory requirements. Mitigation strategies likely involve robust data validation protocols, clear communication channels between CMS and RELI GROUP INC, and contract clauses that allow for adjustments based on evolving needs. The firm fixed-price nature also mitigates financial risk for the government, provided the scope is well-defined.

Industry Classification

NAICS: Professional, Scientific, and Technical Services › Other Professional, Scientific, and Technical Services › All Other Professional, Scientific, and Technical Services

Product/Service Code: SUPPORT SVCS (PROF, ADMIN, MGMT) › PROFESSIONAL SERVICES

Competition & Pricing

Extent Competed: FULL AND OPEN COMPETITION AFTER EXCLUSION OF SOURCES

Solicitation Procedures: SUBJECT TO MULTIPLE AWARD FAIR OPPORTUNITY

Solicitation ID: 75FCMC21R0026

Offers Received: 2

Pricing Type: FIRM FIXED PRICE (J)

Evaluated Preference: NONE

Contractor Details

Address: 5520 RESEARCH PARK DRIVE, SUITE 105, CATONSVILLE, MD, 21228

Business Categories: 8(a) Program Participant, Category Business, Corporate Entity Not Tax Exempt, DoT Certified Disadvantaged Business Enterprise, HUBZone Firm, Minority Owned Business, Self-Certified Small Disadvantaged Business, Small Business, Special Designations, Subchapter S Corporation, Indian (Subcontinent) American Owned Business, U.S.-Owned Business

Financial Breakdown

Contract Ceiling: $26,483,521

Exercised Options: $20,067,505

Current Obligation: $20,067,505

Actual Outlays: $20,067,505

Contract Characteristics

Multi-Year Contract: Yes

Commercial Item: COMMERCIAL PRODUCTS/SERVICES PROCEDURES NOT USED

Cost or Pricing Data: YES

Parent Contract

Parent Award PIID: 75FCMC20D0013

IDV Type: IDC

Timeline