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Is incumbency a golden ticket to strong past performance? TRICARE’s $58 billion managed care support contracts

By Brian Waagner on November 27, 2016
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GAO has published its decision denying multiple protests of the Defense Health Agency’s decision to award the T-2017 managed care support contracts to Humana Government Business, Inc. and Health Net Federal Services, LLC. Humana won the TRICARE contract for the east region with a total evaluated price of $40.7 billion. Health Net won the west region contract with a total evaluated price of $17.7 billion.

One of the key issues addressed in GAO’s decision was the challenge to Humana’s past performance rating. Anthem subsidiary WellPoint Military Care Corporation argued that DHA placed so much weight on prior experience as a TRICARE prime contractor that incumbency amounted to an unstated evaluation criterion. In WellPoint’s view, incumbency was the “golden ticket to attaining the highest Substantial Confidence rating.”

GAO found no merit to WellPoint’s argument. There was nothing in the record to suggest that DHA treated incumbency as an unstated evaluation criterion. Indeed, DHA considered WellPoint’s own past performance superior to that of two other incumbent TRICARE contractors—Health Net and UnitedHealth Military & Veterans Services, LLC.

GAO also rejected the legal basis for WellPoint’s argument. While incumbency is not necessarily a golden ticket, GAO also found that it was reasonable to give credit to Humana for its prior experience managing a large TRICARE regional contract. In GAO’s view, “it is not unreasonable for an agency to place particular emphasis on a firm’s performance as an incumbent contractor, since such performance may be reasonably viewed as a more accurate indication of likely future performance . . . .”

Incumbency is not necessarily a golden ticket, but it certainly can’t hurt.

Further reading—

Military Times: GAO denies protests, clears way for new TRICARE contracts (Nov. 16, 2016)

Federal News Radio:  GAO greenlights $58 billion in DoD TRICARE awards, denying nine industry protests (Nov. 15, 2016)

OFCCP’s five-year moratorium on enforcement actions against TRICARE providers (Apr. 14, 2014)

TRICARE hospitals and pharmacies are not subcontractors (Jan. 9, 2012)

Photo of Brian Waagner Brian Waagner

Brian is the leader of the Government Contracts practice group at Husch Blackwell LLP. Brian represents contractors in federal, state, and local bid protests, contract administration and compliance matters, and in litigation involving complex claims and disputes.

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  • Posted in:
    Government Contracts
  • Blog:
    The Contractor's Perspective
  • Organization:
    Husch Blackwell LLP
  • Article: View Original Source

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