HHS Awards $34M for FTCA Medical Claims Review to Keystone Peer Review Organization
Contract Overview
Contract Amount: $34,021,263 ($34.0M)
Contractor: Keystone Peer Review Organization, LLC
Awarding Agency: Department of Health and Human Services
Start Date: 2020-09-26
End Date: 2025-09-25
Contract Duration: 1,825 days
Daily Burn Rate: $18.6K/day
Competition Type: FULL AND OPEN COMPETITION
Number of Offers Received: 2
Pricing Type: FIRM FIXED PRICE
Sector: Healthcare
Official Description: MEDICAL CLAIMS REVIEW AND RISK MANAGEMENT SERVICES FOR FEDERAL TORT CLAIMS ACT (FTCA) DEEMED HEALTH CENTERS AND FREE CLINICS
Place of Performance
Location: HARRISBURG, DAUPHIN County, PENNSYLVANIA, 17111
Plain-Language Summary
Department of Health and Human Services obligated $34.0 million to KEYSTONE PEER REVIEW ORGANIZATION, LLC for work described as: MEDICAL CLAIMS REVIEW AND RISK MANAGEMENT SERVICES FOR FEDERAL TORT CLAIMS ACT (FTCA) DEEMED HEALTH CENTERS AND FREE CLINICS Key points: 1. Contract awarded via full and open competition, indicating a competitive bidding process. 2. The contract value of $34M over 5 years suggests a significant investment in claims review services. 3. The fixed-price contract type aims to control costs for the government. 4. Services are for deemed health centers and free clinics under the Federal Tort Claims Act. 5. The North American Industry Classification System (NAICS) code 541611 points to management consulting services.
Value Assessment
Rating: good
The contract value of $34M over five years averages $6.8M annually. Benchmarking against similar contracts for administrative management and general management consulting services is difficult without more specific data on the scope of services provided.
Cost Per Unit: N/A
Competition Analysis
Competition Level: full-and-open
The contract was awarded under full and open competition, suggesting multiple vendors had the opportunity to bid. This method typically promotes price discovery and competitive pricing.
Taxpayer Impact: The competitive nature of the award is intended to ensure taxpayer funds are used efficiently for essential claims review services.
Public Impact
Ensures proper processing of medical claims for federally supported health centers. Supports the Federal Tort Claims Act by managing liability and risk. Aims to improve the quality and efficiency of healthcare services provided to underserved populations. Provides oversight for financial and administrative aspects of health center operations.
Waste & Efficiency Indicators
Waste Risk Score: 50 / 10
Warning Flags
- Potential for scope creep in claims review services.
- Reliance on a single vendor for a critical function.
- Ensuring continued cost-effectiveness over the contract duration.
Positive Signals
- Awarded through full and open competition.
- Firm fixed-price contract type helps manage cost uncertainty.
- Long-term contract provides stability for essential services.
Sector Analysis
The healthcare sector, particularly services related to federal programs like FTCA, involves complex administrative and management functions. Spending benchmarks for such specialized consulting services can vary widely based on scope and duration.
Small Business Impact
The provided data does not indicate whether small businesses were involved in this contract, either as prime contractors or subcontractors. Further analysis would be needed to assess small business participation.
Oversight & Accountability
The Department of Health and Human Services, through the Health Resources and Services Administration, is responsible for overseeing this contract. Regular performance reviews and audits are expected to ensure accountability and adherence to contract terms.
Related Government Programs
- Administrative Management and General Management Consulting Services
- Department of Health and Human Services Contracting
- Health Resources and Services Administration Programs
Risk Flags
- Contract duration of 5 years.
- Firm Fixed Price contract type.
- Awarded under Full and Open Competition.
- Services are critical for FTCA compliance.
- Contract value of $34M.
Tags
administrative-management-and-general-ma, department-of-health-and-human-services, pa, delivery-order, 10m-plus
Frequently Asked Questions
What is this federal contract paying for?
Department of Health and Human Services awarded $34.0 million to KEYSTONE PEER REVIEW ORGANIZATION, LLC. MEDICAL CLAIMS REVIEW AND RISK MANAGEMENT SERVICES FOR FEDERAL TORT CLAIMS ACT (FTCA) DEEMED HEALTH CENTERS AND FREE CLINICS
Who is the contractor on this award?
The obligated recipient is KEYSTONE PEER REVIEW ORGANIZATION, LLC.
Which agency awarded this contract?
Awarding agency: Department of Health and Human Services (Health Resources and Services Administration).
What is the total obligated amount?
The obligated amount is $34.0 million.
What is the period of performance?
Start: 2020-09-26. End: 2025-09-25.
What specific metrics are used to evaluate the effectiveness of Keystone Peer Review Organization's services in managing FTCA claims and mitigating risk?
Effectiveness is likely measured by key performance indicators such as claims processing accuracy rates, turnaround times for claim reviews, the number of identified fraudulent or erroneous claims, and the overall reduction in financial liability for the government under the FTCA. Performance reports and audits would detail adherence to these metrics.
How does the firm fixed-price structure mitigate risks associated with fluctuating healthcare costs or service demands over the five-year contract period?
The firm fixed-price structure shifts the risk of cost overruns to the contractor, Keystone Peer Review Organization. While this protects the government from unexpected price increases, it requires the contractor to accurately estimate all costs upfront. Potential risks for the contractor include underestimating costs due to unforeseen market changes or increased service demands.
What is the anticipated impact of these services on the operational efficiency and financial stability of the deemed health centers and free clinics?
By ensuring accurate and efficient claims review, these services should reduce administrative burdens on health centers, allowing them to focus more on patient care. Improved claims processing can lead to more predictable revenue streams and help prevent financial penalties or disputes, thereby enhancing their financial stability.
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: 2
Pricing Type: FIRM FIXED PRICE (J)
Evaluated Preference: NONE
Contractor Details
Address: 777 E PARK DR, HARRISBURG, PA, 17111
Business Categories: Category Business, Corporate Entity Not Tax Exempt, Not Designated a Small Business, Special Designations, U.S.-Owned Business
Financial Breakdown
Contract Ceiling: $34,066,925
Exercised Options: $34,066,925
Current Obligation: $34,021,263
Actual Outlays: $18,369,596
Contract Characteristics
Commercial Item: COMMERCIAL PRODUCTS/SERVICES
Parent Contract
Parent Award PIID: 47QRAA20D003U
IDV Type: FSS
Timeline
Start Date: 2020-09-26
Current End Date: 2025-09-25
Potential End Date: 2025-09-25 00:00:00
Last Modified: 2024-08-07
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