Attachment 3 - CCN Next Gen - Medical East TOPR Price Schedule v3.xlsx

This is a pricing template for the Community Care Network (CCN) Next Generation Medical contract with the Department of Veterans Affairs. The template establishes the pricing structure for medical and pharmacy services to be provided over a six-year performance period consisting of a base year plus five option years.

The pricing schedule encompasses sixteen primary CLINs covering healthcare services, medications, administrative services, and optional implementation tasks. Core services include healthcare services priced at Medicare rates (CLIN X001), waiver of payment rates above Medicare or VA Fee Schedule (CLIN X002), seasonal vaccinations (CLIN X003), VA Fee Schedule services (CLIN X004), non-Medicare/non-VA services at 50% billed charges (CLIN X005), and urgent/emergent medications priced as a percentage of Average Selling Price (ASP) with associated dispensing fees (CLINs X006-X007). Administrative services are priced monthly per enrolled veteran population for both healthcare and pharmacy benefits management (CLIN X008). Fixed-price lump sum pricing is required for implementation (CLIN X011) and transition out services (CLIN X012). Optional CLINs include appointment scheduling and care coordination services priced per approved referral across five tiers (CLINs X014-X015), and software development tasks in five size categories from extra-small to extra-large (CLIN X016). Organ acquisition costs are capped at 100% of Medicare rates per CMS guidelines (CLIN X009), and incentive/disincentive percentages are included for adverse credit reporting and value-based care performance (CLIN X010). The template includes separate basis of estimate (BOE) documentation requirements for each CLIN to support offeror pricing submissions.