Health Care Financing Administration 7500 Security Blvd., Baltimore, MD. 21244-1850

B -- CLINICAL DIAGNOSTIC LABORATORY FEE SCHEDULE POC Lucille Fussell-Lee, Contract Specialists (410) 786-5447 The Health Care Financing Administration (HCFA) intends to award on a competitive basis, under the Simplified Acquisition Procedure (Dollar Threshold of $100,000) an award for purchase of data to support inherent reasonableness adjustment of Clinical Diagnostic Laboratory Fee Schedule. HCFA needs to obtain analysis of aggregate-level comparative payer data, representative of the United States and of specific geographical regions. The analysis would be used to evaluate other payer amounts for these services to determine if the Medicare payment amounts are inherently unreasonable. HCFA has already identified 8 clinical diagnostic laboratory tests (conventional Pap smears) for which payment is grossly deficient. These data would be used to support our determination of grossly deficient payment for Pap smears and would also be used in making a determination of grossly deficient or grossly excessive payment for other clinical diagnostic laboratory tests. The Contractor shall identify a source of data to be used in the analysis required by HCFA. Ideally, this would consist of comparative payer data, representative of the major geographic areas United States and of specific geographical variances. The Contractor shall perform analysis of payment amounts of 58 Current Procedural Terminology (CPT) codes contained in the clinical diagnostic laboratory fee schedule to produce a report of aggregate geographic costs. This would be organized either by major zip code area (first three digits of zip) or by State. For each State or major zip-code, the contractor would provide volume (utilization and aggregate cost figures for managed care (HMO and PPO) and for fee for service (indemnity) (FFS) allowed charges as follows: low payments (5th or 10th percentile), medium (50th percentile) and high (90th or 95th percentile). The report should also include the maximum and minimum payment amounts for each State. The supplied data and or reports should constitute the most recent payment information available. In addition, for each State, the report will contain the proportion of providers practicing in the State whose information is represented in the report, and the proportion of volume for each State that is represented in the managed care portion and in the FFS portion. A Request-for-Quote will be issued. Requests for all offerors may be faxed to (410) 786-9088 at the attention of Lucille Fussell-Lee or E-mail at LFusselllee@hcfa.gov. Posted 04/13/99 (I-SN319618). (0103)

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