Top 20: CMS Issues $5.4 Billion Medicare Call Center Draft RFP

The Centers for Medicare and Medicaid Services (CMS) issued a Jan. 26 draft request for proposal for a 10-year, $5.4 billion, contract to provide contact center operations support.

This week’s focus of Bloomberg Government’s Top 20 Opportunities is the recompete of the CMS Contact Center Operations (CCO) contract. The contract will continue to provide service functions to answer customer inquiries. Operations will span multiple contact channels, such as telephone, written mail, email, fax, and web chat.

Requirements will cover a toll-free, nationwide, contact center known as 1-800 MEDICARE, which is accessible 24 hours a day, 7 days a week. Calls and inquiries may also include Affordable Care Act (ACA) issues, consumer health choices, other federal programs and Department of Health and Human Services initiatives, including operation of a Federal Marketplace. Companies interested in submitting a bid should be qualified to accommodate program management and staffing complexities of “peak inquiry volume.” That period runs from October through January as a result of annual enrollment in prescription drug plans, Marketplace plans or other health plans, and managed care non-renewal notices.

The government has not yet established an estimated value. BGOV estimates the upcoming contract value, $5.4 billion, based on the amount of the current contract. Responses to the draft RFP are due February 9.

Incumbent Spending

The incumbent contract has disbursed $4.9 billion spending obligations of a $5.4 billion total value to two companies since it was awarded in April 2013. It is set to expire in May 2022.

General Dynamics accounts for about $4.3 billion in spending obligations, while Maximus Inc., the company that took over management of the contract in fiscal 2020, accounts for $555 million to date.

The contract has provided a steady flow of revenue, averaging $607 million per year between fiscal years 2013 through 2020. Contract spending in fiscal 2021 is expected to keep pace with historical amounts.

The prime contractors have reported seven subcontracts totaling $218 million, accoridng to BGOV data.

What’s Ahead

The CMS has yet to establish a final RFP estimated release date. In addition to the January draft RFP, BGOV expects acquisition planning to also include a comment period with at least one round of questions and answers published publicly and an industry day. Once those two events occur, it’s possible a final RFP could be issued around July.

Given the amount of information CMS is releasing ahead of time, contractors should not anticipate significant changes once a final RFP arrives. The agency has provided detailed information including a pricing template to estimate company costs, a subcontract plan to round up potential partners, and the evaluation plan to gauge competitiveness.

Maintaining ‘CCO’ Status Quo

Two important elements of the contract are almost certain to go unchanged. The agency is unlikely to deviate from the single-award approach or divide portions of contract requirements into separate competitions. According to details listed in the frequently asked questions document:

  • The single vendor approach reduces burden; and
  • Consolidating 1-800-MEDICARE and managing the Marketplace allows CMS to best ensure a consistent customer experience across both programs that leverages best practices across call center operations.

Companies interested in an upcoming bid should click here to set an alert to be notified of future CMS announcements.

Note: The Top 20 Opportunities is a weekly column by Bloomberg Government focused on high-value contracts being competed in the federal government.

To contact the analyst on this story: Daniel Snyder at dsnyder@bgov.com

To contact the editors responsible for this story: Michael Clark at mclark@ic.bloombergindustry.com

Top