Appendix B_020226.pdf
PDF 108 KB Posted
- Attached to
- Part D Transaction Facilitator
- Solicitation number
- 260108J
About this file
This document is Appendix B: Schedule of Deliverables for a federal contract involving the administration and operation of a Part D Prescription Drug Plan Transaction Facilitator system for the Centers for Medicare & Medicaid Services (CMS).
The contract requires the contractor to perform fourteen major task categories with ongoing operational responsibilities. Core deliverables include receiving and maintaining Medicare eligibility indices and pharmacy help desk information (Task 1); processing plan switches (Task 2); submitting daily, monthly, quarterly, and annual reports to CMS with monthly invoicing for activities (Task 3); and maintaining operational support infrastructure including a help desk and transaction facilitator environment with disaster recovery capabilities (Tasks 4-5). The contractor must execute Business Associate Agreements with each Part D sponsor within 15 days of contract award or by December 31, 2022 (Task 6). Additional ongoing responsibilities encompass providing pharmacy eligibility query responses, maintaining testing and replay environments for transaction processing (Tasks 7-9), creating NCPDP Financial Information Reporting transactions to facilitate data transfer between Part D sponsors during beneficiary enrollment changes with annual certification testing (Tasks 10-10b), and responding to historical data and special reprocessing requests (Task 11). The contract also includes as-needed tasks for coordination of benefits education, facilitating inter-plan information coordination, and supporting future CMS initiatives (Tasks 12-14). All major operational tasks are classified as "Ongoing" except for Task 6 (Business Associate Agreements), Task 10b (annual certification testing), and tasks 7b, 12, 13, and 14 which are "As Needed."
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Other files
| File | Type | Posted |
|---|---|---|
| Appendix G_020226.pdf | ||
| Appendix A_020526.pdf | ||
| Appendix C_020526.pdf | ||
| Appendix H_020926.pdf | ||
| Appendix I_020926.pdf | ||
| Appendix F_020226.pdf | ||
| Appendix E_020226.pdf | ||
| Appendix D_020226.pdf | ||
| Draft SOO - Part D Transaction Facilitator.pdf | ||
| RFI Memo - Part D Transaction Facilitation.pdf |
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Appendix B: Schedule of Deliverables
Task Description Due Date 1 Receive and Maintain the Part A/B and D
Eligibility Index Ongoing
1a Creation and Use of a Medicare Eligibility History File
Ongoing
1b Receive and Maintain the Plan Pharmacy Help Desk Telephone Numbers and Plan Types
Ongoing
2 Switch Processing Ongoing 3 Reporting to CMS Ongoing 3a Daily Reporting Daily 3b Monthly Reports, Quarterly, and Yearly for
E1, B and Nx Transactions and Performance Monitoring
Ongoing
3c Invoice CMS for Costs related to PDTransFac Activities
Monthly
4 Maintain a Help Desk Ongoing 5 Maintain Transaction Facilitator
Environment Ongoing
5a Design and Re-Architect Disaster Recovery Site in Accordance with Current CMS Requirements
Ongoing
6 Execute a Business Associate Agreement with Each Part D Sponsor for COB Information Exchange
Within 15 days of contract award or by December 31, 7 Provide Responses to Pharmacy Eligibility Queries
Ongoing
7a Maintain isolated, non-production E1 Sandbox Environment to provide the E1 Replay capability
Ongoing
7b Provide On-Request Data Analysis of E1 Transactions
As Needed
8 Create and Maintain a BIN/PCN Table to Facilitate Routing of Supplemental Paid Claims Transactions
9 Transaction Processing, Capture Paid claims Data, Create the current NCPDP standard Nx Transaction, and Route the Nx Transaction to the Part D Plan
Task Description Due Date 9a Maintain a Replay Environment for the current NCPDP version B and N Transactions
Ongoing
9b Maintain a Follow-up Environment for Specific B and N Transactions
Ongoing
9c Create a Unique Transaction Reference ID for each N1 Transaction Created and Include This ID on N Transactions Routed to the Part D Plan
Ongoing
9d Capture and Route Supplemental Payer Data via a Batch
Ongoing
10 Create NCPDP Financial Information Reporting (FIR) Transactions to Support the Transfer of TrOOP-related Data between Part D Sponsors, when a Beneficiary Changes Enrollment during the Coverage Year
10a Receive and Respond to Part D Plan Requests for Inclusion in the Financial Information Reporting
Ongoing
10b Conduct FIR Certification Testing with New Part D Sponsors/Processors or Upon a New NCPDP Version
On an annual basis
11 Respond to Part D Sponsor and Other Payer Requests for Historical Data or Special Reprocessing of B, N and/or FIR Transactions
Ongoing
12 Coordination of Benefits Educational Activities
As needed
13 Facilitating the Coordination of Information Needed to Coordinate Part D Benefits
As needed
14 Support any CMS Initiatives, Transactions, Information Sharing and Reporting as May be Contracted and Funded by CMS and Agreed to by the Contractor
As needed
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