MODIFICATION
70 -- Sources Sought Notice per the attached RFI
- Notice Date
- 5/12/2009
- Notice Type
- Modification
- NAICS
- 511210
— Software Publishers
- Contracting Office
- Department of Veterans Affairs;Center for AcquisitionInnovation-Austin;1615 Woodward Street;Austin TX 78744
- ZIP Code
- 78772
- Solicitation Number
- V798A-09-RI-0100
- Response Due
- 5/22/2009
- Archive Date
- 6/15/2009
- Point of Contact
- Angela Deren512-326-6662Angela.Deren@va.gov
- Small Business Set-Aside
- N/A
- Description
- V798A-09-RI-0100 GENERAL INFORMATION The Department of Veterans Affairs is searching for a Medicare Pricingsolution that accurately prices services using Medicare paymentschedules, adheres to HIPAA rules, and has capacity to supportgovernment Enterprise that includes 150+ facilities. Solution must bedeployable at one location and accessible by all Enterprise facilitiesvia web front end. RESPONSE DUE BYDue to VA by 4pm CST, 05/22/2009. PURPOSE This Request for Information (RFI) is to seek products/systems that areavailable to apply the following Medicare Payment Schedules and Pricingsystems that are necessary to accurately edit, group and price claims,or re-price claims. In response confirm whether proposed solution canaccommodate each of these schedules. Systems and Schedules 1) Acute Care IPPS: http://www.cms.hhs.gov/acuteinpatientpps/2) Physician Fee Schedule:http://www.cms.hhs.gov/PhysicianFeeSched/3) Clinical Laboratory Diagnostic Schedule: http://www.cms.hhs.gov/ClinicalLabFeeSched/ 4) Ambulance Fee Schedule:http://www.cms.hhs.gov/ambulancefeeschedule/5) Ambulatory Surgical Center (ASC) Payments(a) http://www.cms.hhs.gov/HealthCareConInit/03_ASC.asp (b) http://www.cms.hhs.gov/ASCPayment/6) Hospital Outpatient PPS:http://www.cms.hhs.gov/hospitaloutpatientPPS/7) Inpatient Psychiatric Facility PPS:http://www.cms.hhs.gov/inpatientPsychFacilPPS/8) Inpatient Rehabilitation Facility PPS:http://www.cms.hhs.gov/InpatientRehabFacPPS/9) Long Term Care Hospital PPS(http://www.cms.hhs.gov/longtermcarehospitalpps/ )10) Durable Medical Equipment, Prosthetics/Orthotics, and SuppliesFee Schedule http://www.cms.hhs.gov/dmeposfeesched/11) Home Health PPS (http://www.cms.hhs.gov/HomeHealthPPS/ )12) End Stage Renal Disease (ESRD) (http://www.cms.hhs.gov/PCPricer/02e_ESRD_Pricer.asp )13) Dental (a) (http://www.cms.hhs.gov/MedicaidDentalCoverage/ and(b) http://www.cms.hhs.gov/SCHIPDentalCoverage/ )14) Hospice (http://www.cms.hhs.gov/Hospice/ )15) Skilled Nursing Facility PPS (http://www.cms.hhs.gov/SNFPPS/ ) A single solution is being sought to fill these Medicare paymentmethods. Proposal should reference vendor's products that arecurrently available instead of possible future products. The solution should provide/include: 16) Web-based interface. 17) Enterprise system that is centralized; can be hosted at onelocation and deployed on a common platform to provide a single point ofmaintenance for the common suite of integrated applications. 18) Centralized reporting for nationwide or specified sites, whilestill supporting the option for local reports accessible by 170facilities nationwide. 19) Compliance with VA security standards and HIPAA regulations.20) Timely update of the schedules and software according to thelatest regulations, rules, and guidelines.21) Easy integration with other applications (ex, the pricingresults may be used by other applications.)22) Ability to process request and return pricing results on-line23) Ability to process request and return results via batch process. 24) Ability to customize interface, output and other systemfeatures.25) Ability to archive the pricing results and the original inputdata (for both batch and one-line use) which may be used by otherapplications.26) Ability to price claims up to 10 years old using appropriateschedule for the year of the claim/care. (If this 10-year requirementis not possible, then state the length of time that can be priced.)27) Ability to maintain CMS reference files for processing claims upto 10 years old.28) Ability to print and save reports of pricing transactions.29) Web-enabled reporting with different levels of security; i.e.,one facility, group of facilities, or all.30) Tools to search and locate report information for specificveteran or vendor. 31) Ability to handle over 100,000 transactions per day via webplatform, or at one time for batch processing. The number oftransactions per day may increase dramatically in the near future. RESPONSES NEED TO INCLUDE 32) Company Information and experience33) Government customers utilizing the proposed product (all orpart)34) Confirm that product exists and is currently in production atcustomer location35) Size and statistical information about system performance andnumber of transactions processed by largest enterprise customer36) Background and description of the proposed technology37) Benefits, Risks, and Constraints38) Solutions for items under 'PURPOSE' section39) Scalability40) Platforms the package can reside on 41) Ability and availability to provide demo 42) Ability to provide technical support for installation,acceptance testing, and problems that may rise in productionenvironment ORGANIZATION & BACKGROUNDThe Department of Veterans Affairs (VA), Chief Benefits Office, FeeProgram (Purchased Care for Veterans) is a program that provides fornon-VA care for eligible veterans including those not able to access VAhealth care facilities based on geographic constraints or due to medicalemergencies, or it is economically advantageous to provide treatment inthe community. Effective July 19, 2001, the VA is authorized to utilize variousMedicare claims pricing schedules in the processing of payment orreimbursement for fee basis non-service connected emergency care (USCode: Title 38, 1725 - Reimbursement for emergency treatment) approvedunder the Veterans Millennium Health Care and Benefits Act of 1999(Section 111 of Public Law 106-117) (Mill Bill). This speciallegislation authorized the Secretary to determine the appropriatereimbursement for these services. To learn more about the Fee Program access http://www.nonvacare.va.gov/ CURRENT ENVIRONMENTAll claims pricing done by the VA systems described below may be sent tore-pricing agent to see if they can provide a better price for theservice. Inpatient Prospective Payment System (IPPS)The pricing transactions for IPPS are created by VistA (The VeteransHealth Information Systems and Technology Architecture) system usingeither data previously entered into VistA Fee (from Fee Basis Invoicefile) or data entered electronically by a user and are processed usingMedicare Code Editor (3M product), MS-DRG Grouper (CMS product - Centersfor Medicare and Medicaid Services), PPS Pricer (CMS product), and COBOLinterface programs (developed in-house) on z/OS Enterprise Server. ThePricer reports and Reject reports are transmitted to each station (over170 VA Medical Centers located nation-wide) three times a day. Thecurrent system can process transactions using proper schedules/versionsas old as fiscal year 1998. All pricing results are saved in FeeHistory file and available for audit purposes. Outpatient and Inpatient AncillaryThe VistA Fee Basis software has two built-in schedules for pricingoutpatient and inpatient ancillary claims. It contains the MedicarePhysician Fee schedule (RBRVS) and the VA Fee schedule (75thpercentile). If the service is provided under an existing vendorcontract, then the VA pays the contracted amount. If it is not providedunder a current contract and is subject to the Medicare Physician Feeschedule (RBRVS), then the amount from that schedule is paid. If it isnot subject to RBRVS, the VA Fee schedule is used assuming there was anamount calculated for the fiscal year for that service on that schedule.There are exceptions; i.e., Dental services are paid using a differentschedule and Mill Bill (emergency care) is paid at 70% of the applicableMedicare schedule. OthersDesktop applications - either CMS PC Pricers or Excel worksheets basedon Medicare Fee schedules that are downloadable from CMS are used atsome sites. POINT OF CONTACT All questions and/or documentation should be submitted electronically ina Word document format to Angela Deren at Angela.Deren@va.gov usingsubject line of "Response to RFI for Pricer" Questions subject lineshould be "Questions on RFI for Pricer" GENERAL INFORMATION & DISCLAIMER This RFI, as defined in FAR 15.201 (e), is conducted to determineavailable software/applications in the current market that meet servicesdescribed below. This information is being obtained for informationpurposes only and the Government will not reimburse for any costincurred as a result of this request. Vendors are requested to provide information with sufficientdocumentation to allow for the evaluation of the potential solution tomeet the Government's requirements. There is no solicitation documentavailable at this time and no guarantee that one will be forthcoming. FAR 52.215-3 Request for Information or Solicitation for PlanningPurposes (Oct 1997) (a) The Government does not intend to award a contract on the basisof this solicitation or to otherwise pay for the information solicitedexcept as an allowable cost under other contracts as provided insubsection 31.205-18, Bid and proposal costs, of the Federal AcquisitionRegulation. (b) Although "proposal" and "offer" are used in this Request forInformation, your response will be treated as information only. It shallnot be used as a proposal. (c) This solicitation is issued for the purpose of obtaininginformation on a possible permanent pricing system described above. NOTE: THIS NOTICE WAS NOT POSTED TO FEDBIZOPPS ON THE DATE INDICATED IN THE NOTICE ITSELF (12-MAY-2009); HOWEVER, IT DID APPEAR IN THE FEDBIZOPPS FTP FEED ON THIS DATE. PLEASE CONTACT 877-472-3779 or fbo.support@gsa.gov REGARDING THIS ISSUE.
- Web Link
-
Link To Document
(https://www.fbo.gov/notices/b6f820711991f3decd6a7f96b2b39a80)
- Record
- SN01815198-F 20090514/090512233049 (fbodaily.com)
- Source
-
FedBizOpps Link to This Notice
(may not be valid after Archive Date)
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