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

This is a pricing template for the Community Care Network (CCN) Next Generation Medical West contract offering with the Department of Veterans Affairs. The template establishes a comprehensive pricing structure across six contract line items (CLINs) spanning a base period and five option periods, covering healthcare services, pharmaceuticals, administrative support, and optional services.

Core service CLINs include standard Medicare rate healthcare services (CLIN X001), PPS-exempt healthcare services, waivers of payment rates capped at a maximum percentage above Medicare or VA fee schedules, seasonal vaccinations and adult immunizations priced per unit, VA and Alaska fee schedules, non-Medicare/non-VA/non-Alaska fee schedule services at 50 percent of billed charges, and urgent and emergent medications priced as a percentage of average wholesale price (AWP) with separate tiers for brand name and generic medications plus dispensing fees. Administrative services are priced monthly per enrolled veteran population for both healthcare services and pharmacy benefits management. Additional CLINs address organ acquisition costs at up to 100 percent Medicare rates, performance-based incentives/disincentives for adverse credit reporting and value-based care outcomes, fixed-price implementation and transition-out services, and five optional task categories including appointment scheduling and comprehensive care coordination at tiered pricing per approved referral, care coordination follow-up services, and software development tasks in five size categories (extra-small through extra-large) priced per task. The template includes basis of estimate (BOE) sections for multiple CLINs requiring offerors to provide detailed cost justification for their proposed pricing across all service categories.