TRICARE Medicare Eligible Program Second Generation (TMEP2)

This solicitation awards a firm‑fixed‑price contract to provide the full suite of TRICARE Medicare Eligible Program (TMEP2) services for dual‑eligible beneficiaries across the United States and its territories. The contractor will be responsible for high‑volume claims processing (electronic and paper), provider payments via EFT, 24/7 beneficiary and provider customer‑service call center operations, transition‑in and transition‑out activities, quality‑management and program‑integrity functions, and extensive reporting to the Defense Health Agency. The effort includes a 12‑month base transition‑in period, up to seven one‑year option periods, and a possible six‑month extension, for a total performance window of up to 8½ years. • Process ~64‑71 M electronic claims and ~0.9‑1.4 M paper claims per year, applying TRICARE cost‑share rules and Medicare coordination. • Operate a 24 × 7 toll‑free call center with live‑agent availability 6 am‑11 pm ET, meet stringent performance metrics (blockage ≤ 5 %, hold‑time ≤ 2 min, satisfaction ≥ 90 %). • Deliver monthly, quarterly, and annual data reports (CDRLs) covering financial, quality, fraud‑prevention, and records‑management requirements. • Execute transition‑in/out plans, including MOUs with BCRC and other TRICARE contractors, bank‑account setup, and integrated master plan/schedule delivery.