The Department of Health and Human Services, Centers for Medicare and Medicaid Services has a requirement for Datalink services.

Medicare is a national health insurance program in the United States, begun in 1966 under Title XVIII of the Social Security Act. It primarily provides health insurance for Americans aged 65 and older, but has expanded over the years to include permanently disabled individuals under age 65, as well as individuals with end stage renal disease. The Centers for Medicare & Medicaid Services (CMS) is the agency within the Department of Health & Human Services (HHS) responsible for administering Medicare, Medicaid, the State Children’s Health Insurance Program (CHIP), and the private health insurance exchanges.

CMS is the largest purchaser of health care in the United States, with CMS programs accounting for a significant portion of the nation’s health expenditures. Section 1874(b) of the Social Security Act provides the Secretary the authority to enter into contracts for data and other information as may be necessary to operate its programs. As an effective steward of public funds, CMS is committed to strengthening and modernizing the nation’s health care system to provide access to high quality care and improved health at lower cost. In order to carry out this mission, CMS requires data analytics and active claims monitoring to evaluate beneficiary access, major health outcomes, program safeguards, and program costs over time.

The primary role is for the contractor to access, integrate, link, analyze, and interpret large and disparate data sources at the payment system, provider, and beneficiary levels to assist CMS with seasonal health care and payment policy rulemaking activities; monitor and assess the impact of policy and payment changes on access to care, beneficiary health outcomes, and Medicare payments; and conduct active surveillance of notable trends in Medicare payment systems. The contractor will also assist CMS in itsefforts to identify and assess exposure to fraud, waste, and abuse in the Medicare program; evaluate the impact of initiatives aimed at preventing or recovering improper payments; and conduct numerous and varied ad hoc data analyses.

Additionally, Datalink provides information for emergency responders related to Medicare beneficiaries during disasters; program integrity monitoring for waste, fraud, and abuse in the Medicare program; and support for analytic activities for Federal partners. This program requires Contractor coordination not only within CMS and its components, but also with a broad range of government agencies at the federal, state, and local levels, as well as a diverse range of stakeholders within the health care system of the United States.

The Contractor shall furnish all of the necessary services, qualified personnel, equipment and facilities, not otherwise explicitly provided by CMS, to accomplish the requirements of the contract.

• The purpose of the DataLink statement of work (SOW) is to detail the tasks and requirements to access, integrate, link, and analyze large and disparate data sources at the payment system, provider, and beneficiary levels to assist CMS with seasonal health care and payment policy rulemaking activities; monitor and assess the impact of policy and payment changes on access to care, beneficiary health outcomes, and Medicare payments; and conduct active surveillance of notable trends in Medicare payment systems. It will also assist CMS in its efforts to identify and assess exposure to fraud, waste, and abuse in the Medicare program; evaluate the impact of initiatives aimed at preventing or recovering improper payments; and conduct numerous and varied ad hoc data analyses. Recompete of GS-10F-0133S 75FCMC21F0067.