Attachment 3 - CCN Next Gen - Medical West 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 pricing structures across six budget years (Base Period through Year 5 with an Option to Extend) for healthcare services delivered through the Medical West network, with pricing organized by 16 primary CLINs (Contract Line Item Numbers) and multiple sub-CLINs.

The core healthcare services CLINs establish pricing at Medicare rates (CLIN X001), including standard Medicare rates and PPS-exempt rates, with additional CLINs for VA Fee Schedule services (CLIN X004), non-Medicare/non-VA services at 50% of billed charges (CLIN X005), and waivers of payment rates above established schedules (CLIN X002). Pharmacy-related CLINs include pricing for urgent and emergent medications—both brand name and generic—priced as percentages of Average Wholesale Price (AWP) with per-unit dispensing fees (CLINs X006 and X007), and organ acquisition costs at 100% Medicare rates (CLIN X009). Administrative services are priced monthly per enrolled veteran population for both healthcare services and pharmacy benefits management (CLIN X008). Optional CLINs include implementation costs (CLINs X011 and X013) as fixed lump sum amounts, transition-out services (CLIN X012), appointment scheduling and care coordination across five tiers priced per approved referral (CLIN X014), care coordination follow-up per referral (CLIN X015), and software development tasks in five size categories from extra-small to extra-large priced per task (CLIN X016). The template also requires basis-of-estimate (BOE) documentation for multiple CLINs to support the offeror's pricing proposals.