World Trade Center Health Program - Comprehensive Cost Avoidance, Coordination of Benefits, and Recovery Program
ID: SS-CDC-75D301-2026-01Type: Sources Sought
Overview

Buyer

HEALTH AND HUMAN SERVICES, DEPARTMENT OFCENTERS FOR DISEASE CONTROL AND PREVENTIONCDC OFFICE OF ACQUISITION SERVICESATLANTA, GA, 30333, USA

NAICS

All Other Insurance Related Activities (524298)

PSC

SOCIAL- GOVERNMENT INSURANCE PROGRAMS: OTHER (G008)

Original Source

https://sam.gov/workspace/contract/opp/10076ba1dac84678882dc4fb24fbdc6f/view
Timeline
    Description

    The Department of Health and Human Services, through the Centers for Disease Control and Prevention (CDC) Office of Acquisition Services, is seeking sources for a Comprehensive Cost Avoidance, Coordination of Benefits, and Recovery Program for the World Trade Center Health Program (WTCHP). The program aims to enhance operational efficiency and control healthcare costs by implementing a robust insurance identification system, validating coordination of benefits, and recovering incorrectly paid claims, all while ensuring quality assurance and payment integrity. This initiative is critical for providing medical monitoring and treatment for responders and survivors of the 9/11 terrorist attacks, as mandated by the James Zadroga 9/11 Health and Compensation Act of 2010. Interested parties must submit their capability statements by 10:00 a.m. Eastern Standard Time on December 22, 2025, to the primary contact, Serina Allingham, at xog9@cdc.gov.

    Point(s) of Contact
    Serina Allingham
    17704484602
    xog9@cdc.gov
    Lauren Peel
    (770) 488-2649
    ijt9@cdc.gov
    Files
    Title
    Posted
    CCA Draft PWS October 2025.doc
    This DRAFT Performance Work Statement outlines a Comprehensive Cost Avoidance, Coordination of Benefits, and Recovery Program for the World Trade Center (WTC) Health Program. The program, mandated by the James Zadroga 9/11 Health and Compensation Act of 2010, aims to improve efficiency and control healthcare costs by identifying primary health insurance, coordinating benefits, and recovering incorrectly paid claims. Key objectives include establishing a robust, near-real-time insurance identification system, validating Coordination of Benefits (COB), recouping funds from Other Health Insurance (OHI) and the NYS Workers' Compensation Board (WCB) Health Insurance Matching Program (HIMP), identifying deceased members, and providing quality assurance payment integrity services. The contract's period of performance is from July 29, 2026, to July 28, 2031, with a base year and four option years. The contractor must have at least three years of experience in financial services for a federal healthcare program and will work off-site. The PWS also details critical regulatory compliance requirements, including HIPAA, FISMA, and records management.
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