HHS Awards $26.9M for Operational Analytics and Fraud Surveillance to Opera Solutions, LLC

Contract Overview

Contract Amount: $26,943,500 ($26.9M)

Contractor: Opera Solutions, LLC

Awarding Agency: Department of Health and Human Services

Start Date: 2012-09-28

End Date: 2015-09-29

Contract Duration: 1,096 days

Daily Burn Rate: $24.6K/day

Competition Type: FULL AND OPEN COMPETITION

Number of Offers Received: 3

Pricing Type: TIME AND MATERIALS

Sector: IT

Official Description: OPERATIONAL ANALYTICS AND FRAUD SURVEILLANCE

Place of Performance

Location: JERSEY CITY, HUDSON County, NEW JERSEY, 07302

State: New Jersey Government Spending

Plain-Language Summary

Department of Health and Human Services obligated $26.9 million to OPERA SOLUTIONS, LLC for work described as: OPERATIONAL ANALYTICS AND FRAUD SURVEILLANCE Key points: 1. Contract awarded to Opera Solutions, LLC for $26.9M. 2. Services fall under Administrative Management and General Management Consulting. 3. Full and open competition was utilized. 4. Contract duration is approximately 3 years. 5. The contract was awarded as a delivery order.

Value Assessment

Rating: fair

The contract value of $26.9M over three years for specialized analytics and fraud surveillance services appears within a reasonable range for complex government IT and consulting projects. Benchmarking against similar contracts for data analytics and management consulting within HHS or other large agencies would provide a clearer picture of value.

Cost Per Unit: N/A

Competition Analysis

Competition Level: full-and-open

The contract was awarded under full and open competition, suggesting a robust process for soliciting bids and ensuring fair pricing. This method typically leads to better price discovery and potentially more competitive pricing compared to limited or sole-source awards.

Taxpayer Impact: The use of full and open competition aims to ensure taxpayer funds are used efficiently by fostering a competitive environment among potential contractors, leading to potentially better value for the government.

Public Impact

Enhances Medicare and Medicaid's ability to detect and prevent fraud, waste, and abuse. Improves operational efficiency within CMS through advanced analytics. Supports data-driven decision-making for healthcare program integrity. Potential for significant cost savings through fraud reduction. Impacts millions of beneficiaries by safeguarding program funds.

Waste & Efficiency Indicators

Waste Risk Score: 50 / 10

Warning Flags

Lack of specific performance metrics in provided data.
Potential for scope creep in analytics projects.
Reliance on a single delivery order for a significant amount.

Positive Signals

Awarded under full and open competition.
Focus on critical areas of fraud and operational efficiency.
Experienced contractor likely involved.

Sector Analysis

This contract falls within the IT and professional services sector, specifically focusing on administrative management and general management consulting. Spending in this area for government agencies is substantial, driven by the need for data analysis, system modernization, and operational improvements to manage complex programs like Medicare and Medicaid.

Small Business Impact

The provided data does not indicate any specific set-asides for small businesses. While the contract was awarded under full and open competition, it's unclear if small businesses had the opportunity to participate as prime contractors or subcontractors.

Oversight & Accountability

The Centers for Medicare and Medicaid Services (CMS) is responsible for overseeing this contract. Standard government oversight mechanisms, including contract performance reviews and financial audits, would be in place to ensure accountability and proper use of funds.

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 if proprietary solutions are used.
Dependence on the quality and completeness of data provided to the contractor.
Risk of evolving fraud schemes outpacing detection capabilities.
Challenges in integrating analytics solutions with existing legacy systems.

Frequently Asked Questions

What is this federal contract paying for?

Department of Health and Human Services awarded $26.9 million to OPERA SOLUTIONS, LLC. OPERATIONAL ANALYTICS AND FRAUD SURVEILLANCE

Who is the contractor on this award?

The obligated recipient is OPERA SOLUTIONS, 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 $26.9 million.

What is the period of performance?

Start: 2012-09-28. End: 2015-09-29.

What specific analytical tools and methodologies are being employed by Opera Solutions, LLC to achieve the stated goals of operational analytics and fraud surveillance?

The provided data does not detail the specific analytical tools or methodologies. However, given the nature of fraud surveillance and operational analytics for healthcare programs, it likely involves advanced data mining, statistical modeling, machine learning algorithms, and potentially AI-driven pattern recognition to identify anomalies and suspicious activities within vast datasets of healthcare claims and provider information.

How will the effectiveness of the fraud surveillance be measured, and what are the key performance indicators (KPIs) for this contract?

Key performance indicators are not detailed in the provided data. Effectiveness is typically measured by metrics such as the amount of fraud detected and prevented (in dollar value), the reduction in improper payments, improvements in operational processing times, and the accuracy of fraud detection algorithms. Regular reporting and performance reviews would track these KPIs.

What is the potential return on investment (ROI) for the government in terms of fraud reduction and operational cost savings resulting from this contract?

The potential ROI is significant, as effective fraud surveillance can recover billions in improperly paid funds and deter future fraudulent activities. While the contract cost is $26.9M, successful fraud detection and prevention efforts often yield returns many times the investment. Operational efficiencies can also lead to long-term cost savings in administrative overhead.

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: 3

Pricing Type: TIME AND MATERIALS (Y)

Evaluated Preference: NONE

Contractor Details

Address: 10 EXCHANGE PL FL 11, JERSEY CITY, NJ, 07302

Business Categories: Category Business, Limited Liability Corporation, Minority Owned Business, Not Designated a Small Business, Special Designations, Indian (Subcontinent) American Owned Business, U.S.-Owned Business

Financial Breakdown

Contract Ceiling: $26,943,500

Exercised Options: $26,943,500

Current Obligation: $26,943,500

Contract Characteristics

Commercial Item: COMMERCIAL ITEM

Parent Contract

Parent Award PIID: GS23F0006X

IDV Type: FSS

Timeline