Q -- MARKET SURVEY FOR NATIONAL QUALITY MONITORING CONTRACT (TRICARE)

Notice Date

May 24, 2001

Contracting Office

Department of Defense (CMP), Tricare Management Activity, 16401 E. Centretech Parkway, Aurora, CO 80011-9043

ZIP Code

80011-9043

Solicitation Number

N/A

Response Due

June 25, 2001

Point of Contact

Cindy Dahlstrom, Contracting Officer, 303-676-3516

E-Mail Address

CLICK HERE TO CONTACT THE CONTRACTING OFFICER BY E-MAIL (Cynthia.Dahlstrom@tma.osd.mil)

Description

MARKET SURVEY -- The DoD is in the process of planning for the National Quality Monitoring Contract (NQMC) reprocurement. The purpose of this contract is to assist the TRICARE Management Activity (TMA), the Services and the Lead Agents by providing the government with an independent, impartial evaluation of the care provided to Military Health Services (MHS) beneficiaries. The scope of the review includes the following: validation of utilization management decisions, monitoring the quality of care, providing a second level appeal, obtaining expert professional evaluation of the qualification of the specialized mental health and substance abuse institutional providers, and providing peer review for selected TMA cases. This is not a Request for Proposal (RFP). This is a Market Survey in accordance with Federal Acquisition Regulation Part 10. DoD does not intend to award a contract on the basis of the survey submitted in response to the market analysis nor pay for costs associated with responses received. Interested parties may submit a response visiting TMA's URL http://www.tricare.osd.mil/contracting/tmamenu.cfm and select "Health Care" to access the market survey; by e-mail to Ms. Debbie Melton at Debbie.Melton@tma.osd.mil; by mail to TRICARE Management Activity (CMA), 16401 E. Centretech Parkway, Aurora, CO 80011-9066, or via facsimile to 303-676-3987 no later than 30 days from the date of May 25, 2001. Please answer all of the questions presented in this survey and provide a rationale for your comments. To aid in the Government's review of responses submitted, please indicate the specific issue you are addressing by utilizing the respective number in the "Specific Market Survey" portion of this document for each of your responses. Information received in response to this market survey will be considered confidential and will not be disclosed to anyone other than the personnel working on this project. POC: Cindy Dahlstrom, Contracting Officer, 303-676-3516. CONTENT. The intent is for TRICARE to comply with the DoD Federal Acquisition Regulation (FAR) Part 12, Acquisition of Commercial Items, for a commercial line of business or to comply with FAR Part 15, Contracting by Negotiation, for source selection. Please respond to the following questions about your commercial line of business. You must answer all of the questions in order to submit the survey. (1) Do you have board certified physicians in each specialty and subspecialty of the American Board of Medical Specialties available to perform medical record reviews? (2) Do you have health care providers other than physicians (e.g. physical therapists, speech therapists, clinical psychologists, registered nurses, dentists) available to perform medical record reviews? (3) Do you conduct retrospective reviews of medical records reviews to include DRG coding reviews, utilization reviews, quality of care reviews, and malpractice reviews? (4) Do you have experience in providing peer reviews on a retrospective, prospective and concurrent basis for medical surgical care, behavioral health care and dental care to assist in the determination of the medical necessity and appropriateness of health care services involving all levels of care? (5) Do you perform independent medical review and issue timely appeal determinations for care denied by managed care organizations? (6) a. Do you use screening criteria for your first level reviewers? b. If yes, then what criteria are you using? (7) Are your first level medical surgical reviewers licensed registered nurses? (8) Are your first level mental surgical reviewers licensed registered nurses? (9) Do you have mental health clinicians that have experience in surveying mental health facilities for the Joint Commission on Accreditation of Healthcare, National Committee for Quality Assurance, the Health Care Financing Administration, or other organizations available? (10) Do you conduct mental health facility certification reviews to determine compliance with licensure, accreditation and quality of care standards? (11) Do you conduct retrospective reviews of managed care organization utilization management decisions to ensure that the health care services provided are not compromised by financial incentives? (12) How many years of experience does your company have in performing medical records review? (13) How many years of experience does your company have in conducting facility certification reviews?

Web Link

ERROR -- (http://www.tricare.osd.mil/contracting/tmamenu.cfm)

Record

Loren Data Corp. 20010529/QSOL012.HTM (W-144 SN50N037)