36C10G25Q0078_1.docx

SUBJECT*

VA Community Care Network (CCN) Next Generation Dental

GENERAL INFORMATION

SET-ASIDE

OPAL | Strategic Acquisition Center

10300 Spotsylvania Ave | STE 400 Fredericksburg VA 22408-2697

POINT OF CONTACT*

Contracting Officer Jacqueline Boudreaux Jacqueline.Boudreaux@va.gov See email

PLACE OF PERFORMANCE

POSTAL CODE

COUNTRY

ADDITIONAL INFORMATION

AGENCY’S URL

URL DESCRIPTION

AGENCY CONTACT’S EMAIL ADDRESS

EMAIL DESCRIPTION

DESCRIPTION

For Information Purposes Only

Sources Sought Notice Sources Sought Notice

Sources Sought Notice

Community Care Network Next Generation – Dental Network Request for Information (RFI)

Department of Veterans Affairs Integrated Veteran Care Veterans’ Health Administration

Date: April 21, 2025

36C10G25Q0078 FAR Part 52.215-3 (a) The Government does not intend to award a contract on the basis of this solicitation or to otherwise pay for the information solicited except as an allowable cost under other contracts as provided in subsection 31.205-18, Bid and proposal costs, of the Federal Acquisition Regulation. (b) Although "proposal" and "offeror" are used in this Request for Information, your response will be treated as information only. It shall not be used as a proposal. (c) This solicitation is issued for the purpose of information and planning.

Disclaimer: The following document is NOT a solicitation or Request for Proposal. This document is for informational purposes only. The VA is requesting industry feedback on the program concepts as drafted however these concepts are not finalized and are subject to change.

TABLE OF CONTENTS

No table of contents entries found.

REQUEST FOR INFORMATION

1.0 INTRODUCTION

THIS IS NOT A SOLICITATION.

The Department of Veterans Affairs (VA) Veterans Health Administration (VHA) is issuing this Request for Information (RFI) as part of market research for a potential procurement to acquire contractor services to develop and maintain a national network of high-performing, licensed dental providers and practitioners. In addition to developing and maintaining a robust dental provider network, where providers deliver standard dental services in accordance with industry standards, the contractor shall also provide enhanced community dental care services such as appointment scheduling, case management, oral disease management, population oral health strategies, and other innovative, industry-recognized best practices and lesson learned. VHA looks to become the trend-setter and standard-bearer for streamlined healthcare services and to deploy an innovative healthcare model throughout the nation via the Community Care Network Next Generation (CCN Next Gen) program.

This RFI is issued solely for information and planning purposes. There is no obligation for the Government to acquire any products or services described in this RFI. In accordance with the Federal Acquisition Regulations (FAR) Subpart 15.201(e), responses to this notice 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), Dental Network Contractor Manual, QASP and other associated documents relevant to this concept. Interested parties are responsible for adequately marking proprietary, confidential, restricted, or competition sensitive information contained in their response. Only electronic responses to this RFI will be accepted. The Government will not pay for any time expended or information submitted in response to this RFI. Eligibility in participating in a future acquisition does not depend upon a response to this RFI.

This RFI is for CCN Next Gen – Dental Network only. The VA intends to post a RFI for CCN Next Gen – Medical Network at a later date.

2.0 BACKGROUND

The VA provides care to Veterans through community providers when VA cannot provide the care needed or when Veterans are unable to access local VA medical centers. Community care is based on specific eligibility requirements, availability of VA care, and the needs and circumstances of individual Veterans. In an effort to streamline VA’s community care programs, the VA Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act was signed into legislation on June 6, 2018, providing more choices and robust care coordination for Veterans using one consolidated program instead of multiple programs. Over time, community care program needs evolved with requirements for expanded healthcare services and improvements in customer service, accountability, health information exchange, referrals, scheduling, and provider payments. This evolution led to development of the VA Community Care Network (CCN).

The current CCN program is comprised of five (5) regional IDIQ contracts that serve as the primary vehicle through which VA purchases care from community-based providers for Veterans, covering all U.S states and territories. The VA is presently conducting market research as part of its acquisition planning process for the upcoming CCN Next Gen initiative. While the CCN program has made significant efforts to expand access and improve the quality of care for Veterans, the VA aims to further streamline and enhance community care processes and service delivery through this initiative. CCN Next Gen seeks to build upon lessons learned from previous efforts and incorporate industry best practices through comprehensive market research, innovative acquisition strategies, and in-depth analysis of acquisition and contract requirements. This RFI represents a key step in gathering insights to inform the development of a more effective, responsive, and outcomes-driven community care dental network.

The Contractor shall serve as a Third-Party Administrator (TPA) with responsibility to provide regionally managed dental services for Veterans referred to community-based dental providers. The Contractor shall (i) provide exemplary customer service; (ii) monitor and manage quality outcomes; (iii) use data and performance metrics to improve services; and (iv) process and pay claims for services ordered against the contract.

3.0 PURPOSE

The Veterans Health Administration (VHA) Office of Integrated Veteran Care (IVC) is seeking information in support of Community Care Next Generation (CCN-Next Gen) Dental Network.

The purpose of this Request for Information (RFI) notice is to:

1. Communicate a vision of the scope of services that VHA would ideally like to implement.

2. Inform potential respondents that the Veterans Health Administration (VHA) is seeking industry feedback on the attached draft Performance Work Statement (PWS), Dental Network Contractor Manual, and corresponding Quality Assurance Surveillance Plan (QASP), in support of refining requirements and ensuring effective performance oversight and accountability.

3. Collect information about market capabilities and state of practice.

4.0 REQUESTED INFORMATION

Interested parties are invited to submit the following when responding to the RFI:

4.1 Vendor Information

· Vendor Name

· Vendor Address

· DUNS Number

· Vendor Website

· Vendor Point of Contact name, telephone number, and email address.

· Unique Entity Identifier (UEI), number under which the vendor is registered in SAM.gov and/or VetBiz.gov.

· Vendor Socioeconomic Status; Business Size and Status [e.g., Large Business, Service-Disabled Veteran-Owned Small Business (SDVOSB), Veteran-Owned Small Business (VOSB), Small Business (SB), etc.]

· GSA or similar Governmentwide contract vehicle to include contract number, schedule, and SIN category(s), if applicable.

· The number of years in business operating under NAICS 524114, if applicable.

4.2 Vendor Responses to Instructions

Vendors shall provide responses to the Questions outlined in section 6.0 of this RFI on attachment 4 -Vendor Responses Template. Each response should clearly and concisely address the vendor’s approach to meet the objectives, requirements, and constraints described in this notice. Responses should reference the specific section of the RFI or associated documents (e.g., PWS, QASP) to which the feedback pertains. General comments or recommended revisions should include sufficient context to ensure clarity.

When preparing responses, vendors are encouraged to consider all relevant information contained in this RFI, including the Performance Work Statement (PWS), and the Quality Assurance Surveillance Plan (QASP). Where applicable, vendors are requested to include examples of relevant experience or solution from the past five years.

5.0 SUBMISSION INSTRUCTIONS

Vendors shall submit written feedback in response to this RFI via email in PDF and/or excel format to the following point of contact:

Email: NextGenRFI_Industryday@va.gov

Subject Line: “Response to RFI 36C10G25Q0078, Community Care Network Next Generation Dental Network.”

Submission Deadline: May 16, 2025, 2:00 PM EST.

Feedback may include responses to the questions in Section 6.0 Questions of this RFI, as well as: comments on the draft Performance Work Statement (PWS), Dental Network Contractor Manual, Quality Assurance Surveillance Plan (QASP), recommended revisions, industry best practices, potential risks, innovative solutions, and any additional input relevant to this RFI.

Formatting Guidelines:

Vendors shall not submit any documents in response to this RFI that are password protected. Any documents not in conformance with these requirements may not be reviewed.

Vendors may submit clarification questions regarding this RFI to the contact above no later than April 25, 2025. The Government may issue a consolidated response to all questions received, at its discretion.

Disclaimer: VHA reserves the right to not respond to any emails, questions, or materials submitted in response to this notice. Responses are for market research purposes only and do not obligate the Government in any way.

Proprietary Information: If your submission contains proprietary information, business sensitive or includes trade secrets, please clearly mark it as “Proprietary Information” on each applicable page. The Government will handle all submissions in accordance with applicable procurement regulations and confidentiality guidelines.

6.0 QUESTIONS

When responding to the questions below, please provide examples from within the last five (5) years, if applicable. If you have addressed or partially addressed answers to any of these questions in your prior CCN Next Generation responses, feel free to include what you previously provided in your response. Please be as specific as possible in your responses.

PWS Questions

1. What strategies would you propose for managing dental provider availability in underserved or rural areas? PWS Section 3.1 and 3.3 (Network Adequacy and Management).

2. What industry-standard metrics should be considered to evaluate dental network performance and beneficiary satisfaction? PWS Section 5.7 and 13 (Performance Requirements & Clinical Quality).

3. How does your organization ensure accuracy and completeness of submitted documentation for claims and audit purposes? PWS Sections 8 & 12 (Medical Documentation & Program Integrity).

4. What are industry norms regarding the integration of diagnostic imaging (e.g., X-rays, intraoral photos) into electronic documentation returns? PWS Section 8.2 and 8.4 (Data Elements & Compliance).

5. What is the industry standard for turnaround time on prior authorization requests for dental services? PWS Section 6 (Referrals / Request for Services) and related claims sections.

6. What technologies or systems do you use to manage utilization review, and how do they integrate with provider workflows or electronic dental records? PWS Sections 12 & 13 (Program Integrity and Clinical Quality).

7. What data or documentation is typically required from providers to support prior authorization or utilization review for common dental procedures? PWS Sections 8 and 12.

8. How can prior authorization be implemented efficiently to minimize delays in care and administrative burden for providers? Referral process and Customer Experience mandates.

9. Briefly describe your company’s experience in providing Project Management of a Dental Network as outlined in the PWS. Provide a detailed brief of your company’s understanding of each section of the PWS, the QASP, and Manual.

Acquisition Process Questions

1. Market Interest: Based on your review of the draft Performance Work Statement (PWS), would your organization be interest in submitting a proposal (RFP) as currently written? If not, please briefly describe any barriers or concerns that may prevent your participation.

2. Alignment with Commercial Best Practices: Are there elements of the draft PWS that diverges significantly from standard industry practices for dental benefit administration? Please list any specific requirements or expectations that may impose unnecessary burden or deviate from commercial norms.

3. Scalability and Infrastructure Readiness: Based on your review of the VA dental network standard, does the draft PWS reflects an approach that could be scaled to a similar level of nationwide coverage, including U.S territories? Are there any infrastructure expectations-such as claims processing or beneficiary support that may not align with current commercial capabilities?

4. Experience: How many years has your company performed the services/task outlined in the attached PWS?

5. Contracts: Has your company performed or worked with the Federal Government or any other level of Government managing the scope of services/task outlined in the PWS? Does your company have or previously have a Federal Government contract for the scope of services/task outlined in the PWS? Please provide Contract Number, Agency, and value.

Technical Questions

1. Are there any recommended additions, deletions, or clarifications to the CDT Codes or dental services outlined in the draft manual or referenced documents?

2. What strategies would you organization propose for ensuring or improving dental provider availability in underserved or rural areas, including U.S territories? Please describe any proven approaches, challenges, or innovative models you have used in similar programs.

3. What industry standard metrics are commonly used to evaluate dental network performance and beneficiary satisfaction? Please identify specific benchmarks or reporting methods that are widely accepted.

4. Are there technologies, operational models, or tools that the Government should consider adopting to improve access to care or reduce administrative burden (e.g., claims processing, provider credentialing, or beneficiary engagement)?

5. What processes or systems does your organization use to ensure the accuracy and completeness of claims documentation, particularly in support to audit readiness and regulatory compliance.

6. Are there emerging standards or technologies (e.g., FHIR, APIs, teledentistry platforms) that the Government should consider enabling more efficient data exchange and improve program interoperability?

7. What are the industry norms and technical standards regarding the integration of diagnosis imaging (e.g., X-rays, intraoral photos) into the electronic claims submissions and documentation returns?

8. What elements of the PWS/manual would benefit most from additional clarification or revision before formal solicitation?

9. What are the industry standards for turnaround times on prior authorization request for dental services? Please specify any commonly accepted timeframes and influencing factors.

10. What utilization management strategies are commonly used in large-scale dental plans? Please include examples such as clinical decision support tools, retrospective process review.

11. How can prior authorization be implemented efficiently to minimize delays in care and administrative burden for providers?

12. What technologies or systems do you use to manage utilization review, and how do they integrate with provider workflows or electronic dental records?

13. What data or documentation is typically required from providers to support prior authorization or utilization review for common dental procedures?

14. Are there best practices for reducing unnecessary care while maintaining access and quality in a population-based dental program?

15. Are there the options standards for reviewing identified quality concerns of a practice or provider?

7.0 ATTACHMENTS

See attached document: Attachment 1 – CCN Next Gen - Dental Network PWS See attached document: Attachment 2 – CCN Next Gen - Dental Network Contractor Manual See attached document: Attachment 3 – CCN Next Gen - Dental Network QASP See attached document: Attachment 4 – CCN Next Gen Dental Draft RFP Program Concepts See attached document: Attachment 5 - Vendor Responses Template See attached document: CCN Next Gen Dental_PWS_v7.2_RFI Draft.

See attached document: CCN Next Gen_Draft_Dental_Manual_v3.1.

See attached document: CCN Next Gen_Dental QASP_Draft.

See attached document: CCN Next Gen Dental DRAFT RFP Program Concepts v.01.

See attached document: CCN Next Gen_Vendor Responses Template.

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