A “dental care administrator” is the VA’s third‑party contractor (a Dental Network Administrator/Third‑Party Administrator) that will build, maintain and operate VA’s national community dental network. Under the RFP the contractor must recruit and credential providers, manage provider enrollment and directories, handle referrals/scheduling and electronic claims/EDI, adjudicate and pay claims, verify veteran eligibility (integration with VA DAS), report on and meet network‑adequacy and performance metrics, run quality‑assurance and provider satisfaction programs, support pharmacy and ancillary services, and provide regular data/management reports and corrective actions per the Performance Work Statement/QASP.
VA dental eligibility is limited — not all enrolled Veterans qualify. Eligibility is determined under VA rules (and program statutes) by specific categories such as: Veterans with service‑connected dental conditions or a 100% service‑connected disability rating, Veterans whose dental conditions are a result of VA care, certain Veterans in vocational rehabilitation, former POWs, and other statutorily defined groups. The RFP and VA publications note ~26% of VA enrollees are eligible; exact eligibility for an individual is verified through VA enrollment/eligibility systems (DAS) and by the contractor when scheduling/authorizing care.
The solicitation requires the contractor to verify veterans’ VA dental eligibility and coordinate billing; VA will pay community providers for authorized care. The RFP/Explanation of Benefits template states the EOB is not a bill to Veterans and the program is designed to cover authorized dental services at VA’s expense; use of private dental insurance can be coordinated (coordination of benefits rules apply), but the RFP emphasizes contractor handling of claims/coordination of benefits rather than shifting costs to Veterans. The press release does not change statutory co‑payment or cost rules; out‑of‑pocket costs depend on a Veteran’s eligibility category and whether services are authorized.
The procurement timeline in the solicitation: RFP posted Dec 2025, pre‑proposal conference Jan 21, 2026, questions/amendments through Jan–Feb 2026, proposals due March 16, 2026; contract is a single‑award IDIQ with a base year plus option years (periods in amendments). Evaluation factors listed in the Combined Synopsis/Solicitation are Technical (including PWS approach), Veteran Involvement/Subcontracting Plan, Past Performance, and Price; award will follow FAR Part 12.6 procedures with formal evaluation and source selection as described in the solicitation and its amendments (see Solicitation/Amendments and Record of Questions for specifics).
Quality, credentialing and standardization are addressed in the PWS/Contractor Manual and QASP: the contractor must perform provider credentialing and re‑credentialing, maintain up‑to‑date provider data, meet network‑adequacy standards (drive‑time/appointment timeliness), comply with VA clinical and data rules, support quality monitoring (performance reports, audits, provider surveys), and follow VA’s Quality Assurance Surveillance Plan and PRS with measurable Acceptable Quality Levels and corrective action processes.
Veterans will be referred into the community dental network via VA referrals/authorizations; the contractor must schedule appointments and return standardized reason codes if a referral is returned. The solicitation requires provider directories, veteran choice of available providers where network adequacy allows, and formal scheduling processes (including appointment timeliness standards); specific assignment vs. choice depends on referral reason, availability standards, and scheduling rules in the PWS and scheduling companion guides.
Yes. The solicitation includes detailed network‑adequacy and access requirements and a Medical Network Waiver Request process for areas where standards cannot be met. Performance attachments set drive‑time and appointment timeliness standards by VAMC catchment and require the contractor to document recruitment and expansion efforts and submit Dental Network Build Reports showing provider recruitment in underserved areas.
VA’s RFP materials and accompanying attachments identify access, standardization and scalability gaps in current community dental delivery — e.g., variable network adequacy across catchment areas, inconsistent credentialing/claims processes, and appointment timeliness — and the solicitation’s PWS/QASP, network‑build reporting, and performance metrics are designed to address those gaps by standardizing processes, improving provider recruitment, and monitoring performance.