Veterans Affairs Canada (VAC) Contract Administration Unit (CAU) falls under the Service Delivery and Program Management (SDPM) division within the Service Delivery Branch. CAU provides general oversight and management of activities conducted across the organization to administer national service contracts which provide services to VAC recipients. One of these contracts is the Federal Health Claims Processing Services (FHCPS) contract which delivers service to Veterans, Canadian Armed Forces Members and Royal Canadian Mounted Police Members. Areas of focus include oversight and ongoing maintenance of the following:
- Standard Operating Procedures
- Data Retention and Storage of Records
- Annual Operations Plan and Annual Operations Report
- FHCPS Executive Dashboard Report
- Service Request Management
- Task Authorization Management
- Security & Privacy
- Service Management
VAC has outsourced health claims administration since 1989. Claims processing and services offered through the contract play an important role in the delivery of some of VAC’s largest programs, including the Veterans Independence Program (VIP), Treatment Benefits, and Long Term Care.
Aside from VAC and the third party health claims processor, there are other stakeholders to the contract, including two additional federal partner organizations (Canadian Armed Forces and Royal Canadian Mounted Police) and the Contracting Authority (Public Service and Procurement Canada (PSPC)). VAC CAU is responsible for management of the contract for all partner organizations.
In January 2014, PSPC awarded the current contract which ends on July 31, 2022. The contract contains provisions for two option periods, each two years in duration. If both option periods were to be exercised, the contract would end July 31, 2026. The approved value for the current contract is $159M (plus applicable taxes) with an additional [Redacted] Footnote §1 (plus applicable taxes) for the option periods. Approximately $980M worth of program benefits are paid via the FHCPS system each year.
An Audit of FHCPS Contract Management was identified as part of the Multi-Year Risk-Based Audit and Evaluation Plan Fiscal Years 2017-22.