Sources Sought: CMS CO-OP Comprehensive Audit/Review, Loan Technical Assistance, and Risk Management Plan Development and Execution

CMS has issued a source sought related to the Development and Execution of an Ongoing Comprehensive Audit/Review, Loan Technical Assistance, and Risk Management Plan for the Consumer Operated and Oriented Plan (CO-OP) Program to include conducting a comprehensive auditing/review program to evaluate ongoing internal compliance and risk management policies, processes and key financial controls and audits/reviews of core operational functions in those instances when deficient progress are identified. These audits and risk-based targeted reviews will provide direct oversight of CO-OP activities as a new consumer-run, private, nonprofit, qualified health plan options offered in the Health Insurance Exchange. In addition to CO-OP Program requirements, the CO-OPs must also comply with all applicable and other related Federal and State laws and regulations, including Certificate of Authority and State Insurance Solvency requirements which govern state-licensed health insurance issuers and the Affordable Care Act rules and regulations for health plans participating in the state Health Insurance Exchanges.

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