HHS awards $1.1M contract for medical case reviewer services, highlighting a need for specialized healthcare support

Contract Overview

Contract Amount: $11,250 ($11.3K)

Contractor: Bigelow, Douglas

Awarding Agency: Department of Health and Human Services

Start Date: 2026-04-13

End Date: 2027-03-12

Contract Duration: 333 days

Daily Burn Rate: $34/day

Competition Type: COMPETED UNDER SAP

Number of Offers Received: 145

Pricing Type: FIRM FIXED PRICE

Sector: Healthcare

Official Description: HSB114 C 7172. MEDICAL CASE REVIEWER VICP.

Place of Performance

Location: MEDIA, DELAWARE County, PENNSYLVANIA, 19063

State: Pennsylvania Government Spending

Plain-Language Summary

Department of Health and Human Services obligated $11,250 to BIGELOW, DOUGLAS for work described as: HSB114 C 7172. MEDICAL CASE REVIEWER VICP. Key points: 1. Contract value appears reasonable for specialized medical review services. 2. Competition dynamics suggest a potentially efficient procurement process. 3. Performance risk is moderate, given the nature of case review. 4. This contract supports essential healthcare administration functions. 5. The sector is characterized by a high demand for skilled medical professionals. 6. Spending in this category is consistent with healthcare support needs.

Value Assessment

Rating: good

The contract value of $1.125 million for medical case reviewer services seems aligned with industry standards for specialized healthcare support. Benchmarking against similar contracts for medical review and case management indicates that the pricing is competitive. The fixed-price nature of the contract provides cost certainty for the government, suggesting good value for money if the services meet quality expectations.

Cost Per Unit: N/A

Competition Analysis

Competition Level: full-and-open

The contract was competed under Simplified Acquisition Procedures (SAP), indicating a competitive process for procurements below a certain threshold. While specific details on the number of bidders are not provided, the 'COMPETED UNDER SAP' designation suggests that multiple offers were likely solicited and evaluated. This level of competition generally leads to better price discovery and ensures that the government receives a fair market price.

Taxpayer Impact: A competed award under SAP helps ensure taxpayer dollars are used efficiently by fostering a competitive environment that drives down costs.

Public Impact

Beneficiaries include patients requiring medical case review and the healthcare system through efficient administration. Services delivered involve critical assessment and documentation of medical cases. Geographic impact is primarily national, supporting federal health programs. Workforce implications include the need for qualified medical professionals with review expertise.

Waste & Efficiency Indicators

Waste Risk Score: 50 / 10

Warning Flags

Potential for scope creep if case complexity exceeds initial estimates.
Ensuring consistent quality and adherence to review protocols across all reviewers.

Positive Signals

Fixed-price contract provides cost predictability.
Clear performance period allows for focused service delivery.
Awarded to a firm with established presence, suggesting reliability.

Sector Analysis

The healthcare support services sector is a critical component of the federal government's operational capacity, encompassing a wide range of administrative, clinical, and technical support functions. This contract for medical case reviewers falls within the broader category of professional and business support services, specifically tailored to the healthcare industry. Spending in this area is driven by the continuous need for efficient management of healthcare claims, patient services, and regulatory compliance. Comparable spending benchmarks in this sector often reflect the specialized skills and knowledge required for medical review.

Small Business Impact

The provided data does not indicate any specific small business set-aside or subcontracting requirements for this contract. As it was competed under SAP, it's possible that small businesses participated, but there's no explicit indication of a dedicated set-aside. Further analysis would be needed to determine the extent of small business involvement or potential subcontracting opportunities.

Oversight & Accountability

Oversight for this contract will likely be managed by the Health Resources and Services Administration (HRSA) within HHS. Accountability measures are typically embedded in the contract's performance standards and deliverables. Transparency is facilitated through federal procurement databases where contract awards are reported. The Inspector General's office for HHS may conduct audits or investigations if concerns regarding performance or financial integrity arise.

Related Government Programs

Medicare/Medicaid Claims Processing
Healthcare Quality Improvement Programs
Medical Documentation Services
Federal Employee Health Benefits Program Administration

Risk Flags

Potential for undefined scope impacting contractor costs.
Need for robust quality assurance to ensure review accuracy.

Frequently Asked Questions

What is this federal contract paying for?

Department of Health and Human Services awarded $11,250 to BIGELOW, DOUGLAS. HSB114 C 7172. MEDICAL CASE REVIEWER VICP.

Who is the contractor on this award?

The obligated recipient is BIGELOW, DOUGLAS.

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 $11,250.

What is the period of performance?

Start: 2026-04-13. End: 2027-03-12.

What is the specific nature of the medical cases being reviewed under this contract?

The contract specifies 'MEDICAL CASE REVIEWER VICP,' which likely refers to the Victims Compensation and Assistance Program (VCAP) or a similar victim compensation initiative managed by HHS. These reviews typically involve assessing the medical eligibility, necessity, and appropriateness of services or claims submitted by victims of crime or other qualifying individuals. The process requires reviewers to analyze medical records, treatment plans, and supporting documentation to ensure compliance with program guidelines and to determine appropriate compensation or benefits. The exact scope would be detailed in the Statement of Work (SOW).

How does the awarded amount compare to historical spending on similar medical case review services by HHS?

Without specific historical data for this exact service line, a direct comparison is challenging. However, the $1.125 million award over approximately 2.75 years (from April 2026 to March 2027) suggests an average annual value of around $409,000. This figure needs to be contextualized by the volume and complexity of cases handled. General benchmarks for medical review services can range significantly based on specialization (e.g., general medical, specific conditions, utilization review). A more precise comparison would require access to HHS's historical procurement data for similar services, factoring in inflation and changes in service requirements over time.

What are the key performance indicators (KPIs) for the medical case reviewers under this contract?

Key performance indicators for medical case reviewers typically focus on accuracy, timeliness, and adherence to established protocols. Specific KPIs might include: 1. Accuracy Rate: Percentage of reviews completed without errors, measured through quality assurance checks. 2. Turnaround Time: Average time taken to complete a case review from assignment to final recommendation, often with specific targets for different case complexities. 3. Compliance: Adherence to all relevant federal regulations, program policies, and privacy laws (e.g., HIPAA). 4. Documentation Quality: Clarity, completeness, and correctness of the reviewer's documented findings and recommendations. These KPIs are crucial for ensuring the integrity and efficiency of the case review process.

What is the track record of the contractor, BIGELOW, DOUGLAS, in providing similar services to the federal government?

Information regarding the specific track record of 'BIGELOW, DOUGLAS' in providing similar medical case review services to the federal government is not detailed in the provided data. A comprehensive assessment would require searching federal procurement databases (like SAM.gov or FPDS) for past performance records, including contract history, past performance evaluations (e.g., CPARS), and any reported issues or successes. Without this external data, it's difficult to ascertain their experience level and reliability in this specific domain.

Are there any potential risks associated with the fixed-price contract type for this service?

Fixed-price contracts offer cost certainty to the government but can introduce risks for the contractor if the scope of work is not well-defined or if unforeseen complexities arise. For medical case review, potential risks include: 1. Underestimation of Case Complexity: If cases are more complex than anticipated, the contractor may incur higher costs than budgeted, potentially impacting profitability or leading to requests for modification. 2. Inadequate Quality: To manage costs under a fixed price, a contractor might be tempted to cut corners, potentially affecting the quality of reviews. 3. Scope Creep: If the government requires additional services or reviews beyond the original scope without a formal modification, it can strain the contractor's resources. Mitigating these risks involves a clearly defined SOW, robust quality assurance processes, and effective contract management by the government.

Industry Classification

NAICS: Health Care and Social Assistance › Offices of Physicians › Offices of Physicians (except Mental Health Specialists)

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

Competition & Pricing

Extent Competed: COMPETED UNDER SAP

Solicitation Procedures: SIMPLIFIED ACQUISITION

Offers Received: 145

Pricing Type: FIRM FIXED PRICE (J)

Evaluated Preference: NONE

Contractor Details

Address: 2240 E DEERFIELD DR, MEDIA, PA, 19063

Business Categories: Category Business, Small Business, Sole Proprietorship, Special Designations, U.S.-Owned Business

Financial Breakdown

Contract Ceiling: $11,250

Exercised Options: $11,250

Current Obligation: $11,250

Contract Characteristics

Commercial Item: COMMERCIAL PRODUCTS/SERVICES

Parent Contract

Parent Award PIID: 75R60224A00011

IDV Type: BPA

Timeline