JA Limited Source Justification NCQA PMMAP

FEDERAL SUPPLY SCHEDULE LIMITED-SOURCES JUSTIFICATION

Acquisition Title: PERFORMANCE MEASUREMENT FOR THE MEDICARE ADVANTAGE PROGRAM

Agency: Centers for Medicare and Medicaid Services
Acquisition Year: FY 2026
Author: Daniel G. Lehman

1. Description of Action:

Nature
‫ ܈‬New Requirement
‫ ܆‬Follow-On Order
‫ ܆‬Modification of Existing Purchase Order / Contract Number Contract Type
‫ ܈‬Firm-Fixed Price
‫ ܆‬Time and Materials
‫ ܆‬Cost Plus Fixed Fee (CPFF)
‫ ܆‬Term
‫ ܆‬Completion
‫ ܆‬Cost Plus Award Fee (CPAF)
‫ ܆‬Other:
Total Projected Cost / Price: $9,777,718.00
Funding Source (s): 8393: Medicare Program Integrity_Direct:Disc Name of Proposed Contractor(s): National Committee for Quality Assurance (NCQA) Street Address: 1100 13th Street, NW, Third Floor
City, State, Zip: Washington, DC 20005

2. Description of Supplies or Services:

The estimated value of the proposed action, including all options, is $9,777,718.00 (base year + 4 option years), delineated as follows:
Contract Period
Base Period
Option Period 1
Option Period 2

Period of Performance
09/29/2026-09/28/2027
09/29/2027-09/28/2028
09/29/2028-09/28/2029

IGCE

$2,025,000.00
$2,025,000.00
$2,025,000.00

Option Period 3

09/29/2029-09/28/2030

$1,851,359.00

Option Period 4
Total

09/29/2030-09/28/2031

$1,851,359.00
$9,777,718.00

The purpose of this contract is to support CMS in the evaluation and approval of each VSHFLDOQHHGVSODQ¶V SNP’s model of care (MOC). Section 1859(f)(7) of the Act and 42 CFR §§422.4(a)(1)(iv), 422.101(f), and 422.152(g) require that each Medicare Advantage (MA) organization (MAO) offering a SNP must submit a MOC to be approved by NCQA. In addition, 42 CFR §422.101(f) requires that MAOs offering SNPs develop and implement a MOC that provides structure for care management processes and systems that enable the SNP to provide a high level of care coordination to address the specialized needs of the target population. NCQA shall also provide program management support (Task 1), including a kickoff meeting, work plan, monthly progress reports, annual reports, and an AI MOC Enhancement Plan. Under Task 2 of this contract, NCQA reviews, scores, and approves each SNP MOC using CMS-established standards for the approval process. Under Task 2, beginning in Option Year 1, NCQA shall implement a technology strategy leveraging Commercially Available Off-The-Shelf (COTS) AI large language models (LLMs) to streamline MOC review, identify missing information, and assess compliance with CMS regulations and scoring guidelines.