PGBA, LLC, B-292679.2; B-292679.3, November 17, 2003

PGBA, LLC, B-292679.2; B-292679.3, November 17, 2003 TITLE: PGBA, LLC, B-292679.2; B-292679.3, November 17, 2003 BNUMBER: B-292679.2; B-292679.3 DATE: November 17, 2003 ********************************************************************** 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 too 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. 4. Agency reasonably evaluated awardee's proposal regarding transitioning requirements as superior to protester's proposal, notwithstanding protester's incumbent status, where requirements of contract being competed have significant differences from prior contract requirements and awardee's proposal contained a detailed discussion of those new requirements, discussed anticipated risks, problems and potential disruptions, and identified potential strategies and solutions. 5. Agency reasonably evaluated awardee's proposal as superior to protester's regarding data access where awardee proposed to provide access to all points designated in the solicitation, identified two additional points where data access would be provided, and proposed to host semi-annual, customer focused, "discovery meetings" with government representatives to identify and discuss data access issues. 6. In evaluating protester's past performance, agency reasonably relied on content of performance reports that had been previously disclosed to, and discussed with protester, and for which protester had previously provided written comments; agency was not required to present the previously discussed information with protester again during discussions. DECISION PGBA, LLC protests the Department of Defense (DOD), Tricare Management Agency's (TMA) award of a contract to Wisconsin Physicians Service Insurance Corporation (WPS) under request for proposals (RFP) No. MDA906-02-R-0007. This solicitation sought proposals to provide health care claims processing and related services for military members, and their dependents, who are eligible for both Medicare and Tricare benefits. PGBA protests that the agency erred in evaluating proposals under various technical subfactors, failed to properly evaluate the offerors' past performance, failed to conduct meaningful discussions, and failed to perform an appropriate price/technical tradeoff. We deny the protest. BACKGROUND DOD provides health care to active-duty and retired members of the seven uniformed services, and to their dependents, through an extensive network of military treatment facilities (MTFs), supplemented by a network of civilian health care providers operating under managed care support (MCS) contracts with DOD. In the early 1990s, DOD implemented the Tricare program, which provides three basic health care options: a managed care program, a preferred-provider option, and a fee-for-service option.