TRICARE Claims Review Services (TCRS)

The Defense Health Agency (DHA) awarded a Firm Fixed Price (FFP) contract bridge extension for TRICARE Claims Review Services to Concept Plus on February 24, 2025 under contract HT9402-17-D-0001. The extension was issued sole-source in accordance with Federal Acquisition Regulation (FAR) 6.302-1, only one responsible source and no other supplies or services will satisfy agency requirements. The period of performance will be from March 01, 2025 - February 28, 2026. A bridge extension was necessary to prevent a gap in support to mission critical DHA requirements until a follow-on contract is awarded and the awardee completes transition-in.

The Defense Health Agency (DHA) supports health services for more than 9.4 million beneficiaries of the Military Health System (MHS). The purpose of the TCRS contract is to assist the DHA Improper Payment Evaluation Branch (IPEB) in identifying and reporting improper payments and discrepancies in payment recording for the MHS. TCRS support provides an independent impartial review of claims processing procedures and reimbursement methodologies utilized by purchased-care contractors and assesses purchased-care contractor compliance with TRICARE policies and directives by evaluating the accuracy of claims payment and payment record coding for the MCSC, TMEP, TPharm, TOP, and ADDP contracts. TCRS helps support IBEP’s requirement to assess the potential risk of improper payments and to identify and report improper payments to the Office of Management and Budget (OMB) for publication in the Department of Defense (DoD) Agency Financial Report (AFR) pursuant to Public Laws 107-300, and the Payment Integrity Act of 2019 (PIIA), Public Laws 116-117.

The total estimated value of the twelve (12) month extension is $4,588,256. Mr. Todd Young is the Contracting Officer and the Defense Health Agency, Aurora, CO 80011, is the contracting activity (HT9402).Performance of this contract will be accomplished at the contractor’s facilities.