Medicare Fee-For-Service Corrective Action Strategic Analysis (CASA)

The Centers for Medicare & Medicaid Services (CMS) – Center for Program Integrity (CPI) / Provider Compliance Group (PCG) is issuing Sources Sought Notice 261097 to identify qualified small businesses (including 8(a), SDVOSB, HUBZone, SDB, VOSB, and WOSB) capable of supporting the Medicare Fee‑For‑Service (FFS) Corrective Action Strategic Analysis (CASA). Respondents must submit a capability statement (max 15 single‑sided pages) and a separate Structured Capability Response Matrix detailing past performance for each of six capability areas: (1) Medicare FFS claims data analysis and CMS system access, (2) improper‑payment analysis, vulnerability identification, and ROI assessment, (3) corrective‑action‑plan (CAP) development, assessment, and medical review, (4) federal health‑program integrity ecosystem coordination, (5) provider education materials/compliance products (preferred), and (6) stakeholder engagement and federal program‑office support (preferred). Four capabilities are mandatory; the ecosystem coordination requirement (Capability 4) uniquely demands documented experience with at least two of the following entities: Medicare Administrative Contractors (MACs), Unified Program Integrity Contractors (UPICs), and other listed program‑integrity partners. All past‑performance examples must be federal contracts/subcontracts of ≥ $2.5 M, performed within the last six years, and related to Medicare FFS, Medicaid, CHIP, or analogous health‑payment integrity programs. Responses must include UEI, company name and address, effort percentages for each team member, and comply with FAR 52.219‑14 subcontracting limits (≥ 50 % of contract cost to be performed by the small‑business concern or its similarly situated subcontractors). Preferred capabilities require experience developing Section 508‑compliant, plain‑language education products and supporting electronic medical‑documentation (esMD) and Additional Documentation Request workflows. Submissions are to be emailed to Eisha Banks (eisha.banks@cms.hhs.gov, 410‑786‑5145) with the subject line “SB Response to CASA SSN 261097” no later than 12:00 PM local time, Baltimore, MD, on May 8, 2026. This notice is a Sources Sought; it does not constitute a solicitation or guarantee of award.

Notice ID

19bf2e433dd349a388a36fa5f11db8fb

Solicitation Number

261097

NAICS Code

541611

Classification Code

R499