Attachment 3 - CCN Next Gen Medical - East TOPR Price Schedule v6.xlsx

This is a pricing template for the Community Care Network (CCN) Next Generation Medical East contract, establishing the cost structures and billing mechanisms for healthcare services provided to Veterans through a network of community care providers. The template covers a base period plus five option years and requires offerors to provide pricing across sixteen primary CLINs (Contract Line Item Numbers) and associated sub-CLINs.

The pricing structure encompasses diverse healthcare service categories including standard Medicare-rate healthcare services, PPS-exempt services, waivers of payment rates, seasonal vaccinations and adult immunizations, VA fee schedule services, non-Medicare/non-VA fee schedule services, urgent and emergent medications (both brand name and generic with AWP-based pricing), disaster response medications, administrative services for healthcare and pharmacy benefits management, organ acquisition costs, performance incentives/disincentives, and implementation/transition services. Optional CLINs address healthcare appointment scheduling and comprehensive care coordination across five tiers, care coordination follow-up services, and software development tasks in five size categories (XS through XL). Pricing methodologies include percentage-of-Medicare rates, percentage-of-VA-fee-schedule rates, percentage markups on AWP (Average Wholesale Price), monthly per-enrolled-veteran-population fees, fixed lump-sum amounts for implementation and transition activities, per-referral fees, and per-task software development pricing. The template requires offerors to submit detailed basis-of-estimate (BOE) documentation for multiple CLINs including waivers, vaccinations, medications, administrative services, implementation, transition, optional task implementation, appointment scheduling, care coordination follow-up, and software development services.