SOURCES SOUGHT
R -- Durable Medical Equipment (DME) Medicare Administrative Contractor (MAC)
- Notice Date
- 6/3/2009
- Notice Type
- Sources Sought
- NAICS
- 524114
— Direct Health and Medical Insurance Carriers
- Contracting Office
- Department of Health and Human Services, Centers for Medicare & Medicaid Services, Office of Acquisition and Grants Management, 7500 Security Blvd., C2-21-15, Baltimore, Maryland, 21244-1850
- ZIP Code
- 21244-1850
- Solicitation Number
- DME-MAC-SS-2009
- Point of Contact
- Lyandra Emmanuel, Phone: 4107865130, Linda L Hook, Phone: 410-786-8371
- E-Mail Address
-
lyandra.emmanuel2@cms.hhs.gov, LHook@cms.hhs.gov
(lyandra.emmanuel2@cms.hhs.gov, LHook@cms.hhs.gov)
- Small Business Set-Aside
- N/A
- Description
- DURABLE MEDICAL EQUIPMENT MEDICARE ADMINISTRATIVE CONTRACTOR: SOURCES SOUGHT NOTICE Introduction This SOURCES SOUGHT NOTICE is to determine the availability of potential small businesses (e.g., 8(a), service-disabled veteran owned small business, HUBZone small business, small disadvantaged business, veteran-owned small business, and women-owned small business) that can provide specific fee-for-service (FFS) health insurance benefit administration services, including Medicare claims processing and payment services, in support of the "traditional" Medicare program (also known as the Medicare fee-for service, or FSS program) in accordance with the Draft Statement of Work (SOW) entitled Durable Medical Equipment (DME) Medicare Administrative Contractor (MAC) SOW. The information from this market research will help the Centers for Medicare & Medicaid Services (CMS) plan their acquisition strategy. Please be sure to indicate if you have a GSA schedule contract, a contract on GSA 8(a) STARS, or a contract on GSA VETS GWAC. THIS IS STRICTLY MARKET RESEARCH. CMS WILL NOT ENTERTAIN QUESTIONS REGARDING THIS MARKET RESEARCH. Background As required by section 911 of the Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA), CMS must recompete its MAC contracts every five (5) years. The purpose of this contract is to obtain a DME MAC (hereinafter, referred to as "the Contractor") to provide specified health insurance benefit administration services, including Medicare claims processing and payment services, in support of the Medicare FFS program. The Contractor shall perform its responsibilities under the direction of CMS. The Contractor shall perform numerous functions on behalf of Medicare beneficiaries and shall establish relationships with suppliers of Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS), for a defined geographic area or "jurisdiction." The Contractor shall perform the requirements of this contract in accordance with applicable laws, regulations, Medicare manuals and CMS requirements to ensure the financial integrity of the Medicare FFS program. The Medicare FFS program's legal, policy and operating environment is complex, and the Contractor shall utilize or interact with certain CMS-required payment schedules, systems, equipment and/or operational capabilities in the performance of its functions. Further, the Contractor shall coordinate its activities not only with CMS, but also with a broad range of agencies (at the federal, state and local levels of government), other CMS partners and Contractors, and a diverse range of stakeholders within the health care system of the United States. In accordance with CMS' technical specifications, the Contractor shall receive and control Medicare claims from DMEPOS suppliers and beneficiaries within its jurisdiction, as well as perform edits on these claims to determine whether the claims are complete and should be paid. An edit is defined as "logic within the Standard Claims Processing System (or PSC/ZPIC Supplemental Edit Software) that selects certain claims, evaluates or compares information on the selected claims or other accessible source, and, depending on the evaluation, takes action on the claims, such as pay in full, pay in part, or suspend for manual review." In addition, the Contractor calculates Medicare payment amounts and remits these payments to the appropriate party. The Contractor also conducts a variety of different supplier services, such as answering written inquiries, and educating them on Medicare's rules and regulations and billing procedures. The Contractor also operates Medicare's suppliers toll-free lines across the country to answer a wide-range of supplier questions. Additionally, the Contractor conducts redeterminations on appeals of claims and responds to complex beneficiary inquiries referred from the Beneficiary Contact Centers. This Sources Sought notice is targeted for: Jurisdiction A: Connecticut, Delaware, District of Columbia, Maine, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont Jurisdiction B: Illinois, Indiana, Michigan, Minnesota, Ohio, Wisconsin, Kentucky Jurisdiction C: Alabama, Arkansas, Colorado, Florida, Georgia, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, Puerto Rico, South Carolina, Tennessee, Texas, Virgin Islands, Virginia, West Virginia Jurisdiction D: Alaska, Arizona, California, Guam, Hawaii, Idaho, Iowa, Kansas, Missouri, Montana, Nebraska, Nevada, North Dakota, Oregon, South Dakota, Utah, Washington, Wyoming, Mariana Islands, American Samoa Response Information In order to respond to this notice, potential small businesses must be able to indicate experience and/or the ability: 1. To perform all MAC functions specified in attached DME MAC SOW and outlined in both the CMS Internet-Only-Manuals (IOMs) at this web address: http://www.cms.hhs.gov/Manuals/IOM/list.asp and Paper-Based Manuals; and 2. To provide specified health insurance benefit administrative services, including Medicare claims processing and payment services, in support of the Medicare FFS program. Potential small businesses shall also include the business information outlined in the section below as part of their response. Business Information 1. DUNS: 2. Company Name 3. Company Address 4. Current GSA Schedules appropriate to this Sources Sought 5. Do you have a Government approved accounting system? If so, please identify the agency that approved the system. 6. Type of Company (i.e., small business, 8(a), woman owned, veteran owned, etc.) as validated via the Central Contractor Registration (CCR). All offerors must register on the CCR located at http://www.ccr.gov/index.asp. 7. Company Point of Contact, Phone, and Email address Teaming Arrangements All teaming arrangements should also include the above-cited information and certifications for each entity on the proposed team. Teaming arrangements are encouraged. Response Due Date Responses must be submitted not later than June 24, 2009. Capability statements will not be returned and will not be accepted after the due date. The maximum number of pages for submission is 3 pages. This Sources Sought Notice is for information and planning purposes only and is no to be construed as a commitment by the Government. This is not a solicitation announcement for proposals and no contract will be awarded from this Notice. No reimbursement will be made for any costs associated with providing information in response to this Notice. Respondents will not be notified of the results of this evaluation. Capability statements will not be returned and will not be accepted after the due date. Contact Information: Lyandra Emmanuel, email lyandra.emmanuel2@cms.hhs.gov, phone 410-786-5130 Linda Hook, email linda.hook@cms.hhs.gov, phone 410-786-8371
- Web Link
-
FBO.gov Permalink
(https://www.fbo.gov/spg/HHS/HCFA/AGG/DME-MAC-SS-2009/listing.html)
- Record
- SN01834602-W 20090605/090603235003-a925bec3ee1435ea0ead8aad89ebf3ae (fbodaily.com)
- Source
-
FedBizOpps Link to This Notice
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