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Plan Program Integrity Medicare Drug Integrity Contractor (PPI MEDIC)
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Title:  

Plan Program Integrity Medicare Drug Integrity Contractor (PPI MEDIC)

Agency:  

U.S. Department Of Health And Human Services

State:  

Maryland

NAICS Code:  

541990

Industry:  

Healthcare and Medical Services

Solicitation Type:  

Request for Proposal

Solicitation ID:  

260656J

Open Date:  

11/6/2025

Close Date:  

4/22/2026

Project Duration:  

5 years

Last Updated:  

Description:
The Centers for Medicare & Medicaid Services (CMS) is seeking a contractor to provide oversight of the Medicare Parts C and D programs. The contractor will be responsible for tasks such as data analysis, audits, and reviews of Medicare Advantage Organizations (MAOs) and Prescription Drug Plan (PDP) sponsors. The contractor will also be involved in outreach, education, and referrals to law enforcement. The scope of work includes providing support for CMS audits and program integrity oversight activities related to fraud, waste, and abuse efforts within the Medicare Parts C and D programs. Some key aspects of the job include: • Data analysis and audits of MAOs and PDP sponsors • Reviews of MAOs and PDP sponsors to ensure compliance with regulations • Outreach, education, and referrals to law enforcement • Support for CMS audits and program integrity oversight activities • Ongoing work with the Medicare Parts C and D programs
Attached Files:

Please visit the bid source via the “Link to Bid Source” button below for documentation.

Contact Information:

Jennifer Kuhn(Contracting Officer)

jennifer.kuhn@cms.hhs.gov

(410) 786-2299

Budget Estimate (AI):

$1,000,000 – $10,000,000

The budget for this contract is not explicitly stated in the document. However, considering the scope of work and the fact that the contractor will be working with the Medicare Parts C and D programs, the budget could be substantial. The contractor will be responsible for tasks such as data analysis, audits, and reviews of MAOs and PDP sponsors, which could involve significant resources and personnel. A possible budget range could be between $1 million and $10 million, considering the complexity of the work and the potential number of personnel involved. However, this is a rough estimate and the actual budget could be higher or lower, depending on the specific requirements of the contract and the resources needed to complete the work. Factors that could influence the budget range include the number of personnel required, the level of expertise needed, the duration of the contract, and the specific tasks and deliverables required.

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