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 two separate or core tasks within the Center for Program Integrity (CPI) including 1) 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, and 2) Program Integrity Reviews for which the Contractor shall provide comprehensive medical review in support of CMS requests. 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

Aug 14, 2026

Contract type

Cost Plus Fixed Fee

Period of performance

May 10, 2027 – —

• PSCQ403