IVC CCN NG Industry Day_111323_final.pptx

VHA Office of Integrated Veteran Care CCN Next Generation Industry Day November 13, 2023

Working Draft, Pre-Decisional, Deliberative Document

Integrated Veteran Care

Agenda Opening Remarks Ground Rules Multiple Domains Q&A Appendix

Opening Remarks

Shereef Elnahal, MD, MBA Under Secretary for Health U.S. Department of Veterans Affairs

Amanda Villa, FAC-PPM Director of Acquisitions

Veterans Health Administration

Christopher Parker, SES Associate Executive Director, Strategic Acquisition Center U.S. Department of Veterans Affairs

Hillary Peabody, MPH Deputy Assistant Under Secretary for Health for Integrated Veteran Care Veterans Health Administration

Ground Rules The Department of Veterans Affairs, VHA Office of Integrated Veteran Care (IVC) and Strategic Acquisition Center are hosting this industry day event to support Market Research used for the potential procurement of services.

The information discussed and gathered during this event is solely for information and planning purposes.

There is no obligation for the Government to acquire any products or services discussed during this event.

In accordance with the Federal Acquisition Regulations (FAR) Subpart 15.201(e), any responses to questions asked during this event are not offers and cannot be accepted by the Government to form a binding contract. No funds have been authorized, appropriated, or received for this effort.

The information provided may be used by VA in developing its acquisition strategy and informing, refining, and finalizing a Performance Work Statement (PWS).

The Government will not pay for any time expended or information submitted in response to questions asked during this event. Eligibility in participating in a future acquisition does not depend upon a response to questions asked during this event.

Nothing discussed in this event authorizes you to work, start work, or bill for work. Any such authorization will be in writing from a duly authorized contracting officer.

Multiple Domains Based on lessons learned and industry feedback, VA is exploring the concept of organizing certain IVC capabilities and requirements into separate domains.

These multiple domains could potentially cover a broad scope of services for Veterans and Veteran Family Member Programs (VFMP) through one Request for Proposal (RFP) with multiple single award contracts.

It is VA’s intent to have contract language and Memorandum of Understandings (MOUs) established within each contract to ensure collaboration between each contractor and to delineate roles and responsibilities.

It is anticipated that VA will solicit proposals from organizations capable of performing tasks required in one or more of these domains.

VA anticipates notifying industry of the updated procurement timeline by the end of FY24 Q1.

Multiple Domains

Integrated Services

Integrated services at the national level

Dental

National dental network & claims processing

Pharmacy

VFMP Claims

National pharmacy network & claims processing

National claims adjudication for Veterans Family Member Program

Network - East

Network - West

East region healthcare network & claims processing

West region healthcare network & claims processing

Below are the high-level capabilities that VA is exploring for each domain.

Ticketing system(s) (e.g., provider directory) Data consolidation and reporting Program Integrity Veteran/VA Customer Service Self-Service Network (Regional Networks) Healthcare Network Network adequacy Credentialing Referrals Scheduling and care coordination (optional) Durable Medical Equipment Claims processing Provider Customer Service Medical Documentation Retrieval and Portal Payment Integrity/FWA Utilization Management

Network adequacy Credentialing Compliance, referrals, and prior authorization Scheduling and care coordination (optional) Claims processing Provider Customer Service Medical Documentation Retrieval and Portal Payment Integrity/FWA Utilization Management

Network adequacy Routine/maintenance prescriptions for disaster response Compliance Claims processing Provider Customer Service Payment Integrity/FWA

Surge support for manual VFMP claims processing Customer Service

Multiple Domains Below are a few key advantages that VA anticipates of the multiple domain concept.

Standardization, consistency and operational efficiencies in enterprise capabilities Direct contractual relationships with each domain contractor Receiving high-quality services and solutions from vendors that provide unique domain capabilities Increased opportunity for domain specific competition and small business/Veteran-owned participation

Q&A Session VA will ask a series of questions to support market research. VA will ask each question individually and will take verbal responses from vendors in the open forum.

To provide a verbal response, please utilize the “raise hand” function in WebEx and VA will call on each raised hand to respond.

If vendors would like to submit responses in writing, please follow the submission instructions found in the appendix.

VA will accept questions only related to clarifications on content shared during this event. Any additional questions asked must be submitted to NextGenRFI_Industryday@va.gov and those questions and answers are subject to public posting on sam.gov (FBO).

Q&A Session Multiple Domain Questions for Industry Feedback:

What recommendations would you provide to ensure collaboration between domain contractors?

What approaches would you recommend to ensure that multiple contractors can implement the domains and capabilities simultaneously?

How does this concept impact your interest in submitting a proposal for previously shared requirements or capabilities?

What other considerations should VA consider with this multiple domain model?

Additional Questions for Industry Feedback:

What considerations should VA consider if cryopreservation storage was included in the regional network contracts to support Assisted Reproductive Technology/In Vitro Fertilization (ART/IVF) benefits for Veterans?

What recommendations would you provide to allow access to TPA maintained records (without requiring a subpoena) when requested by the Office of Inspector General (OIG)?

What recommendations would you provide regarding communication with providers on compliance with federal anti-fraud provisions?

Appendix

Written Response Submission Instructions For written responses, please utilize the following submission instructions.

Submit responses via email to NextGenRFI_Industryday@va.gov.

Submissions are due no later than November 21, 2023 at 4:00 p.m. EST.

The email subject line must contain the following: “Response to RFI 36C10G23Q0058, Community Care Network Next Generation”.

VHA reserves the right to not reply to any emails, responses, questions, and materials submitted in response to this event.

Mark your response as “Proprietary Information” if the information included is considered to be business sensitive and/or includes trade secrets.

Please format any documents in PDF format and responses shall not exceed 20 pages total (exclusive of the title/cover page, and table of contents). VA will not review any other data or attachments that are in excess of the 20-page limit. All documents must measure 8.5 x 11-inches (charts may be landscaped but must be 8.5 x 11-inches) and shall be in Times New Roman, font size (12), with 1” margins.

All pages of the response shall be appropriately numbered, and identified with the RFI number (i.e., 36C10G23Q0058). Any documents not in conformance with these requirements may not be reviewed.

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