MODIFICATION
R -- Market Conduct Examination for HIPAA Compliance
- Notice Date
- 4/29/2004
- Notice Type
- Modification
- NAICS
- 524292
— Third Party Administration of Insurance and Pension Funds
- Contracting Office
- Department of Health and Human Services, Centers for Medicare & Medicaid Services, formerly known as the Health Care Financing Administration, Acquisition and Grants Group, 7500 Security Blvd. C2-21-15, Central Building, Baltimore, MD, 21244-1850
- ZIP Code
- 21244-1850
- Solicitation Number
- RFP-CMS-2004-0022
- Response Due
- 6/1/2004
- Archive Date
- 6/16/2004
- Point of Contact
- Mark Smolenski, Contract Specialist, Phone 410-786-0175, Fax 410-786-9088,
- E-Mail Address
-
MSmolenski@cms.hhs.gov
- Small Business Set-Aside
- Total Small Business
- Description
- The Centers for Medicare and Medicaid Services (CMS) intends to award a contract to provide market conduct examination services of private health insurers on an ?as needed? basis. Examinations will involve the in-depth examination of private health insurers business practices and operations for compliance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and its related legislation in those States where CMS has direct enforcement responsibility. Examinations for compliance will include a review and analysis of some or all of the following general subject areas: insurer?s complaint register; selected company operations; marketing and sales; policy forms; underwriting, terminations and denials; certificates of creditable coverage issuance; and policyholder files. Information collected will be reported through Progress Reports and Final Examination Reports in accordance with CMS guidelines. The ability to cross reference findings with specific evidence collected in a clear manner is critical, as well is the knowledge and ability to perform examinations applying Federal HIPAA laws, regulations, program memoranda, and interpretations. The insurers reviewed may be located in any of the 50 states In addition, firms may be requested to perform actuarial and/or statistical analysis ?Special Projects? defined by CMS on an as needed basis. Such actuarial and/or statistical analysis ?Special Projects? may include (but not be limited to) activities such as: 1) assisting CMS in the measurement of it?s direct enforcement efforts through the gathering and analysis of market share data, and 2) review of insurers actuarial assumptions when issuing ?representative policy forms? pursuant to Federal Regulations found at 45 CFR 148.120(c)(3). In accordance with FAR 19.102, the NAICS code that will apply to this work is 524292, Third Party Administration of Insurance and Pension Funds. This procurement is a 100% set-aside for Small Business Concerns. The period of performance will be a base year plus four one-year options. A formal solicitation package will be available on or about March 16, 2004. Questions related to this synopsis should be referred to Mark Smolenski on (410) 786-0175.
- Place of Performance
- Address: Contractor Site - Multiple Sites throughout the United States
- Country: USA
- Country: USA
- Record
- SN00576651-W 20040501/040429211813 (fbodaily.com)
- Source
-
FedBizOpps.gov Link to This Notice
(may not be valid after Archive Date)
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