Private Marketscan Commercial Health Insurance Claims Database(Notice of Intent to Award Sole Source)

The Contractor will provide CMS with a license to access the Private Marketscan Commercial Health Insurance Claims Database, including data from 1998 through the most recent available year, delivered via a secure data sharing portal. Specifically, the contractor will provide:

1. Commercial claims data including total payments (claim payments and allowed charges) by provider and health care service, using standard classification codes such as ICD-9, CPT, DRG, and NDC.


2. Cost-sharing data including co-payments, co-insurance, and deductibles.


3. Utilization data including visits, stays, and prescriptions dispensed.


4. Demographic identifiers including age and gender.


5. Claim payer plan type information sourced from numerous private health insurance plans.


6. Technical support and documentation, including a data dictionary or glossary of terms/data variables, answers to database-related questions, and documentation detailing the methods used to construct the database.


7. Data quality notifications to the CMS Contracting Officer's Representative (COR) within 3 business days of identifying any data quality issues, including a remediation plan.


8. Section 508 compliance support, ensuring all data files and associated documentation meet ICT accessibility requirements.