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FBO DAILY - FEDBIZOPPS ISSUE OF NOVEMBER 24, 2013 FBO #4383
DOCUMENT

R -- Sources Sought Notice - FBO *****(REVISION I)***** - Attachment

Notice Date

11/22/2013
 

Notice Type

Attachment
 

NAICS

541611 — Administrative Management and General Management Consulting Services
 

Contracting Office

Department of Veterans Affairs;Program Contracting Office East (PCOE);201 Hay Street, Suite 305;Fayetteville NC 28301
 

ZIP Code

28301
 

Solicitation Number

VA73014I0011
 

Response Due

11/29/2013
 

Archive Date

12/29/2013
 

Point of Contact

Greg Florey
 

Small Business Set-Aside

N/A
 

Description

SOURCES SOUGHT Agency: Department of Veterans Affairs Office: Consolidated Patient Account Center (CPAC) Program Management Office (PMO) Notice Type:Posted Date: Sources SoughtNovember 22, 2013 Response Date: November 29, 2013 Classification Code: R- Support - Professional: Other PSC Code: R499 - Other Professional Services Management, Organizational and Business Improvement Services NAICS Code: NAICS Code: 541611 Administrative Management and General Management Consulting Services Synopsis: THIS IS NOT A SOLICITATION. This is a Request for Information (RFI)/Sources Sought notice issued in accordance with FAR 15.201(e) to conduct market research. This RFI is issued solely for information and planning purposes - it does not constitute a Request for Quote (RFQ) - or a promise to issue a RFQ in the future. This RFI does not commit the Government to contract for any supplies or services whatsoever. The Department of Veterans Affairs (VA) is not, at this time, seeking proposals and will not accept unsolicited proposals or costs incurred in response to this RFI; all costs associated with responding to this RFI will be solely at the interested party's expense. Not responding to this RFI does not preclude participation in any future RFQ, if any is issued. Any information submitted by respondents to this RFI is strictly voluntary. All submissions become Government property and will NOT be returned. This announcement is based upon the best information available and is subject to future modification. Contracting Office Address Department of Veterans Affairs (VA), Consolidated Patient Account Center (CPAC) Contracting Office 201 Hay Street, Suite 305 Fayetteville, NC 28301 Point of Contact: Greg Florey 301-693-5894 Greg.Florey@va.gov Overview: The Department of Veterans affairs is also considering whether or not to set aside an acquisition for Historically Underutilized Small Business Zone (HUBZone) concerns, Service-Disabled Veteran-Owned Small Business concerns (SDVOSB), 8(a) certified Small Business concerns, Woman-Owned Small Business concerns or Small Business concerns, or solicit Unrestricted. The applicable North American Industry Classification System (NAICS) code is 541611, with a small business size standard $14.0 Million. Interested Small Business concerns and small businesses with a socioeconomic status shown above may respond if your company can perform this requirement in accordance with FAR Part 52.219-14 Limitations on Subcontracting (Nov 2011). As prescribed in 19.508(e) or 19.811-3(e), insert the following clause: Limitations on Subcontracting (Nov 2011) (a) This clause does not apply to the unrestricted portion of a partial set-aside. (b) Applicability. This clause applies only to- (1) Contracts that have been set aside or reserved for small business concerns or 8(a) concerns; (2) Part or parts of a multiple-award contract that have been set aside for small business concerns or 8(a) concerns; and (3) Orders set aside for small business or 8(a) concerns under multiple-award contracts as described in 8.405-5 and 16.505(b)(2)(i)(F). (c) By submission of an offer and execution of a contract, the Offeror/Contractor agrees that in performance of the contract in the case of a contract for- (1) Services (except construction). At least 50 percent of the cost of contract performance incurred for personnel shall be expended for employees of the concern. (2) Supplies (other than procurement from a nonmanufacturer of such supplies). The concern shall perform work for at least 50 percent of the cost of manufacturing the supplies, not including the cost of materials. (3) General construction. The concern will perform at least 15 percent of the cost of the contract, not including the cost of materials, with its own employees. (4) Construction by special trade contractors. The concern will perform at least 25 percent of the cost of the contract, not including the cost of materials, with its own employees. (End of clause) Please review the attached draft Performance Work Statement (PWS) detailing the scope and specific tasks for the CPAC PMO, PRO Pharmacy Agreement Management Support and Pharmacy Data Analytics requirement. This overview/summary does not include all requirements to complete the Performance Work Statement (PWS). Specific Response Instructions: Please submit your RFI response in accordance with the following: 1) No more than 15 pages (excluding transmittal page). Include the name, email address and phone number of the appropriate representative of your company; 2) Submit your response via email to Greg Florey at Greg.Florey@va.gov. 3) Submit your response by 2:00 P.M. (EST) on November 29, 2013; 4) Mark your response as "Proprietary Information" if the information is considered business sensitive. 5) NO MARKETING MATERIALS ARE ALLOWED AS PART OF THIS RFI. The government will not review any other information or attachments included, that are in excess of the 15 page limit. Information Requested from Industry: In response to the RFI, interested parties shall submit the following information: 1.Company Information / Socio-Economic Status 1.Provide the company size and POC information. VA has identified the appropriate North American Industry Classification System (NAICS) Code 541611 Administrative Management and General Management Consulting Services which has a size standard of $14.0 Million for this RFI. Please identify and explain any other NAICS codes your company believes would better represent the predominated work included in the attached PWS. 2.Indicate whether your company, subcontractors, teaming partners, joint ventures have a Federal Socio-Economic Status, e.g., Small Business, Service-Disabled Veteran Owned Small Business, Veteran Owned Small business, Women-Owned Small Business, Disadvantaged Small business, and Hub Zone. If Service Disabled or Veteran Owned Small business, is your company and or partners registered in VA's VetBiz repository? 2.Background/Past Experience - Provide the following information on a maximum of three similar projects dealing with Pharmacy Agreement Management Support and Pharmacy Data Analytic services. All projects referenced must have been completed within the last three years for which the responder was a prime or subcontractor. 1.The name, address, and value of each project. 2.The Prime Contract Type, Firm Fixed-Price, Cost Reimbursement or Time and Material 3.The name, telephone and address of the owner of each project 4.A description of each project, including difficulties and successes 5.Your company's role and services provided for each project. 3.Capabilities/Qualifications - Overview of proposed solution(s). Include a description of the capabilities/qualification/skills your company possesses for each of the below statements: 1.Assessment of capabilities to perform requirements noted in the RFI. 2.Assessment of the types of changes required to accomplish the goals. 3.Approach to be utilized to develop necessary changes to the systems to meet the organizational goals 4.Draft schedule to complete necessary changes. 4.Teaming Arrangements - Description of Teaming Partners, Joint Ventures that your company would consider to perform work. 5.Price Information - Provide your commercial price history and rough order of magnitude for the same or similar products/solutions. 6.Other Market Information - Provide any other relative information, this information must be included within the 15 page limitation. 7.Other Federal Experience - Identify the federal contract vehicles DRAFT PERFORMACE WORK STATEMENT: A.GENERAL INFORMATION Title of Project: CPAC PMO, PRO Pharmacy Agreement Management Support and Pharmacy Data Analytics 1)Purpose The Department of Veterans Affairs (VA), Veterans Health Administration (VHA), Chief Business Office (CBO),Consolidated Patient Accounts Centers (CPAC), Payer Relations Office (PRO) is seeking professional services to assist with its efforts to increase Pharmacy Benefit Management company (PBM) and other pharmacy third-party payer compliance with federal statutory and regulatory payment requirements and to assist with the continued development of VA pharmacy network agreements with PBMs and other third-party pharmacy payers (TPPs). 2)Background The Veterans Health Administration (VHA) Consolidated Patient Accounts Centers (CPAC) has developed a plan to address opportunities for improving revenue cycle business functions, identify new strategies to increase revenue and assist the field facilities in maximizing their revenue stream. PRO has assumed management and development responsibility of outpatient pharmacy agreements with pharmacy benefit managers (PBMs) and other types of third party payers and requires assistance in determining if agreements and rate proposals from PBMs and other third party payers for outpatient pharmacy services meet federal payment requirements. 38 USC 1729 authorizes the Department of Veterans Affairs (VA) to recover and collect reasonable charges from third parties (for example, PBMs and TPPs) for the cost of non-service-connected medical care furnished to insured Veterans. The money collected from PBMs and TPPs help offset the cost of delivering world-class health care services to our nation's Veterans, and is revenue anticipated in the President's budget. Under regulations published at 38CFR Section 17.101, reasonable charges consist of: "VA's billed charges (that is, the total charges VA submits for the service, less any Plan copayment for which the member is responsible), or "Amount the payer demonstrates it reimburses other providers in the same geographic area for the same services. If a third party declines to reimburse VA its billed charges and elects to pay VA as it would pay other providers in the same geographic area, VA has the authority to require the third party submit evidence, including claims data and agreements between the third party and non-government providers, to substantiate that the amount the third party is paying VA is the same as what it is paying non-government providers in the same geographic area. (38 CFR 17.101(a)(4)) The billing methodology VA uses to arrive at its billed charges for pharmacy claims are: "For claims with Dates of Service on and after March 18, 2011, VA billed charges per prescription equals the total amount of the acquisition cost to VA of the drugs, plus a standard administrative charge that is computed annually. The administrative charge is computed based on national VA costs for providing outpatient prescriptions (both overhead costs and dispensing costs). The 2013 administrative charge is $13.18. "For claims with Dates of Service prior to March 18, 2011, VA billed charges per prescription are the standard amount of $51.00. Following are several statutory and regulatory references related to payment third-party payer requirements for VA: "38 USC1729 (a)(1) "Recovery by the United States of the cost of certain care and services" "38 CFR Part 17 "Charges Billed to Third Parties for Prescription Drugs Furnished by VA to a Veteran for a Nonservice-Connected Disability" and Section 17.101 "Collection or recovery by VA for medical care or services provided or furnished to a veteran for a non-service-connected disability," effective date March 18, 2011 (Federal Register October 6, 2010) "38CFR Part 17 "Reimbursement Offsets for Medical Care or Services" and Section 17.106 "VA Collection Rule; Third-Party Payers," effective date July 25, 2011. (Federal Register June 24, 2011) 3)Performance Objectives The Contractor shall provide support as stated to accomplish the deliverables described in this Performance Work Statement (PWS), which will enable VA to increase Pharmacy Benefit Management company (PBM) and other pharmacy third-party payer (TPP) compliance with federal statutory and regulatory payment requirements and to assist with the continued development of VA pharmacy network agreements with PBMs and other third-party pharmacy payers. Within this effort, CPAC will use contractor services to increase PBM and other third-party payer compliance with federal third-party payment requirements and identify whether individual PBMs and other third-party payer reimbursements meet federal payment requirements. Contractor shall analyze and report on (1) the language (terms, conditions) and reimbursement methodology in existing, new, and in-progress VA pharmacy network agreements with PBMs and other third-party payers, (2) VA reimbursement claims data specific to individual PBMs and other third-party payers, (3) VA third-party pharmacy billing and drug pricing data as it compares to commercial industry reimbursement trends, (4) VA pharmacy revenue-related business processes and operational issues that impact VA relationships with PBMs and other third party pharmacy payers. Contractor shall also (1) perform reimbursement verifications for specific PBMs and third-party payers to determine whether their reimbursements to VA meet federal payment requirements, (2) provide pricing and rate modeling scenarios to assist VA in network agreement negotiations, (3) project revenue impact to VA resulting from specific PBM and third-party payer proposed or implemented changes, and (4) provide additional data analyses related to special projects within the CPAC PMO PRO business objective. 4)Scope of Work The Contractor shall provide support as requested to accomplish the deliverables described in the Performance Work Statement (PWS), except as may otherwise be specified. Deliverables will include ad-hoc, short-term analyses as well as overarching, long-term analyses and reports/presentations. They will require a wide range of data analytics spanning simple (single-source data) to complex (multiple-source data). Deliverables will require collection and analysis of information from multiple VA stakeholders and VA cross-functional teams, as well as from external parties including PBMs and TPPs. The contractor shall analyze in the context of the pharmacy industry's past, current, and future states (1) VA third-party pharmacy billing and drug pricing data, (2) VA revenue-related pharmacy operational issues, (3) VA business processes related to its relationships with pharmacy third-party payers, and (4) VA contracts/agreements with pharmacy third-party payers. The contractor shall extract claims data from VA databases and store the claims extract in a secured server. The Contractor shall provide the queries that produced the outputs for the VA in the event a request/dispute/ challenge are received after the contract period that will allow the VA to replicate the studies or analysis. The Contractor shall provide general consultative services to the VA to position and leverage VA's uniqueness, quality metrics, and technology. 5)Mandatory Tasks and Deliverables The Contractor shall provide the specific deliverables described below within the contract performance period. If for any reason, any deliverable cannot be delivered on time according to the schedule below, the contractor shall provide a written explanation three days prior to the due date to the Contracting Officer Representative (COR). This written transmittal shall include a firm commitment of when the work shall be completed. This transmittal to the COR shall cite reasons for the delay, and the impact on the overall project. The COR will review collaboratively with the program office and facts and issue a response in accordance with the contract terms and conditions. Unless otherwise specified an electronic copy shall be placed in the designated CPAC SharePoint site or other CPAC-designated site. Specifically, the contractor shall: 5.1 Task One. The Contractor shall provide and maintain a detailed, product based, resource loaded, project management plan/schedule (PMP) compliant with PMBOK guidance in MS Project format. The Contractor shall ensure that the Work Breakdown Structure (WBS) elements incorporate a sufficient level of detail to adequately delineate a comprehensive overview of the level of effort of the work tasks. The PMP will also incorporate a Risk Management Plan/Risk Register together with a Quality Control Plan (QCP) incorporating QCP elements which are quantifiable and measureable. Subsequent to acceptance of the PMP the VHA/CBO/CPAC/PRO will develop a Quality Assurance Surveillance Plan (QASP) which will identify performance metrics for selected QCP elements. Additional PMP requirements: "WBS elements used in the Project Schedule should indicate s developmental work, tasks, start/finish dates, allocated resources and, at a minimum, include the following: omeetings oteleconferences otravel/site visits oProject documentation submissions/revisions odevelopmental efforts structure to reflect development of a deliverable product oproject milestones odeliverables "Upon acceptance of the PMP by the COR, the following will be considered "Baselined": oProject Schedule, oWBS, oTasks, oStart/Finish Dates, Allocated Resources (Equipment or Personnel) "In the event that the project schedule will clearly indicate the critical path; the Project Schedule should clearly indicate corresponding resources (personnel/equipment) for each WBS task. Deliverable 5.1.1 The Contractor shall provide an initial PMP within 10 business days of contract award. The Contractor shall be responsible for maintaining and revising the PMP and providing version controlled revisions. In event of any change or impact to the PMP which would affect the baseline elements, the Contractor shall notify the COR in writing within 7 days subsequent to the identification of the event/issue. Deliverable 5.1.2 The Contractor shall establish a bilaterally acceptable date (but within 21 calendar days of contract award) for a meeting to review the QCP and the QASP to define what methodologies and metrics will be used to track contract performance. This meeting may be held remotely (e.g., Live Meeting, teleconference etc.). Deliverable 5.1.3 The Contractor shall provide a briefing in (MS PowerPoint format) to the VHA/CBO/CPAC/PRO team within 10 business days of contract award. This briefing is expected to, at a minimum, discuss Contractor roles, initial report on the methodologies to be implemented by the Contractor in the execution of the assigned Tasks/Deliverables (including a high-level description of the methodology the contractor shall use to ensure VA business requirements are fully understood and that deliverables meet VA current business needs), report the progress of key metrics including but not limited to EDI compliance and identification of any potential barriers. This meeting may be held remotely (e.g., Live Meeting, teleconference etc.). Deliverable 5.1.4 The contractor shall define and implement a methodology, processes and procedures for ensuring that VA detailed business needs and requirements are fully understood and addressed during development of the deliverables and that final deliverables meet current VA business needs. 5.2 Task Two. The Contractor shall prepare and attend informal bi-weekly teleconferences (or on site meetings) to review and discuss current status of activities. Contractor shall incorporate monthly updates to the project plan and present them during the monthly briefing described below to provide VA a high-level view of project progress. Deliverable 5.2.1 The Contractor shall attend informal teleconferences (or on-site meetings) on a bi-weekly basis and provide a written up-to-date report detailing activities, accomplishments, issues, and actions necessary to complete assigned tasks. The Contractor shall update the PMP to reflect recent efforts. The Contractor shall ensure that personnel involved with assigned projects will actively participate in these meetings and be prepared to address any issues related to assigned tasks. Deliverable 5.2.2 By the 15th calendar day of each month or an alternative date mutually agreeable to the COR and Contractor, the Contractor shall provide to the COR an updated master project plan and briefing in Microsoft PowerPoint summarizing activities and accomplishments of the prior month along with identifying actions necessary to complete assigned projects. The Contractor shall update the PMP to reflect recent efforts. The Contractor shall provide the updated project plan and briefing via teleconference or on-site meeting and ensure that personnel involved with assigned projects will actively participate in these meetings and be prepared to address any issues related to assigned projects. 5.3 Task 3: The contractor shall analyze and report on network amendments proposed by specific PBMs and other third-party payers, as selected by VA. VA intent is to use the analysis and recommendations to decide whether to accept, reject or renegotiate a PBM's proposed changes. PBM proposed network revisions are generally communicated to VA as network amendments beginning in September and require extremely quick turnaround. The contractor shall extract data from the VA Business Development Data Warehouse and other VA data sources as appropriate. The contractor shall store claims information on a secured contractor server in compliance with VA information security provisions. Deliverable 5.3.1: For up to 12 PBMs identified by VA, the contractor shall conduct a preliminary analysis of VA data to determine volume of claims VA submits to the PBM and total charges VA bills to the PBM. Contractor shall present pros and cons of selecting the PBM for detailed analysis. Analyses must be completed over a 12-month period, with at least 2-4 PBMs quarterly. Each analysis must be completed within a 2-week period. Contractor estimated price shall consist of 12 PBMs over a 12-month period. Deliverable 5.3.2: For up to 6 PBMs selected by VA for further analysis, contractor shall provide within 4 weeks of VA selection and request, detailed analysis of the PBM's proposed updates to the network agreements. Analysis will include, but will not be limited to, financial analysis of the proposed reimbursement provisions at a detailed level and projecting impacts on VA revenue for the upcoming year. Contractor estimated price shall consist of 6 PBMs over a 12-month period. For each PBM, Contractor shall among other things generate series of scenarios that identify best-case, average-, and worst-case impacts to VA revenue resulting from proposed and/or existing rates for individual PBMs. Scenarios and analysis must be performed for each network covered by the PBM and must be based on: "Contractor knowledge of past, current, and future states of industry pricing and reimbursement factors such as WAC, AWP, etc. "Contractor knowledge of pharmacy reimbursement states - past, current, and future -- by Trade Drug names and/or NDCs "Contractor data extraction and analysis of VA data, if VA makes available (all data extraction to be performed by contractor) "Maximum Allowable Charge (MAC) pricing lists if VA makes available "VA Trade Drug usage, submitted charges, and other aspects, based on raw data (which will require contractor extraction and analysis of VA data) or estimates made available by VA 5.4 Task 4: The contractor shall analyze and report findings on up to 3 years of VA data to identify specific PBM's reimbursement methodology, patterns, trends, and amounts paid to VA and compare them to commercial industry methodology, patterns, trends, and payment amounts. The contractor shall conduct analysis and create reports for up to 6 PBMs over a 12-month period, with up to 2 quarterly as specified by VA. VA will specify the PBMs for this task. The contractor shall extract data from the VA Business Development Data and other VA data sources as appropriate. The contractor shall store claims information on a secured contractor server in compliance with VA information security provisions. Deliverable 5.4.1: For up to 6 PBMs identified by VA, the contractor shall conduct a preliminary analysis of VA data to determine the volume of claims VA submits to the PBM and total charges VA bills to the PBM. Each analysis will be completed within 2 weeks of VA request. Contractor shall provide pros and cons of selecting the PBM for a detailed analysis. Contractor estimated price shall consist of 6 PBMs over a 12-month period. Deliverable 5.4.2: For up to 6 PBMs identified by VA (based on results of Deliverable 5.4.1.), the contractor shall analyze VA pharmacy claims data to identify by PBM, the PBM's VA reimbursement patterns, trends, and reimbursements amounts by generic/brand type and drug trade name during the previous 2 years. Contractor estimated price shall consist of 6 PBMs over a 12-month period. At minimum, the analysis will include: "Analysis of reimbursement patterns and trends across factors such as: "Plan sponsors (that is, the PBM's clients) "Categories and/or types of pharmacy benefit plans "Geographic regions "Adjudication platforms and/or legacy PBMs "Analysis of actual reimbursements taking into account factors such as: "VA third-party pharmacy billing and drug pricing data, "VA drug usage "Third-party payer reimbursements to VA for pharmacy services. "Third-party payer proposed rate and contract changes "Comparison of the PBM's reimbursement patterns, trends, and amounts with commercial industry's past, current, and future states/trends "Discussion of possible strategies for VA to consider when adopting strategies for persuading the PBM to reimburse VA its billed charges. At least two of the possible strategies shall assume VA will make no change to the placement of reimbursement-related values in the NCPDP transaction. 5.5 Task 5: The contractor shall analyze up to 5 VA business processes that are or have been items discussed in VA current or past pharmacy agreement discussions or that have implications for VA's business relationships with third-party payers. The business processes will be specified and defined by VA. The contractor shall evaluate how each positively and/or negatively affects VA relationships with third-party payers/PBMs and present options for changing or enhancing the processes. Contractor estimated price shall consist of 5 VA business processes. Deliverable 5.5.1: Contractor shall analyze up to 5 VA pharmacy revenue-related business processes as identified and described by VA and will determine whether and how each positively and/or negatively affects VA relationships with pharmacy the payers in the context of commercial industry's expectations and business models and the contractor's expertise and experience. The contractor shall report on options for changing and/or enhancing f that will assist VA in strengthening relationships with pharmacy third-party payers. Contractor estimated price shall consist of 5 VA business processes. 5.6 Task 6: The contractor shall analyze and report on up to 6 in-progress agreements with PBMs, as specified by VA, provide ad-hoc reports on issues as they arise during VA's agreement negotiation process with the PBM and, as requested, provide redlines of up to 3 interim versions of each of the in-progress agreements. Contractor shall attend up to 5 discussions between VA and the PBM per agreement and shall provide written comment to VA after each discussion to address VA technical questions about industry practices, concerns, and terminology that surface during the discussions and options that VA can consider for moving forward with the discussions. Contractor estimated price shall consist of 6 in-progress agreements for the 12-month period, with 5 discussions between VA and PBM per agreement and 3 red lines per agreement. Deliverable 5.6.1: Contractor shall analyze and report on up to 6 in-progress agreements with PBMs, as specified by VA. Contractor shall provide redlines of up to 3 interim versions of each of the in-progress agreements, attend up to 5 VA-PBM discussions per agreement, and provide reports on each of the VA-PBM discussions. Contractor estimated price shall consist of 6 in-progress agreements, with 5 discussions between VA and PBM per agreement and 3 red lines per agreement. 5.7 Task 7: The contractor shall perform reimbursement verifications for up to 4 PBMs, as selected by VA, to determine whether the PBM is reimbursing VA in compliance with federal third-party payer requirements. The contractor shall determine, as part of the verification, whether the PBM is reimbursing VA equal to the reimbursements it makes to non-VA pharmacies in the same geographic areas for the same services. The contractor shall perform reimbursement verifications (to include VA claims analysis, claims analysis of PBM reimbursements to other providers, and review of PBM contracts with other non-government pharmacy providers) for VA-selected third-party payers to support PRO efforts to ensure third-party payers reimburse VA in compliance with federal regulation. The contractor shall provide pricing/rate modeling scenarios to assist the VA with contract negotiations. Contractor estimated price shall consist of reimbursement verifications for 4 PBMs for the 12-month period. Deliverable 5.7.1: The contractor shall perform reimbursement verifications for up to 4 PBMs, as selected by VA, to determine whether the PBM is reimbursing VA equal to the reimbursements it makes to non-VA pharmacies in the same geographic areas for the same services. Contractor estimated price shall assume a single PBM is considered one of the top 10 PBMs per number of covered lives (or other criteria suggested by the contractor) and whose size may be the result of mergers with and acquisitions of legacy PBMs over the years. Contractor estimated price shall consist of reimbursement verifications for 4 PBMs for the 12-month period. At a minimum, the Contractor shall: "Identify the data elements VA needs from the PBM or third-party payer "Analyze raw data the PBM or payer provides; "Extract and analyze raw data from the VA Business Development Warehousedatabase and other VA data sources as appropriate; "Examine and analyze contractual provisions in agreements between the PBM or payer and non-VA pharmacies. "Report detailed findings and recommendations 5.8 Task 8: The contractor shall maintain, store, and package data for turnover. Deliverable 5.8.1: Produce plan for maintenance, storage and turnover of up to 3 terabytes of data. Plan must address storage requirements at the contractor site - to comply with VA information security provisions and to meet necessary data space requirements. Data shall be the result of contractor data extractions from VA databases and of PBM and third-party payer data submissions as part of the verifications. Data shall encompass raw data and data results at various stages of contractor data analytics. Plan must address turnover to VA of appropriate data for records management and for subsequent auditing/certification purposes. Plan must include (1) strategy for working with VA to determine the data that is required to be packaged and turned over to VA at end of project, (2) strategy for determining and advising VA of VA server storage requirements, and (3) steps for implementing the plan. Data and query turnover must be completed 1 week prior to the end of each contract year's period of performance. Contractor estimated price shall assume of maintenance, storage and turnover of 3 terabytes of data. Deliverable 5.8.2. Implement Data Storage, Maintenance and Turnover plan. Contractor estimated price shall assume of maintenance, storage and turnover of 3 terabytes of data. 5.9 Task 9: Contractor shall provide administrative support and training for PRO. Deliverable 5.9.1: Contractor shall develop education plan and training to transfer knowledge gained to Payer Relations Office. Deliverable 5.9.2: Contractor shall provide consultative services in support of pharmacy contract analysis and negotiation. Deliverable 5.9.3: Contractor shall provide general consultative services to leverage VA's uniqueness, quality metrics, and technology Deliverable 5.9.4 Contractor shall provide a report on the impact of Affordable Care Act and provide recommendations and/or scenarios to strengthen VA's position and ensure VA is included in various Health Insurance Exchanges, as appropriate. 5.10Task 10: Contractor shall provide the respective queries or description of the methodologies that resulted in the analysis output so that VA can replicate the analysis and results if requested or challenged. Deliverable 5.10.1: Contractor shall include as part of the closeout process, the listing of all queries and description of the methodologies used to produce any outputs or reports. 5.5 Schedules for Mandatory Deliverables. 5.5.1 Table of Base Period Mandatory Deliverables Due Dates DELIVERABLESDELIVERABLE DESCRIPTIONDUE DATE TASK ONE Task 5.15.1.1Initial PMP as specified in this PWSBy ten (10) business days from contract award date. 5.1.2Review the QCP and QASPBilaterally acceptable date (within 21 calendar days of contract award date). 5.1.3Provide briefing to review Contractor's approach to meet task deliverables. Ten (10) business days of contract award. 5.1.4Provide detailed methodology for ensuring deliverables meet VA current business needs.Within 60 calendar days of contract award, provide final version. TASK TWO Task 5.25.2.1Attend bi-weekly teleconference (or on-site meetings) and provide written up-to-date report detailing activities.Bi-weekly 5.2.2Provide monthly briefing to include updated master project plan and status of activities and accomplishments of prior month.By fifteenth (15th) calendar day of each month or alternative mutually agreeable date. TASK THREE Task 5.35.3.1 For PBM network amendments, analysis and reports: 1.VA third-party pharmacy billing and drug pricing data, 2.VA drug usage 3.Third-party payer reimbursements to VA for pharmacy services 4.Third-party payer proposed rate and contract changes 2 weeks for analysis of data from time of receipt of data. 1 week for initial report from time of data analysis completion. 5.3.2Analysis of the PBM-proposed updates to the network agreements4 weeks from assignment TASK FOUR Task 5.4 5.4.1Pros and cons of selecting the PBM for Task 2 detailed analysis. One week from completion of data analysis. 5.4.2 Analyze VA pharmacy claims by PBM: 1.VA third-party pharmacy billing and drug pricing data, 2.VA drug usage 3.Third-party payer reimbursements to VA for pharmacy services 4.Third-party payer proposed rate and contract changes45 calendar days from receipt of data. TASK FIVE Task 5.55.5.1Analyze business processes and recommend changes and/or enhancements to the processes that would strengthen VA relationships with pharmacy third-party payers45 calendar days from assignment TASK SIX Task 5.6 5.6.1Analyze and report on in-progress agreements with PBMs Ongoing assignment - report as mutually agreed TASK SEVEN Task 5.75.7.1Perform reimbursement verifications 30 calendar days from assignment of PBM - initial report due TASK EIGHT Task 5.85.8.1Produce plan for storage and turnover to VA of raw and manipulated data used during projectWithin 90 calendar days of start of contract 5.8.2Work with VA to determine the data that needs to be turned over to VA at end of project. Due one (1) week before completion of project. TASK NINE Task 5.95.9.1Develop education plan and training planWithin 45 calendar days of assignment 5.9.2Provide consultative services in support of pharmacy contract analysisWithin 30 calendar days of assignment 5.9.3Provide general services to leverage VA's uniqueness, quality metrics, and technology Within 15 calendar days of assignment 5.9.4Provide a report and recommendations on the impact of Affordable Care Act.Within 45 calendar days of assignment TASK 10 Task 5.105.10.1Provide the listing of all queries and description of the methodologies used to produce any outputs or reports. 30 calendar days prior to end of contract. Period of Performance. The period of performance shall be from the date of award for a one-year base period and two one-year option periods. There is ten (10) Federal holidays set by law (U.S.C. Title 5 Section 6103): Under current definitions, four are set by date: New Year's DayJanuary 1 Independence DayJuly 4 Veteran's DayNovember 11 Christmas DayDecember 25 If any of the above falls on a Saturday, then Friday shall be observed as a holiday. Similarly, if one falls on a Sunday, then Monday shall be observed as a holiday. The other six are set by a day of the week and month: Martin Luther King Day Third Monday in January Washington's Birthday Third Monday in February Memorial DayLast Monday in May Labor DayFirst Monday in September Columbus DaySecond Monday in October ThanksgivingFourth Thursday in November 6)Place of Performance. The Contractor shall support this effort at approved Contractor facilities or as directed by the COR and mutually agreed to by Contractor. 7)Key Personnel. Certain skilled experience professional and/or technical personnel are essential for accomplishing the work to be performed. These individuals are defined as "Key personnel" and are those persons whose resumes were submitted and marked by the vendor as "Key Personnel". Substitutions shall only be accepted if in compliance with "Substitutions shall only be accepted if in compliance with "Substitution of Key Personnel" provision identified below. NameTitle The Contracting Officer may notify the Contractor and request immediate removal of any personnel assigned to the task order by the Contractor that are deemed to have a conflict of interest with the government or if the performance is deemed to be unsatisfactory. The reason for removal will be documented and replacement personnel shall be identified within three business days of the notification. Employment and staffing difficulties shall not be justification for failure to meet established schedules. 8.1 Substitution of Key Personnel. All Contractor requests for approval of substitutions hereunder shall be submitted in writing to the COR and the Contracting Officer at least thirty (30) calendar days in advance of the effective date, whenever possible, and shall provide a detailed explanation of the circumstances necessitating the proposed substitution, a complete resume for the proposed substitute, and any other information requested by the Contracting Officer necessary to approve or disapprove the proposed substitution. New personnel shall not commence work until all necessary security requirements, as defined in Section J, have been fulfilled and resumes provided and accepted. The COR and the Contracting Officer will evaluate such requests and promptly notify the Contractor of approval or disapproval in writing. 8.2 The Contractor shall be responsible for managing and overseeing the activities of all Contractor personnel, as well as subcontractor efforts used in performance of this effort. The Contractor's management responsibilities shall include all activities necessary to ensure the Accomplishment of timely and effective support, performed in accordance with the Requirements contained in the PWS. 8.3 Contractor Personnel Requirements. Personnel proposed shall have an in depth knowledge of health care revenue cycle processes in addition to the following: "Knowledge of Pharmacy Benefit Managers; "Specific knowledge of outpatient pharmacy operations; "Expert knowledge of outpatient pharmacy reimbursement and reimbursement methodologies; "Expert knowledge of outpatient pharmacy agreements, language, terms, and conditions; 8.4 Staff Qualifications. 8.4.1 Personnel proposed shall have an in depth knowledge of pharmacy benefit managers (PBM) operations processes and outpatient pharmacy revenue cycle business operations; and health care consulting experience helping pharmacies identify best practices in negotiate agreements with PBMs and other third party payers. 8.4.2 Description 8.4.2.1 Partner: Senior management project oversight. 8.4.2.2 Engagement Director: Senior consultant with project oversight. 8.4.2.3 Project Manager: Provides day-to-day project management 8.4.2.4 Subject Matter Expert(s) 8.4.2.5 Data Analyst 8.4.3 Experience 8.4.3.1 Partner 10 -15 years healthcare experience. 8.4.3.2 Engagement Director 8 or more years' experience 8.4.3.3 Project Manager 3 or more years' experience 8.4.3.4 Subject Matter Expert(s) 10 or more years' experience in PBM operations, or similar health care experience with specific knowledge and expertise in negotiating and evaluating pharmacy agreements. 8.4.3.5 Data Analyst 3 - 5 years health care financial analyst experience with proven track record in financial and research analysis as it relates to revenue cycle management 8.4.4Education: Bachelor's or advanced degree required for all staff. 9.Travel. The CPAC anticipates approximately 15-20 trips during each period of performance to either Washington DC or for face-to-face meetings with PBM or other third party payer staff. The trips should average approximately 2-4 days. All travel is subject to COR written approval in advance. Travel and per diem shall be reimbursed in accordance with VA and Federal Travel Regulations. Travel expenses shall be invoiced in the subsequent month following the completion of travel in order to be reimbursed. This can be found at : www.gsa.gov/federaltravelregulation 10.Type of Contract. A Firm- Fixed Price Task Order/Contract will be issued for this effort. 11.Changes to the PWS Any changes to this PWS shall be authorized and approved only through written correspondence from the Contracting Officer. A copy of each change will be kept in a project folder along with all other products of the project. Costs incurred by the contractor through the actions of parties other than the Contracting Officer shall be borne by the contractor. 12.Government and Contractor Responsibilities. a.The CPAC shall provide the contractor with copies of documents that the VA is required to provide. b.The contractor shall request other VA documentation deemed pertinent to the work accomplishment directly from the COR. The contractor is expected to use common knowledge and resourcefulness in securing all other reference materials, standard industry publications, and related materials that are pertinent to the work. c.The contractor shall maintain frequent communications with the Program Office and the COR to conduct work in progress reviews. Progress reports shall be delivered electronically to the COR, with an electronic courtesy copy to the Program Office. 13.Formal Acceptance or Rejection of Deliverables. The VA shall have 15 business days to review each document and provide feedback and comments. The contractor shall have five business days to incorporate comments. A final review shall be conducted with the COR. Delivery of the post-final review document with incorporated comments from the final review meeting shall constitute acceptance by the VA with COR's written approval. 14.Quality Standards for Deliverables - Performance Measures: Standards: 14.1 Review of relevant materials. Deliverables shall be timely, comprehensive, thoughtful, relevant presentation of alternatives, pros and cons, and feasible recommendations. 14.2 CPAC Presentations. Presentations shall be clear, concise, executive-focused, and written in such a way as to be understood by lay persons. Quality of deliverable directly correlates with effectiveness of CBO communications. 14.3 Project Plan. Project Plan shall be timely and comprehensive; recognize and address authority, perceptions, and concerns of stakeholders; incorporate scope of requisite contract requirements across the CPAC. 14.4 Reports. Reports are submitted on time and include those topics described in the PWS, agreed to in the master plan and as requested for special reports; necessary clearances are obtained as needed in a timely manner. 14.5 Publications and other documents. Deliverables are timely submission in formats appropriate to target audiences; consideration of best dissemination mechanisms; user friendly, clear, thorough and comprehensive documentation and publications. 14.6 Meeting support. Timely and thoughtful pre-meeting preparations and logistics; smooth meeting operations; timely and comprehensive post-meeting summaries. 14.7 Coordination. Contractor collaboration with CPAC is timely, appropriate and demonstrates cooperative support to VHA Executives and staff. 14.8 Analyses and Assessments. Analyses and assessments are performed with accuracy, comprehensiveness and adherence to industry best practices. 14.9 Modifications. Timely, comprehensive, high quality covering all functional, performance, and physical areas as delineated in the PWS; final plan incorporates VA feedback in a timely manner. 14.10 Obtain relevant stakeholder input. Deliverables are innovative, timely implementation of input mechanisms; accurate and comprehensive synthesis of results and recommendations. Integration of relevant stakeholder input documented for deliverable. 15. SECTION - PRIVACY REQUIREMENTS 1.GENERAL Contractors, contractor personnel, subcontractors, and subcontractor personnel shall be subject to the same Federal la s, regulations, standards, and VA Directives and Handbooks as VA and VA personnel regarding information and information system security. 2.ACCESS TO VA INFORMATION AND VA INFORMATION SYSTEMS a. A contractor/subcontractor shall request logical (technical) or physical access to VA information and VA information systems for their employees, subcontractors, and affiliates only to the extent necessary to perform the services specified in the contract, agreement, or task order. b.All contractors, subcontractors, and third-party servicers and associates working with VA information are subject to the same investigative requirements as those of VA appointees or employees who have access to the same types of information. The level and process of background security investigations for contractors must be in accordance with VA Directive and Handbook 0710, Personnel Suitability and Security Program. The Office for Operations, Security, and Preparedness is responsible for these policies and procedures. c.Contract personnel who require access to national security programs must have a valid security clearance. National Industrial Security Program (NISP) was established by Executive Order 12829 to ensure that cleared U.S. defense industry contract personnel safeguard the classified information in their possession while performing work on contracts, programs, bids, or research and development efforts. The Department of Veterans Affairs does not have a Memorandum of Agreement with Defense Security Service (DSS). Verification of a Security Clearance must be processed through the Special Security Officer located in the Planning and National Security Service within the Office of Operations, Security, and Preparedness. d.Custom software development and outsourced operations must be located in the U.S. to the maximum extent possible. If such services are proposed to be performed abroad and are not disallowed by other VA policy or mandate, the contractor/subcontractor must state where all non-U.S. services are provided and detail a security plan, deemed to be acceptable by V.A., specifically to address mitigation of the resulting problems of communication, control, data protection, and so forth. Location within the U.S. may be an evaluation factor. End of Document.
 

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