HHS Awards $93M for DME MAC Services to CGS Administrators, LLC

Contract Overview

Contract Amount: $93,209,888 ($93.2M)

Contractor: CGS Administrators, LLC

Awarding Agency: Department of Health and Human Services

Start Date: 2023-04-01

End Date: 2027-03-31

Contract Duration: 1,460 days

Daily Burn Rate: $63.8K/day

Competition Type: FULL AND OPEN COMPETITION

Number of Offers Received: 2

Pricing Type: COST PLUS AWARD FEE

Sector: Healthcare

Official Description: JB DME MAC SERVICES

Place of Performance

Location: NASHVILLE, DAVIDSON County, TENNESSEE, 37214

State: Tennessee Government Spending

Plain-Language Summary

Department of Health and Human Services obligated $93.2 million to CGS ADMINISTRATORS, LLC for work described as: JB DME MAC SERVICES Key points: 1. Contract value of $93.2M over 5 years. 2. Competition method is Full and Open. 3. Risk is moderate due to contract type and duration. 4. Sector is Healthcare, specifically insurance carriers.

Value Assessment

Rating: good

The contract is a Cost Plus Award Fee type, which allows for performance-based incentives. The total award value is $93.2M. Benchmarking against similar contracts for Durable Medical Equipment (DME) MAC services is difficult without more granular cost data.

Cost Per Unit: N/A

Competition Analysis

Competition Level: full-and-open

The contract was awarded under full and open competition, suggesting a robust price discovery process. The definitive contract award type indicates a single award to CGS Administrators, LLC.

Taxpayer Impact: Taxpayer funds are being used for essential Medicare administrative services, aiming for efficient program delivery.

Public Impact

Ensures continued access to durable medical equipment for Medicare beneficiaries. Supports the operational efficiency of the Medicare program. Impacts beneficiaries in Tennessee and other service areas.

Waste & Efficiency Indicators

Waste Risk Score: 60 / 10

Warning Flags

  • Cost Plus Award Fee structure can lead to higher costs if not managed effectively.
  • Long contract duration (5 years) may limit flexibility for future technological advancements or market changes.

Positive Signals

  • Full and open competition promotes competitive pricing.
  • Contract aims to ensure continuity of essential services.

Sector Analysis

This contract falls within the Healthcare sector, specifically for insurance carriers administering Medicare benefits. Spending benchmarks for such administrative services are highly variable based on geographic scope and specific services provided.

Small Business Impact

The data does not indicate any specific set-asides for small businesses. The primary contractor, CGS Administrators, LLC, is not identified as a small business in this context.

Oversight & Accountability

The Centers for Medicare and Medicaid Services (CMS) is responsible for overseeing this contract. Oversight will focus on performance metrics and cost control within the Cost Plus Award Fee structure.

Related Government Programs

  • Direct Health and Medical Insurance Carriers
  • Department of Health and Human Services Contracting
  • Centers for Medicare and Medicaid Services Programs

Risk Flags

  • Potential for cost overruns due to Cost Plus Award Fee structure.
  • Long-term contract may not adapt quickly to evolving healthcare needs or technologies.
  • Dependence on a single contractor for critical administrative functions.
  • Lack of specific small business participation noted.

Tags

direct-health-and-medical-insurance-carr, department-of-health-and-human-services, tn, definitive-contract, 10m-plus

Frequently Asked Questions

What is this federal contract paying for?

Department of Health and Human Services awarded $93.2 million to CGS ADMINISTRATORS, LLC. JB DME MAC SERVICES

Who is the contractor on this award?

The obligated recipient is CGS ADMINISTRATORS, 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 $93.2 million.

What is the period of performance?

Start: 2023-04-01. End: 2027-03-31.

What is the expected cost savings or efficiency gain from using a Cost Plus Award Fee structure compared to a fixed-price contract for these services?

A Cost Plus Award Fee structure is intended to incentivize contractor performance by rewarding them for exceeding certain targets, potentially leading to greater efficiency and better service quality than a fixed-price contract. However, it also carries the risk of higher costs if performance targets are not well-defined or if oversight is insufficient. The actual savings or gains depend heavily on the specific award fee criteria and the effectiveness of CMS's monitoring.

What are the key performance indicators (KPIs) that will be used to determine the award fee for CGS Administrators, LLC?

The specific Key Performance Indicators (KPIs) for determining the award fee are not detailed in the provided data. Typically, for DME MAC services, KPIs would include metrics related to claims processing timeliness, accuracy rates, beneficiary satisfaction, fraud detection, and adherence to program integrity requirements. CMS will monitor these KPIs to assess contractor performance and determine the award fee.

How does this contract ensure the continuity and quality of durable medical equipment services for Medicare beneficiaries across its service area?

This contract ensures continuity by awarding services to a single entity, CGS Administrators, LLC, for a defined period. The Cost Plus Award Fee structure incentivizes the contractor to maintain high service quality and operational efficiency. CMS oversight will be crucial in monitoring performance against established metrics to guarantee that beneficiaries receive timely and appropriate access to necessary durable medical equipment.

Industry Classification

NAICS: Finance and InsuranceInsurance CarriersDirect Health and Medical Insurance Carriers

Product/Service Code: SOCIAL SERVICESSOCIAL SERVICES

Competition & Pricing

Extent Competed: FULL AND OPEN COMPETITION

Solicitation Procedures: NEGOTIATED PROPOSAL/QUOTE

Solicitation ID: 75FCMC22R0002

Offers Received: 2

Pricing Type: COST PLUS AWARD FEE (R)

Evaluated Preference: NONE

Contractor Details

Address: 26 CENTURY BLVD STE 610, NASHVILLE, TN, 37214

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: $212,962,887

Exercised Options: $111,283,465

Current Obligation: $93,209,888

Actual Outlays: $53,125,903

Contract Characteristics

Commercial Item: COMMERCIAL PRODUCTS/SERVICES PROCEDURES NOT USED

Cost or Pricing Data: YES

Timeline

Start Date: 2023-04-01

Current End Date: 2027-03-31

Potential End Date: 2030-09-30 00:00:00

Last Modified: 2026-03-18

More Contracts from CGS Administrators, LLC

View all CGS Administrators, LLC federal contracts →

Other Department of Health and Human Services Contracts

View all Department of Health and Human Services contracts →

Explore Related Government Spending