Amendment #2 RFP for Conducting Recovery Audit Services for the VHA Office of Finance, Department of Veterans Affairs (VA) 36C10X25R0021_0002

Solicitation 36C10X25R0021_0002 Copied Notice ID 5bb074fa8aef4d40b4c92113947af037 Copied VETERANS AFFAIRS, DEPARTMENT OF — SAC FREDERICK (36C10X)

SAM.gov

Posted

Aug 27, 2025

Deadline

Sep 09, 2025

Set-aside

NONE

NAICS

541219

PSC

R704

Summary

AI-generated · Aug 28, 2025

Provide recovery audit services to review healthcare claim payments across VA’s VHA Community Care programs. Automated reviews occur at the system level, while more complex cases require a qualified individual to review medical records. Each program uses its own VA-regulated payment methodologies, and audits will cover various paid claim data with scenario-specific dates and criteria.

VA plans to award up to three fixed-fee-of-recovery contracts. Compensation is based on a fixed percentage of funds recovered and depends on accurately identifying valid overpayments and successfully recovering them; the contractor bears all costs associated with RAC tasks and is paid only from actual recoveries. The base period runs for one year from award, with up to four one-year option periods at the government’s discretion.

The Department of Veterans Affairs (VA), VHA Office of Finance (OF) has a requirement for up to conduct Recovery Audit (RA) activities of healthcare claim payments made for a variety of VHA Community Care programs, as described below. Automated reviews occur at the system level while complex reviews require a qualified individual to review the medical record. Each program has specific payment methodologies as defined by VA regulations. In general, the audit will review various types of paid healthcare claim data with specific dates and criteria included in the description of each auditing scenario. The VA intends to award one (1) but not more than three (3) FFP (fixed percentage of recovery) contract(s) to provide healthcare claims recovery auditing services. Contractor compensation under this contract will be contingent upon the accurate identification of valid overpayments and the successful recovery of those overpayments by the Government. The contractor shall assume all costs associated with the execution of RAC tasks and will only be reimbursed based on a fixed percentage of actual funds recovered. The Period of Performance (POP) for the base period shall be from the date of award for a period of one (1) year base period, followed by four (4) year option periods to be awarded at the discretion of the Government.

From Solicitation posted on Aug 27, 2025