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FBO DAILY - FEDBIZOPPS ISSUE OF JUNE 20, 2014 FBO #4591
DOCUMENT

R -- Utilization Management Criteria - Attachment

Notice Date

6/18/2014
 

Notice Type

Attachment
 

NAICS

511210 — Software Publishers
 

Contracting Office

U.S. Department of Veterans Affairs;Strategic Acquisition Center;10300 Spotsylvania Ave;Fredericksburg VA 22408
 

ZIP Code

22408
 

Solicitation Number

VA11914I0193
 

Response Due

6/25/2014
 

Archive Date

8/24/2014
 

Point of Contact

Anne T Ditch
 

E-Mail Address

2-9178<br
 

Small Business Set-Aside

N/A
 

Description

This is a Request for Information: This is a Request for information (RFI) for Utilization Management Criteria for the Department of Veterans Affairs, Veterans Health Administration (VHA). The purpose of this Request for Information (RFI) is to obtain information on the capability of vendors to provide licensing and use agreements for clinical criteria sets which cover the full spectrum of inpatient and outpatient healthcare services. This RFI allows potential contractors to submit a non-binding statement of interest and documentation demonstrating their capabilities, and suggestions that will allow the Government to refine its potential course of action. The RFI effort is intended to assess industry service capabilities and solicit feedback for acquisition planning purposes. The Strategic Acquisition Center (SAC) is requesting responses from qualified businesses concerns. The NAICS code for this effort is 511210. BACKGROUND: The purpose of the Veteran Health Administration (VHA) Utilization Management (UM) program is to safeguard against unnecessary and inappropriate medical care rendered to veteran recipients. VHA's objective is to find an Offeror that provides evidence-based clinical appropriateness criteria, educational training, clinical resources, and customer support to the VHA's Utilization Management Program. General Tasks and Deliverables: 1. Corporate Licensing Agreements The Offeror shall provide Corporate Licensing Agreements for all VHA users to access evidence-based clinical appropriateness criteria. This will include criteria for all 21 VISNs and 153 medical facilities as specified by VHA to reflect differences in complexity and scope of services. The programs accessing the criteria include, but are not limited to Utilization Management, the Chief Business Office, Purchased Care and the Consolidated Patient Account Centers (CPAC). The Corporate Licensing Agreement must encompass the use of the licensed criteria in both printed and electronic formats when available in both. 2. Clinical Appropriateness Criteria Clinical appropriateness criteria are objective, evidence-based clinical statements used to assist in determining the medical necessity of services and the appropriateness of levels of care. The Offeror shall provide current evidence-based clinical appropriateness criteria for the full continuum of care including, but not limited to acute and non-acute inpatient, ambulatory care, specialty care, home care, procedures, imaging, and DME. The criteria shall be provided in print format for the program offices, VISNs, and medical centers as specified by VHA. The criteria shall be provided in an electronic format that can successfully integrate into the enterprise level VHA National Utilization Management Integration (NUMI) architecture web-server system. The electronic format shall provide the following to each user: "Allow the UM user to select a level of care for a patient review "Provide access to clinical appropriateness criteria at a specific level of care "Allow UM staff to select criteria that apply to a patient being reviewed "Determination of whether the patient meets criteria for the selected level of care based on the criteria that has been entered; and "Provide access to clinical references and support information such as clinical notes and literature citations. The Offeror shall provide evidence-based clinical appropriateness criteria and algorithms for performing UM review of all levels of acute and non-acute care along the healthcare continuum including inpatient, ambulatory care, home care, rehabilitation, long term care, hospice, and domiciliary, as well as for procedures and treatments, diagnostic tests, and imaging procedures. 3. Educational Resources Educational resources are the resources necessary to support the VHA goal to create and maintain a core of VA clinical trainers who are experts in the interpretation, application and content delivery of clinical criteria. This core of trainers will then train VA UM end-users on the criteria. a.Continuing Education The Offeror shall develop a comprehensive curriculum and agenda for the educational sessions, provide faculty, educational materials and evaluation tools to assess the effectiveness of the completed training. The Offeror shall provide additional training for all updates to clinical appropriateness criteria. Commercial training materials and tools for all applicable criteria must allow for customization by VHA training staff to allow for organizational variation in the UM review processes. Training must be available to VHA UM end-users utilizing live meeting, onsite, and self-paced learning modules. All downloadable training materials must be Section 508 compliant. b.Registration for Training The Offeror shall establish and coordinate the registration of all VA staff for each training session. The registration process shall be established for VA staff members to enroll in the training directly with the Offeror as well as provide sufficient information to each enrollee regarding the training sessions, e.g., availability and delivery of training materials, contact information, etc. 4. Assessment Tools The Offeror shall provide web-based assessment tools and strategies to appraise inter rater reliability (IRR) that have statistical reporting capability at the National, VISN, and facility levels. The tools and strategies must contain features allowing VHA UM staff customization ability in consideration of potential concerns specific to the patient population of VHA. The IRR assessment tools and strategies will be used to measure consistency of interpretation and application of the clinical appropriateness criteria. 5. Software Integration: The National Utilization Management Integration (NUMI) web-based application is mandated for use by 600 Veterans Health Administration (VHA) Utilization Management professionals. The NUMI product automates clinical appropriateness review of patient care at over 150 VHA facilities across the nation. The Offeror shall provide a web-based computer application to provide access to clinical appropriateness criteria. The software application shall integrate seamlessly with the NUMI system. The integration will be structured so that appropriateness criteria and associated algorithms can be utilized and review outcomes can be determined while keeping all VHA data internal to the NUMI database. INSTRUCTIONS: Submit a brief description, five (5) pages or less (including cover letter) that demonstrates how your company can provide Utilization Management Criteria services for UM professionals operating anywhere in the United States. Provide your past experience in performing these services for other government (federal or states) agencies. Responses should include business size, business type, socio-economic status, and capability. Please submit your responses to the following contracting specialist: Anne Ditch at anne.ditch@va.gov. Responses are due by 2:00 p.m. EST, June 25, 2014. DISCLAIMER: Issuance of this RFI or Sources Sought is to assist the VA in determining sources only and does not commit or bind the Government under any circumstances, nor does it constitute any obligation whatsoever on the part of the Government to procure these services or to issue a solicitation, nor to notify respondents of the results of this notice. No solicitation documents exist at this time; the Department of Veterans Affairs is neither seeking proposals nor accepting unsolicited proposals, and responses to this RFI or Sources Sought cannot be accepted as offers. Any information the vendor considers proprietary should be clearly marked as such. The U.S. Government will not pay for any information or administrative costs incurred in response to this RFI or Sources Sought.
 

Web Link

FBO.gov Permalink
(https://www.fbo.gov/notices/6cd17ef30ad874b289f6fdfdb2473798)
 

Document(s)

Attachment
 

File Name: VA119-14-I-0193 VA119-14-I-0193.docx (https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=1437009&FileName=VA119-14-I-0193-000.docx)

Link: https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=1437009&FileName=VA119-14-I-0193-000.docx

 

Note: If links are broken, refer to Point of Contact above or contact the FBO Help Desk at 877-472-3779.
 

Record

SN03399301-W 20140620/140619022216-6cd17ef30ad874b289f6fdfdb2473798 (fbodaily.com)
 

Source

FedBizOpps Link to This Notice
(may not be valid after Archive Date)

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