Details for sustainment of CMS DME QIC competition protest published

DIGEST

  1. Protest that the agency failed to evaluate a potential impaired objectivity organizational conflict of interest is sustained where the awardee’s wholly-owned subsidiary would review decisions on appeal from the parent company’s own claims decisions, and the agency did not meaningfully consider whether this structure created an impaired objectivity organizational conflict of interest.
  2. Protest that the agency failed to evaluate a potential unequal access to information organizational conflict of interest is sustained where the record does not demonstrate that the agency reasonably evaluated a potential unequal access to information conflict arising from the relationship between the awardee and one of its subsidiaries.

DECISION

C2C Innovative Solutions, Inc. (C2C), of Jacksonville, Florida, protests the issuance of a task order to MAXIMUS Federal Services, Inc. (MAXIMUS), of Reston, Virginia, under letter request for proposals (RFP) No. 171751, which was issued by the Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) under its indefinite-delivery, indefinite-quantity (IDIQ) contract for qualified independent contractors (QICs).  The solicitation sought proposals from QICs to provide reconsiderations of denials of Medicare claims related to durable medical equipment.[1]   The protester alleges that CMS failed to meaningfully consider whether the issuance of a task order to MAXIMUS would create an organizational conflict of interest (OCI) as a result of the more senior appeals review role currently performed by a MAXIMUS subsidiary.

We sustain the protest.

BACKGROUND

CMS issued the solicitation on June 5, 2017, under Federal Acquisition Regulation (FAR) subpart 16.5, which addresses the competition for task orders under IDIQ contracts.  Agency Report (AR), Tab 15, Negotiation Memorandum, at 8.  The agency sent the RFP to the four…” Read the full 12-page decision document here.

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