Sources Sought
RFI Comprehensive Medical Review & Audit Support
Department of the Interior
AI summaryThe Interior Business Center, for the Department of Health and Human Services (HHS) Office of Inspector General (OIG), is asking in a request for information (RFI) whether firms can provide medical record review, audit and expert witness support. This is market research only: no proposals or quotes are accepted, and the attached draft performance work statement (PWS, the document describing the work) may change. The response due date is November 13, 2026, 12:00 PM Eastern, by email. More in the summary
Market research, not a bid. Replying is free and tells Department of the Interior who could do this work. Send a short reply to the contracting contact; no price is needed. See the contact
AI summary Beta
The notice looks incomplete: Part of the draft PWS was not read: the middle of Draft_PWS_1.pdf (the end of Section 2 and the start of Section 3, Evaluations and Inspections) was left out, so some requirements and workloads there are missing. Check the attachments on SAM.gov.
The Interior Business Center, for the Department of Health and Human Services (HHS) Office of Inspector General (OIG), is asking in a request for information (RFI) whether firms can provide medical record review, audit and expert witness support. This is market research only: no proposals or quotes are accepted, and the attached draft performance work statement (PWS, the document describing the work) may change. The response due date is November 13, 2026, 12:00 PM Eastern, by email.
Who can bid (6)
- Draft PWS (may change): the contractor's organization must have been in business at least three calendar years before award
- Draft PWS (may change): at least three years of Medicaid and/or Medicare consultation and medical record review experience, at a Federal agency or a commercial business, before award
- Draft PWS (may change): all contractor personnel need at least a Public Trust Level 5 clearance
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- Draft PWS (may change): no employee may appear on the List of Excluded Individuals/Entities (LEIE), the list of people barred from federal health care programs
- Draft PWS (may change): medical record reviews must be done by licensed or certified professionals, with key staff such as a licensed Medical Director who is a medical doctor, nurses and certified coders
- Draft PWS (may change): staff who can read, write and speak English and Spanish for customer interactions and record review
How to submit: Email to the Contracting Officer, Shavonda_Jamison@ibc.doi.gov, and the Contracting Specialist, Dorothy_Royster@ibc.doi.gov. What to include is under Full summary below. Check the solicitation's instructions on SAM.gov.
Things to watch (8)
From the version posted Oct 13, 2026.
- Serious: Large review capacity and physician specialists. The RFI asks for maximum monthly claim review capacity and availability of specialist physicians, which a small firm may need teaming partners to meet.
- Serious: Public Trust Level 5 for all personnel. The draft PWS says every worker needs at least a Public Trust Level 5 clearance, so staff may need government screening before they can work.
- Worth checking: Liquidated damages and reduced pay for late work. The draft PWS lets the Government charge liquidated damages (preset penalties) or pay a reduced rate when deliverables are late.
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- Worth checking: Expert witness testimony in criminal proceedings. Office of Investigations work includes expert testimony and trial preparation for federal grand jury and criminal cases, which needs experienced physicians willing to testify.
- Minor: Market research only, no proposals or quotes. Nothing can be bid yet, and the notice does not say a solicitation will follow.
- Minor: Draft PWS may change. Requirements shown in the draft may differ in any later solicitation, so the list of qualifications and metrics is not final.
- Minor: Workload may change. The audit section gives expected volumes, but they are estimates based on prior experience and can change with OIG budget and priorities.
- Minor: Limits on using artificial intelligence. The draft PWS bars using OIG documents for machine learning and requires disclosing any use of artificial intelligence.
Read from the notice and 2 attachments. Show which files.
- A14_MR_-_RFI_Notice_1.pdf (read)
- Draft_PWS_1.pdf (read)
Full summary
What they want
- Medical record review and consulting for OIG audits of Medicare Parts A, B, D and Medicaid claims: about 100 to 200 claims per audit, about 1,500 claims and 15 audits per year
- Medical record review for audits of Medicare Part C (Medicare Advantage, the private health plan option) to check diagnoses sent to the Centers for Medicare & Medicaid Services (CMS)
- Medical record review and consulting for OIG evaluations and inspections
- Expert consultants and witnesses for the OIG Office of Investigations: records analysis, written reports, and testimony in federal grand jury and criminal proceedings
- A medical expert for the Office of Counsel to the Inspector General, with opinions, written reports, testimony and travel as options
- Review instruments, review result letters and quality assurance plans that OIG approves, with monthly reports
- Hourly consulting on entity comments and ad hoc medical questions as OIG plans its work
- From respondents now: capability, a technical approach of up to 5 pages, past performance, pricing drivers, and feedback on the draft PWS
- Contract type
- Not stated in the RFI. The draft PWS describes a performance-based labor-hour contract (paid for hours worked) in its Evaluations and Inspections section and consulting at a fixed fee per hour in its audit section
- Period of performance
- Not stated for the whole buy. The draft PWS says Office of Investigations work runs six months to 1 year, possibly longer, and the Counsel to the Inspector General initial task can take up to 3 years, with four optional tasks
- Estimated value
- Not stated
- Contract vehicle
- Not named in the RFI. The draft PWS says the contract would be issued under Federal Acquisition Regulation (FAR) subpart 8.4
- Offers due
- November 13, 2026, 12:00 PM Eastern
- How to submit
- Email to the Contracting Officer, Shavonda_Jamison@ibc.doi.gov, and the Contracting Specialist, Dorothy_Royster@ibc.doi.gov
- Page limits
- Technical methodology narrative: 5 pages total, organized by the 5 PWS sections
What to include when you submit
- Do not send proposals, quotes, proprietary pricing or line-item estimates: send high-level, non-price information only
- Section 1, Corporate Capability: show how you meet the draft PWS areas and your experience with large-volume medical claims reviews and expert witness support in the five areas (Audit Medicare Parts A/B/D and Medicaid, Audit Medicare Part C, Evaluations and Inspections, Office of Investigations, Office of Counsel to the Inspector General)
- Describe past nationwide or multi-jurisdictional medical claim reviews
- State your maximum monthly claim review capacity and how you scale between normal and surge workloads
- Name likely subcontractors and give an estimated percentage of work for the prime contractor versus subcontractors
- Section 2, Technical Approach: a high-level methodology of no more than 5 pages, a quality assurance framework, and a risk and mitigation summary
- Give a staffing structure or organizational chart with typical roles and credentials (such as medical doctor, registered nurse, certified professional coder), say whether staff are current employees or would be hired, and show availability of physician specialists
- Section 3, Past Performance: up to three similar Federal medical review contracts and up to three similar Federal medical expert consultant and witness support examples, each performed within the last five years
- Summarize outcomes of those contracts: timeliness, accuracy rates including how often findings were overturned on appeal, and audit findings
- Give a general view of your commercial pricing structure and main cost drivers
- Section 4, Industry Feedback: point out unclear, overly restrictive or infeasible items in the draft PWS and suggest improvements
- Mark proprietary information clearly
Not in the notice text
- Part of the draft PWS was not read: the middle of Draft_PWS_1.pdf (the end of Section 2 and the start of Section 3, Evaluations and Inspections) was left out, so some requirements and workloads there are missing.
- The RFI does not give a place of performance or say whether work must be done on site.
- The RFI gives no estimated value or total number of awards, and does not name a set-aside or say whether a solicitation will follow.
- The workloads for Medicare Part C, Evaluations and Inspections, and the Office of Investigations are not shown in the text read.
- The draft PWS describes different contract forms by section (labor-hour, fixed fee per hour, options), so the final contract type is not settled.
Eligibility and how to respond
- No set-aside. Any business can reply: this is market research, and no bid is being taken yet.
- To respond, send a short reply to the contracting contact near the top of this page. No price is needed.
Notice details
- Posted
- Oct 13, 2026
- Notice type
- Sources Sought
- Office
- Ibc Acq SVCS Directorate (00004), Herndon, VA
- Business type
- Consulting & professional services (FedReady's grouping, from NAICS 541611)
- Attachments
Past awards and competition
Who has won work like this before, the likely incumbent, and what similar contracts paid, from USAspending.gov.
Before you respond
Terms on this notice: Sources sought notice
Full notice text from SAM.gov
This Request for Information (RFI) is issued in accordance with FAR Part 10 to conduct market research. The Government's purpose is planning only; this notice does not constitute a Request for Proposal (RFP)/Request for Quotation (RFQ) nor a promise to issue one in the future. The Government will not pay any costs for responding, and any submissions become Government property and will not be returned. Not responding to this RFI does not preclude participation in any future procurement. The Government is not seeking proposals or quotes at this time. Scope of Interest / Functional Areas: The Government is assessing the market's capability to provide comprehensive support under the following disciplines: a. Audits for Medicare Parts A, B, D, and Medicaid medical record review and consultative services b. Audits for Medicare Part C medical record review and consultative services c. Evaluations and Inspections medical record review and consultative services d. Expert consultant and witness services in support of the Office of Investigations and/or Office of Counsel to the Inspector General A draft Performance Work Statement (PWS) is provided for industry feedback; requirements may change prior to any future solicitation. Requested Information (do not submit proposals or quotes): Please provide high level, non price specific information addressing the elements below. Do not include proprietary pricing, line item estimates, or any proposal/quote content. Section 1: Corporate Capability & Experience a. PWS Alignment: Demonstrate your organization's core capability to fulfill the functional areas outlined in the draft PWS. b. Medical Review Experience: Outline your firm's high-level experience in conducting large-volume medical claims reviews for audits and evaluations and inspections; and support services for medical expert consultants and witnesses specifically across the following five domains (as referenced in the attached PWS): 1. Audit Medicare Parts A/B/D and Medicaid 2. Audit Medicare Part C 3. Evaluations and Inspections 4. Office of Investigations 5. Office of Counsel to the Inspector General c. Geographic Reach: Describe your prior experience managing and executing nationwide or multi-jurisdictional medical claim reviews. d. Capacity & Scalability: State your organization's maximum monthly claim review capacity, including your approach to scaling operations between normal workloads and surge conditions. e Teaming & Subcontracting: Identify potential subcontracting partners or specialized vendors you would anticipate utilizing, including an estimated percentage breakdown of work performed by the prime contractor versus subcontractors. Section 2: High-Level Technical Approach & Operations a. High-Level Technical Methodology: Describe your conceptual approach to fulfilling the core tasks in PWS. Please limit this narrative to no more than 5 pages total, organized by the 5 PWS sections. Focus on your overarching claims review methodology, general sampling plan frameworks, documentation standards, and typical project timelines rather than a granular, step-by-step solution. b. Quality & Accuracy Frameworks: Outline your corporate quality assurance processes, internal review protocols, and standard strategies used to reduce error rates and ensure consistency across large volumes. b. Staffing & Key Qualifications: Provide a conceptual staffing structure or organizational chart. Identify the typical roles, credentials (e.g., MD, RN, CPC), and qualifications of the key personnel required to successfully support a PWS of this nature. Please identify whether these staff will need to be hired or if they are current employees/contractors. Also, indicate staffing availability for physicians with specialties (i.e. hospice, vascular surgeon, nephrologist, physical medicine and rehabilitation or physiatrists). c. Risk & Mitigation: Identify the primary technical or operational challenges anticipated with a medical review scope of this size and outline your high-level mitigation strategies. Section 3: Past Performance & Market Pricing a. Relevant Past Performance: Provide up to three examples of similar Federal medical review contracts performed within the last five years. Also, provide up to three examples of similar Federal support services for medical expert consultants and witnesses within the last five years. b. Performance Outcomes: Summarize the high-level outcomes of those past contracts, focusing on standard metrics such as timeliness, accuracy rates (including rate at which findings were overturned during the appeals process), and a history of successful audit findings. c. Cost Drivers & Efficiencies: Provide a general overview of your commercial pricing structure and the primary cost drivers (e.g., specific labor categories, specialized technology/AI tools, administrative overhead). Highlight any built-in efficiencies or innovative workflows in your approach that typically yield cost savings for the government. Section 4: Industry Feedback & PWS Refinement a. Clarity & Feasibility Review: Identify any requirements, metrics, or tasks within the draft PWS that appear ambiguous, overly restrictive, or technologically infeasible based on current commercial market capabilities. b. Recommendations for Improvement: Suggest specific enhancements, industry standard metrics, or structural changes to the PWS that would improve the clarity, feasibility, and competitiveness of the final solicitation. Submission Instructions: Email responses by November 13, 2026, 12:00 PM Eastern Time to the Points of Contact below. Mark proprietary information clearly; the Government may use non proprietary information to refine its acquisition approach. Points of Contact: a. Contracting Officer: Shavonda Jamison – Shavonda_Jamison@ibc.doi.gov b. Contracting Specialist: Dorothy Royster – Dorothy_Royster@ibc.doi.gov Attachments: a. Draft PWS (for market research and feedback only; subject to change). Disclaimer: This RFI is for market research; it does not commit the Government to any acquisition. The Government will not reimburse costs for responding. Not responding does not preclude participation in any future solicitation. No proposals or quotes will be accepted in response to this notice.