Supplemental Medical Review Contract (SMRC)

The CMS plans to procure a Supplemental Medical Review Contractor (SMRC) (the “Contractor”) to perform and/or provide support for a variety of nationwide, post payment medical review and related tasks aimed at lowering the improper payment rates and combatting fraud, waste, and abuse. The contract consists of one core task within the Center for Program Integrity (CPI) including the Provider Compliance Group (PCG) ‘Specialty Reviews’ in support of issues identified by Federal agencies, such as the Office of Inspector General (OIG), the Government Accountability Office (GAO), etc., as well as CMS’ internal data analysis programs. The medical review will be performed on Medicare Fee for Service claims for Medicare Part A, Part B, and durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) programs.

Estimated value

>= $100M

Est. solicitation date

Dec 15, 2026

Anticipated award

May 10, 2027

Contract type

Cost No Fee

Period of performance

May 9, 2027 – —

• PSCQ403