CMS Sources Sought: Health Insurance Medical Loss Ratio (MLR) Examinations

Re: Solicitation Number: CMS200369

This is a CMS mission critical requirement and supports one of the primary goals of the Agency – better care and lower costs.  Beneficiaries should receive high quality, coordinated, effective, efficient care and, as a result, health care costs may be reduced.

Important knowledge requirements include, but are not limited to: strategic planning and project management expertise; sophisticated knowledge of MLR regulations, premium and claims data; ability to validate, test, analyze, review, document, and/or manipulate issuers’ MLR data, including all the data elements reported on the MLR Annual Reporting Form, and any other forms developed and utilized by CCIIO to collect MLR-related data.

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