The U.S. Government Accountability Office has denied Nuance Communications' protest of the Veterans Affairs Department's $19 million task order awarded to Cerner Corp. to develop clinical documentation improvement tools.
Nuance, which currently provides the VA with tools for health information coding under a contract that expires this year, in October filed a protest arguing that awarding the task order to Cerner denied Nuance the opportunity to submit proposals for the services, and should have been subject to a separate competition.
But the GAO determined the task order is within the scope of the VA's underlying contract with Cerner, a $10 billion deal to overhaul the agency's electronic health record system.
"Nuance's assertions that the requirements of (the task order) are beyond the scope of the underlying … contract are without merit," the GAO wrote in its decision.
Nuance did not respond to a request for comment at deadline.
In its protest, Nuance argued that since the VA's underlying contract with Cerner didn't reference coding or clinical documentation improvement, the task order—which requires Cerner to develop those tools in support of the VA's revenue cycle work—extends beyond the reach of the initial EHR contract.
The GAO said the scope of Cerner's work, as outlined in a performance work statement the VA posted to the federal business opportunities website in 2017, specifically included revenue cycle reporting. Coding and clinical documentation improvement both support accurate revenue cycle reporting, according to the GAO.
"Based on our review of the record, it is clear that the coding and CDI requirements of (the task order) are inherent to performance of the comprehensive EHR requirements, specifically including the requirement to provide support for the revenue cycle," the GAO wrote.
It added that the $19 million task order is less than 1% of the value of the $10 billion contract.
Nuance isn't the first company to raise concerns over the VA's work with Cerner.
In 2017, EHR vendor CliniComp sued the VA for allegedly improperly awarding a no-bid contract to the company for the agency's EHR overhaul, arguing that the VA failed to conduct a competitive bidding process. A federal appeals court ultimately tossed CliniComp's challenge, after ruling CliniComp had failed to show that it could have successfully competed for the contract.
The VA selected Cerner for its EHR in large part to support interoperability with the Defense Department, which awarded an EHR contract to Leidos, Cerner and Accenture in 2015.
The VA is slated to bring its first site live on the Cerner EHR in March.
Lawmakers have expressed skepticism over whether the VA will be ready by that time, citing issues like a reported lack of coordination between the VA and the DOD. A joint office to help the agencies make decisions on the EHR project, called the Federal EHR Modernization Program Management Office, won't have its organizational structure finalized until after the go-live starts.
