SOURCES SOUGHT
D -- MAINTENANCE OF MEDICARE COMMON WORKING FILE SYSTEM
- Notice Date
- 6/13/2006
- Notice Type
- Sources Sought
- NAICS
- 541511
— Custom Computer Programming Services
- Contracting Office
- Department of Health and Human Services, Centers for Medicare & Medicaid Services, formerly known as the Health Care Financing Administration, Office of Acquisition and Grants Management, 7500 Security Blvd. C2-21-15, Baltimore, MD, 21244-1850
- ZIP Code
- 21244-1850
- Solicitation Number
- Reference-Number-CMS-RFI-CWF
- Response Due
- 7/5/2006
- Archive Date
- 7/20/2006
- Description
- This is a SOURCES SOUGHT NOTICE to determine the availability of potential small businesses (e.g., 8(a), veteran-owned small business, service-disabled veteran owned small business, HUBZone small business, small disadvantaged business, and women-owned small business) that can provide computer software services over a five year period to support the Common Working File (CWF) system, to include maintenance, developmental enhancements, and special projects as required by the Centers for Medicare and Medicaid Services (CMS). The CWF system is a major component of the Medicare claims processing function within CMS to provide a single data source where Fiscal Intermediaries (FIs), carriers and Durable Medical Equipment Regional Carriers (DMERCs) verify beneficiary eligibility and receive prepayment review and approval of claims. Medicare currently serves over 40 million beneficiaries and processes more than 1 billion claims per year. The CWF is made up of over 1.5 million lines of program code based on traditional CICS online and COBOL and COBOL II, using a VSAM data structure. The CWF is controlled by the following components: Controller/router (prioritize actions and route claims), Accept/reject process, Administrative edits, Part A consistency edits, Part B consistency edits, Durable Medical Equipment Prosthetic, Orthotic, and Supplies (DMEPOS) consistency edits, Duplicate edits, A/B Crossover alerts, A/B Crossover edits, Entitlement edits, Part A utilization edits, Part B utilization edits, DMEPOS utilization edits, Medicare Secondary Payer (MSP) consistency edits, MSP utilization edits (secondary payer claims), Coordination of Benefits (COB), monitoring of Veterans Administration (VA) claims, Out-of-service area claims process, beneficiary updates, unsolicited responses and claim related functions. CWF also contains the following sub-systems: Part A Eligibility and query support, Part B Eligibility and query support, Health Insurance Master Record (HIMR), Reports, Purge, History Conversions, Internal Test Facility, and Cross Reference/Merge process. The CWF software is a Medicare Part A/Part B benefit coordination and pre-payment claims validation system. The CWF software uses localized databases maintained by designated contractors called Hosts. There are currently nine virtual and two physical CWF Hosts that maintain a distributed database of beneficiary master records. Each beneficiary master record resides at its assigned Host?s database only. FIs, carriers, and DMERCs are referred to as satellites and each one is associated with one or more CWF Hosts. Currently there are more than 100 satellites. The computer software services required by the contract include CWF maintenance of over 1.5 million lines of code, developmental enhancements to the CWF, and special projects as approved by CMS. The contract will include the following scope of services: (1) update and maintain the CWF software to include, but not limited to, CMS mandated changes or corrections for program code as well as user-related changes and enhancements, data dictionary maintenance (mainframe and web based), JCL and PROC development, and database maintenance; (2) provide comprehensive testing of all changes before distributing each software release (includes unit, system and regression testing, as well as supplying baseline test data with each release to be used at the Hosts and Single Testing Contractor [STC] to ensure the release has been installed properly); (3) provide quarterly standardized, fully tested computer software releases and up-to-date documentation (mainframe and web based), as well as special and emergency releases to the CWF Hosts; (4) provide computer software maintenance service activities to CWF Hosts including 24/7 production support for customer service to each of the CWF Hosts (9 Hosts run the CWF software for more than 100 satellites processing Part A and B claims); (5) provide computer software maintenance service activities to the STC; (6) maintain HETS (HIPAA Eligibility Transaction System), a system that is processing 270/271 eligibility transactions on a 3-tier architecture in a real-time environment, X12N transactions sent via the Medicare Data Communications Network (MDCN). The logical architecture is organized into three layers that consist of the User Interface Layer, Business Logic Layer and the Data Access Layer. The system consists of contractor developed J2EE software interfacing with Commercial off the Shelf (COTS) products. (7) maintain adequate security as well as comply with federal statutes and regulations as identified in the CMS Business Partners Systems Security Manual. This is a highly simplified illustration and does not address the more complicated aspects of the process, nor does this simplified illustration address the CWF updates to the CMS central office systems such as: the CWF Medicare Quality Assurance (MQA) system, the National Claims History (NCH) system, and the Enrollment Database (EDB) system, the Renal Beneficiary Utilization System (REBUS) the interface to the Beneficiary Operational Data Store (BODS) that supports the HIPAA 270/271 and internet DDE transactions, and Report on Medicare as Secondary Payer System (REMAS). The North American Industrial Classification System (NAICS) code is 541511. This is not an invitation for bid, request for proposal or other solicitation and in no way obligates the Government to award a contract. The minimum contractor requirements are: (1) written proof of a CMMI Level II Certification that can reasonably be applied to the organizational and/or functional group being proposed; said certification must be no more than three years old at the time of contract award, and must have been performed by and signed by a suitable independent entity having no corporate affiliation with the business or with any parent, division, subsidiary, joint venture, partner, affiliate, or other corporate entity connected to or with the business or which holds a financial interest in the business or in which the business holds a financial interest; the appraisal must have been conducted or led by an SEI-licensed and -authorized Standard CMMI Appraisal Method for Process Improvement (SCAMPI) Lead Appraiser. Within 18 months of the contract award, the specific organizational and/or functional unit performing the work under the contract must be re-certified by a suitable independent entity which meets these same requirements and has been approved in advance in writing by CMS. In all cases, the business must provide the name, address, telephone number, employer, and training of the individual(s) who performed and signed the certification; the decision by CMS as to the suitability of the certifying entity and/or applicability of the certification shall be final. (2) similar experience with maintaining a complex computer system with at least one million lines of code; parties should describe their experience and indicate the number of lines of code maintained. (3) similar experience with writing requirements, designing, coding, testing, and implementing changes to a system amounting to approximately 40,000 direct hours annually. Parties should describe their experience or demonstrate their ability to provide the hours, the nature of the system, and the changes performed. (4) extensive knowledge of the Medicare program (i.e., Parts A and B claims processing, CWF, shared system maintainers, etc.) and the complexities associated with its frequently changing nature (i.e., the CMS change management process). In addition, knowledge of the Medicare systems that interfaces with CWF (i.e., Medicare Quality Assurance (MQA), the National Claims History (NCH) system, and the systems identified above. (5) experience with the following: a. Edifecs XEngine 5.5 b. IBM HTTP Listener c. Java 1.1.1_15 SDK d. Java Message Service (JMS) e. Oracle 10G f. SeeBeyond v5.0.5 ICAN Release eWay g. Solaris 9 h. Websphere Application Server (WAS) i. Websphere Business Integration Message Broker j. Websphere MQ Server 5.3. Interested parties having the capabilities necessary to perform the stated requirements may submit capability statements via email to Christopher.Brennan@cms.hhs.gov. Teaming is strongly encouraged. CAPABILITY STATEMENTS MUST DEMONSTRATE THE MINIMUM REQUIREMENTS OUTLINED ABOVE. Capability statements shall also include the following information: company name, address, point of contact, phone/fax/email, and business size and status,(e.g., small business, 8(a), veteran-owned small business, service-disabled veteran owned small business, HUBZone small business, small disadvantaged business, and women owned small business) including any letters, certificates, or similar documentation indicating such status; corporate structure (corporation, LLC, sole proprietorship, partnership, limited liability partnership, professional corporation, etc.); and tax identification number. Capability Statements shall be limited to 25 pages and shall include any/all teaming arrangements. All teaming arrangements shall also include the above-cited information and certifications for each entity on the proposed team. Responses must be submitted not later than July 5, 2006. Capability statements will not be accepted after the due date.
- Record
- SN01068384-W 20060615/060613220319 (fbodaily.com)
- Source
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