SOURCES SOUGHT
D -- Standard Front End
- Notice Date
- 6/22/2006
- 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
- 062006
- Response Due
- 7/17/2006
- Archive Date
- 8/1/2006
- Small Business Set-Aside
- Total Small Business
- Description
- This is a SOURCES SOUGHT SYNOPSIS. This is not a request for proposal, but instead is a market research tool to determine the availability and adequacy of potential sources. THERE IS NO SOLICITATION AVAILABLE AT THIS TIME. REQUESTS FOR A SOLICTATION WILL NOT RECEIVE A RESPONSE. 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 to support the CMS Standard Front End (SFE). The SFE is an Electronic Data Interchange (EDI) processing system which will be used by approximately 115 thousand EDI trading partners (direct submitting Medicare providers, vendors, and clearinghouses) for exchanging inbound and outbound electronic transactions. It is anticipated that approximately 3 billion transactions a year will be exchanged with the SFE. The SFE will receive, translate and validate inbound and outbound transactions. The SFE system will be operated by the CMS Enterprise Data Center (EDC) Contractor. The SFE CONTRACTOR will provide maintenance to the software and coordinate testing with the Single Testing Contractor (STC) which CMS uses to execute test case specifications for each software release of the shared systems and Common Working File (CWF). The SFE will be implemented as part of the Cycle 1 Medicare Administrative Contractor (MAC) implementation. The goal of the SFE is to provide for consistency within the Medicare environment under contracting reform beginning with Cycle 1. A future effort will determine how the front end will be integrated in the CMS end-state Architecture environment. Medicare currently serves over 40 million beneficiaries and processes more than 1 billion claims per year. The SFE CONTRACTOR must be capable of interfacing with the Medicare shared systems for Part A (Fiscal Intermediary Shared System (FISS), Part B (Multi Carrier System (MCS) and ViPS, the Medicare Administrative Contractors (MACs), as well as every Medicare EDI trading partner. The SFE CONTRACTOR will implement the system requirements for the SFE system based on the statement of work requirements. The SFE CONTRACTOR will use, modify or interface with existing systems to meet the functional requirements. Once tested, the SFE will operate within the EDC. It is expected that the SFE will be based on an existing contractor operation. Complete code testing will be performed by the SFE CONTRACTOR site until the software can be delivered to the Single Testing Contractor (STC) for final testing. The STC will conduct unit and integration testing on the system to evaluate the system?s compliance with its specified requirements. The SFE CONTRACTOR will develop unit test cases that have a case-to-requirements traceability matrix. Unit test data files will be developed at the SFE CONTRACTOR site for testing the processing of Medicare EDI transactions. The SFE CONTRACTOR will conduct validation testing on the complete, integrated system to evaluate the system?s compliance with its specified requirements. A critical part of the testing is to ensure all interfaces with the shared systems are in place and transactions are routed appropriately. The SFE CONTRACTOR will demonstrate proven capability to emulate existing Medicare FFS EDI processing and demonstrate capability to process and manage 13 million inbound and outbound transactions per day with an average of 1000 transactions completed (includes translation and validation) within 10 seconds. The SFE CONTRACTOR will provide maintenance support for the SFE software starting after implementation and continuing through the term of the SFE contract. The SFE CONTRACTOR will develop software enhancements based on change requests approved by CMS and the system will be managed through the SFE quarterly release schedule, in conjunction with the STC and overall FFS Change Control Board. Visit the following websites for information on Medicare EDI processing: http://www.cms.hhs.gov/ElectronicBillingEDITrans/ www.cms.hhs.gov/Manuals/ click on Internet Only Manuals ? Publication 100-04, Chapter 24 The contract will include the following scope of services: (1) provide, update and maintain the SFE software and appropriate Commercial Off the Shelf (COTS) products 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, and database maintenance; (2) provide comprehensive testing of all changes before releasing to the STC for final testing (includes unit, system, and integrated testing with other CMS systems); (3) provide quarterly standardized, fully tested computer software releases and up-to-date documentation, as well as special and emergency releases to EDC(s) that process transactions using the SFE solution and software; (4) provide computer software maintenance service activities to EDC(s) that process transactions using the SFE software, including 24/7 production support for customer service (including EDI help desk services, test-to-production assistance, and provide education and outreach for EDI); and (5) maintain adequate security in compliance with federal statutes and regulations as identified in the CMS Business Partners Systems Security Manual (BPSSM ? also known as Internet Only Manual (IOM) Publication 100-17. The BPSSM may be found on the Internet by going to www.cms.hhs.gov/Manuals/ and clicking on the link: Internet-Only Manuals (IOMs). The contract will include the following: 1.Trading Partner (TP) Management: a. TP authorization/authentication; b. Integrated solution with CMS Enterprise Architecture, including the CMS three-zone Internet Architecture; c. TP profile is trigger for statistical reporting. 2. Transaction Exchange Environment: a. Supports a single logical data communication portal for all inbound and outbound transactions; b. All methods of communication supported by the EDC: direct connect, transmission control protocol/Internet protocol, file transfer protocol, serial line Internet protocol, point to point protocol; c. Maintain adequate security as well as comply with federal statutes and regulations as identified in the CMS Business Partners Systems Security Manual; d. Auto-tools for audit-trail tracking/reporting of inbound/outbound transactions; e. Able to be routed to appropriate contractor/application for production processing (assumes that is the appropriate action for this Beneficiary/Provider); f. Ability to apply claim control numbers prior to sending to the shared system; g. Ability to account for each transaction delivered to a receiving application; h. Ability to account for each transaction received from a processing application; i. Translate/format and edit inbound transactions (837, NCPDP, 276) for input to shared systems; 1. Edits include: EDI syntax integrity (compliance with HIPAA X12N and NCPDP rules) HIPAA syntactical requirements (HIPAA implementation guide specific) Balancing (financial balancing) Situational (if A occurs then B must be populated) Code sets (external HIPAA code sets must be validated ? medical codes, claims status, etc.) Line of business (edits specific to medical specialty or billing code) Payer specific (edits specific to Medicare) j. Translate/format outbound transactions (835, 277, NCPDP response) from shared systems for submission to trading partners; k. Create error reports and acknowledgement transactions (TA1, 997, 999, 824, etc.) for submission to trading partners. 3. Front-end Processes: a. Recognize duplicate file transmissions; b. Single COTS validation translator; c. Subject each claim to Medicare ?pre-screen? edits; d. Date stamps all claims with correct receipt date. 4. Change Management: a. Interface with existing CMS Web-based change management system; b. Update and maintain Commercial off the Shelf (COTS) software (e.g., translator); c. Implement CMS mandated changes or corrections for program code as well as user-related changes and enhancements, data dictionary maintenance, software development, and database maintenance; d. Provide comprehensive testing of all changes before distributing to STC ; e. Provide quarterly standardized, fully tested computer software releases and up-to-date documentation, as well as special and emergency releases to data centers that process claims using the SFE solution and software; f. Provide computer software maintenance service activities to the Enterprise Data Centers (EDCs) that process claims using the SFE software including 24/7 production support for customer service. 5. Reports: The system will support a full range of routine and ad hoc reports. The system will interface with the Part A and Part B claims processing Shared Systems within the Enterprise Data Center to meet claims adjudication processing windows and support the conversion of FI/Carriers to Medicare Administrative Contractor (MAC). The SFE system will also support/provide the following: 1. COTS translator (SFE environment is not a single COTS product solution); 2. Direct data entry, batch, and real time processing; 3. Internet access and web-hosted applications using CMS three-zone Internet architecture; 4. Provider EDI outreach activities include mailings, seminars, teleconferences; 5. EDI enrollment to test takes 1 week or less; 6. A submitter can successfully test their transactions within 2 weeks; 7. EDI Help desk is run 24 hours a day, 7 days a week, includes a toll free telephone number, an online self- service help desk, and provides both technical and business support; 8. Case management includes complete logging, tracking and reporting of help desk calls; 9. Trading partner activities are tracked by the following metrics: number of interchange envelopes, functional groups, transaction sets, business transactions per transaction set, accepted and rejected transactions; 10. Software based data compression is supported; 11. System is available 24 hours a day, 7 days a week, 365 days a year; 12. Transactions will only be accepted electronically (tape, disk, CD, etc. will not be accepted); 13. Trading partners are authenticated using the ISA/GS/ST and business information contained in the transaction set; 14. Duplicate transmissions are detected by duplicate envelope control numbers in the following segments (Interchange Control Header (ISA), Functional Group Header (GS), Transaction Set Header (ST) and business content checking); 15. Transmission date/time stamps are assigned to every transaction set received; 16. Policy and procedures to monitor, detect and address unauthorized access; 17. Risk analysis is performed on all systems weekly; 18. Security changes are monitored through a change control process; 19. System automatically adjusts to increased workload (i.e., peak hours); 20. EDI processing reports are generated including audit reports, troubleshooting, activity reports (# and type of transaction, # failed, by trading partner), etc.; 21. Contingency plans are in place; 22. Data backup is automatically performed daily and is stored both on and off site and is retained 7 years and 1 month; 23. The quality of data back up is assessed weekly; 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) a current, validated CMMI-SW Level 2, or appropriate equivalent such as CMM-SW Level 2 or the ISO 9001:2000 family of standards; (2) current, similar experience maintaining a complex computer system for Medicare Part A and B electronic data interchange (receiving, translating, validating, formatting and sending), including the capability to process and manage 13 million inbound and outbound transactions per day with an average of 1000 transactions processed within 10 seconds; (3) experience with writing requirements, designing, coding, testing, implementing changes to a complex system; and (4) extensive knowledge of the Medicare Part A and Part B program and the complexities associated with its frequently changing nature, especially interfacing with the Medicare Part A and B shared systems; (5) relevant current expertise in a multi-tiered environment; and (6) relevant current experience performing EDI exchange (translation and validation), particularly inbound and outbound HIPAA transactions. Interested parties having the capabilities necessary to perform the stated requirements may submit capability statements via email to Christopher.Brennan@cms.hhs.gov. Capability statements must demonstrate experience and expertise in all of the minimum requirements outlined above and must detail potential teaming arrangements, including a description of the responsibilities of each teaming partner. Teaming and partnerships are greatly encouraged.. Capability statements must 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). The capability statementshall be limited to 35 pages. Capability statements must also include the GSA Schedule 70 contract number, if applicable, and specific GSA contract information. Responses must be submitted not later than July 17, 2006, 5 p.m. ET. Capability statements will not be accepted after the due date. All communications shall be by email. Contact Information Christopher Brennan Centers for Medicare and Medicaid Christopher.Brennan@cms.hhs.gov
- Place of Performance
- Address: n/a
- Record
- SN01075387-W 20060624/060622220557 (fbodaily.com)
- Source
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