Medicare Drug Integrity Contractor (MEDIC)

This Sources Sought Notice is being issued to determine the availability and capability of potential small businesses (e.g., 8(a), service-disabled veteran owned small business, HUBZone small business, small disadvantaged business, veteran-owned small business and woman-owned small business) to support the following:

The purpose of the MEDIC is to provide oversight of the Medicare Part D program. The MEDIC shall perform FWA detection and prevention activities to proactively deter FWA in Medicare Part D. The MEDIC shall perform their responsibilities under the direction of CMS. The MEDIC shall develop and conduct data analysis and audits thoroughly and in a timely manner and take immediate action to ensure that the Medicare Trust Fund is protected.

The MEDIC shall use or interact with CMS-required systems as needed in the performance of its functions. Further, the MEDIC shall coordinate its activities not only with CMS, but also with agencies at the federal, state, and local levels of government as well as other CMS partners and Contractors. CMS has traditionally used the Plan Program Integrity Medicare Drug Integrity Contractor (PPI-MEDIC) for Medicare Part C and D plan oversight, including audits, outreach and education, and data analysis.

The MEDIC will perform the Part D audits, outreach and education, and data analysis work previously performed by the PPI-MEDIC. Another contract, the Part C Program Integrity Contractor (CPIC), will perform the Part C audits, outreach and education, and data analysis work. This announcement is a Sources Sought Notice (SSN) for planning purposes only and is only reviewing responses to this notice from eligible SBs under the NAICS code below.

This is not an invitation for bid, request for quote, or other solicitation and in no way obligates the Government to award a contract. CMS will not entertain questions regarding this market research. PLEASE SEE ATTCHMENT FOR FURTHER DETAIL