Sources Sought Notice / Request for Information (RFI) Historical Medical Claims Data Analysis Services 1. Purpose This Sources Sought Notice/Request for Information (RFI) is issued solely for market research purposes in accordance with Revolutionary FAR Overhaul (RFO) Part 10 and RFO Subpart 8.4. This notice is not a solicitation and does not constitute a commitment by the Government to award a contract. The Government seeks information from contractors to determine the availability of qualified sources, evaluate the capabilities of small business concerns, identify commercially available solutions, obtain budgetary pricing information, and assist in determining the appropriate acquisition strategy, including whether a socioeconomic set-aside is appropriate. The Government will not reimburse respondents for any costs incurred in responding. 2. Background The Federal Bureau of Prisons (BOP) is conducting market research for professional analytical support services to evaluate approximately 2,000,000 historical medical claims. The effort is analytical in nature and will support evaluation of Medicare reimbursement methodologies and future acquisition planning. The contractor will not perform claims adjudication, claims processing, utilization management, provider network management, or payment administration. The analysis will be used to examine the data for fraud, waste, and abuse; as well as to identify trends within the claims data such as over-use or over-billing including duplicate charges. No current real-time data will be provided as this analysis is solely intended for historical evaluation. Additionally, no personally identifiable information (PII) will be provided in the dataset. 3. Draft Requirement The contractor shall furnish all personnel, management, commercial software, analytical tools, and other resources necessary to analyze approximately 2,000,000 historical medical claims. The analysis deliverables shall include: Duplicate claims Inappropriate procedure code based on included diagnostic code Outliers (overuse) of specific procedure codes by specific providers and/or sites Comparison of billed rates to Medicare rates, reported as a percentage of Medicare rates Ranking of providers by amount billed Ranking of patients by amount billed Ranking of sites (facilities) by amount billed Ranking of procedure codes by amount billed Ranking of providers by procedure code The data provided by the Government will include: Claim ID Patient gender BOP internal patient ID number Authorization number Payor/institution information (name, city, state) Diagnostic codes Service Dates Procedure (CPT) codes Procedure description Charge amount Billing provider information (NPI, ID number, name) Providing facility information (name, NPI) 4. Commercial Artificial Intelligence (AI) The Government is interested in commercially available AI-enabled capabilities that could improve the efficiency, quality, and timeliness of the required analyses. The Go…