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B-292679.2,B-292679.3 1 (2003-11-17)

handle is hein.gao/gaobaczba0001 and id is 1 raw text is: G A 0Comptroller General A Accountability * Integrity * Reliability of the United States United States Government Accountability Office DOCUMENT FOR PUBLIC RELEASE Washington, DC 20548 The decision issued on the date below was subject to a GAO Protective Order. This redacted version has been approved for public release. Decision Matter of: PGBA, LLC File: B-292679.2; B-292679.3 Date: November 17, 2003 Kathleen E. Karelis, Esq., W. Jay DeVecchio, Esq., Robert K. Huffman, Esq., Lisanne S. Cottington, Esq., Edward Jackson, Esq., Kimberly R. Heifetz, Esq., Jeffrey C. Walker, Esq., and Alexa Zevitas, Esq., Miller & Chevalier, for the protester. Steven S. Diamond, Esq., Walter F. Zenner, Esq., Marc A. Stanislawcyzk, Esq., W. Susanne Addy, Esq., and Joseph M. Catoe, Esq., Arnold & Porter, for Wisconsin Physicians Service Insurance Corporation, an intervenor. Ellen C. Bonner, Esq., and Michael E. Jonasson, Esq., Department of Defense, Tricare Management Agency, for the agency. Glenn G. Wolcott, Esq., and Michael R. Golden, Esq., Office of the General Counsel, GAO, participated in the preparation of the decision. DIGEST 1. Protest that awardee intends to improperly access proprietary Medicare information in performing claims processing function for Department of Defense (DOD) health care beneficiaries is denied where record shows that, rather than access Medicare databases, the awardee proposed to train its staff regarding Medicare requirements, coordinate communication with Medicare contractors and health care providers, and act as advocates for the DOD health care beneficiaries. 2. Where contract performance requires coordination of benefits available under both Medicare and DOD health care programs, and solicitation advised that proposals would be evaluated regarding the effectiveness of proposed approaches to timely and accurately resolve claims, offerors were reasonably on notice that the agency would consider the extent of an offeror's knowledge and experience regarding the Medicare program. 3. Agency reasonably concluded that protester's proposal to provide one-on-one assistance to a limited number of beneficiaries--selected on the basis of their status as VIP beneficiaries, by virtue of a high call frequency, or due to having submitted a high volume of claims--did not provide the depth of service reflected in awardee's proposed approach to employ higher staffing levels of trained personnel to function as advocates for DOD beneficiaries.

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