Questions and Answers 75D301-21-R-71962 complete.xlsx
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This document provides details regarding a federal contract opportunity with the Centers for Disease Control and Prevention to establish and operate the World Trade Center Health Program Nationwide Provider Network. The five-year time and material contract will provide limited health care delivery services including contract management, member services, program communications, establishing and maintaining a nationwide provider network, administering monitoring and treatment, conducting physician determinations and certifying requests, administering end-to-end medical benefits claims and billing programs, coordinating benefits with private health insurance for survivors, performing quality assurance controls, conducting case management and care coordination. Questions are due by email by August 4, 2021 using the specified template. Award will be made using best value tradeoff procedures. The opportunity provides services for responders and survivors of the 9/11 attacks living outside the New York metropolitan area.
The accompanying document contains questions and answers related to the federal contract opportunity. It addresses topics such as key personnel, government property, deviation requests, proposal contents, submission instructions, past performance questionnaires, provider agreements, call volumes, case management details, claims processing, quality assurance plans, and various performance requirements.
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NPN_RFP_Q-A
| RFP 75D301-21-R-71962 | ||||
| Question | ||||
| Number | RFP or Attachment Page Reference | |||
| (if applicable) | Question | CDC Response | ||
| 1 | RFP: p.14 CDCA.H009 Key Personnel | |||
| Attachment G.1: pp.9-10 Section 4.2.1 | The table on p.14 of the solicitation lists two key personnel, while section 4.2.1 of the PWS lists a total of eight (8). Please clarify. | Key Personnel table has been revised. | ||
| 2 | RFP: p.6 FAR 52.252-2 | |||
| RFP: p.20 CDCA_H040 | The Gov't includes FAR 52.245-1 Government Property (Jan 2017). Is there Gov't property associated with the current contract? If so, can the Gov't provide a detailed listing of that property? | There is no Government property associated with the current contract, and the clauses have been removed from the RFP. | ||
| 3 | RFP: p.39 E.10 Proposal Contents | Per the solicitation, the Offeror is expected to comply with all requirements of the PWS unless a deviation is authorized for the government. Would the government provide information on how to request such an authorization to allow for greater solution innovation? | A change request can be submitted. A template will be provided upon award. See SECTION 4.2.5 – Change Request and Control Process | |
| 4 | RFP: p.39 E.10 Proposal Contents | The last paragraph before the example states that the CRM does not count against any of the proposal 25-page limitation. Please confirm that the page limitation is 60 pages as noted on page 38. | Page limitation is 60 pages. Reference before CRM example has been corrected. Proposal contents is now E.11 | |
| 5 | RFP: General | Would the government provide detailed submission instructions for the proposal response, such as where to submit and whether the submission is to be electronic or paper? | Additional instructions added to section E under E.9 and E.10 | |
| 6 | RFP: p.39 E.10 Proposal Contents | Please confirm that the page limitations stated does not include cover page, table of contents, and acronym table. | The page limitations do not include the cover page, TOC and Acronym table. | |
| 7 | RFP: p.39 E.10 Proposal Contents | The government requests that "at least one (1) of these references shall be for an experience utilized by the offeror in its Factor 1 - Demonstrated Prior Experience submission." Please explain what the government is referring to. | Revised to, "At least one (1) of these references shall be for an experience utilized by the offeror in its Similar Experience section of their Technical Proposal submission." | |
| 8 | Attachment G.1: pp.20-21 Section 4.6 | Would the government confirm that funding under this contract is solely for the administration of benefits, and that all IHEs, AMEs, diagnostic, screening and treatment services will be paid through the normal claims payment process? | All IHEs, AMEs, diagnostic, screening and treatment services will be paid through the normal claims payment process. | |
| 9 | Attachment G.1: pp.22-23 Section 4.6.7 | Would the government provide an estimate of the number of members who receive case management or care coordination services, their geographic locations (state), and acuity level? | Total members in CM may vary by volume and acuity level monthly as member needs are re-evaluated. Total for June 2021: 3341 members receiving Case Management or Care Coordination services. 121 members (3.6%) are in high acuity Case Management; 127 are pending assessment; 1819 are low acuity; 1274 are moderate acuity. The overall NPN members by geographical location is shown in Attachment G.17 - MAP_NPN_Member_Geographic_Distribution_2021-08-13 | |
| 10 | Attachment G.1: p.38, Section 8 | The deliverables table includes reports for the Preferred Provider Group (PPG). However, the PWS description of the PPG pilot (that was in the Draft PWS) is missing from the PWS as released. Is the PPG pilot in scope for this solicitation? | It is not; the deliverables table has been corrected to remove the PPG reports. | |
| 11 | RFP: p.42, F.2, Factor 1.e |
Attachment G.1: p.9 Section 4.2
| Attachment G.1: p.38 Section 8 | The instructions require a "draft Operations Manual that contains a complete set of written Standard Operating Procedures (SOPS)". Since this document is expected to be several hundred pages, would the government accept an abbreviated format, such as a table or outline, and then delivery of the document according to the statement in Section 4.2 and the Deliverables Table. | The abbreviated version with sufficient details is acceptable. The complete draft is due within 60 calendar days of award. | ||
| 12 | Attachment G.1: pp.14-15 Section 4.3.5 | Please provide current volumes of in-bound and out-bound calls by time zones and the average duration of calls. | See call volume and other workload data in tab "NPN Data", and Attachment G.16 - New_NPN_Stats_2021_8_16. | |
| 13 | RFP: pp.39-40 - E.10 a)1) | The solicitation requires three Past Performance Questionnaires (PPQs). Would the government consider CPARS as an alternative to a PPQ for one of the three past performance references? | Yes, 1 reference can be a CPARS report. | |
| 14 | RFP: pp.39-40 E.10 a)1) | |||
| Attachment G4: p.1 | When are the Past Performance Questionnaires to be returned to the government? | By the proposal submission deadline. | ||
| 15 | Attachment G1: p.11 Section 4.2.3 | Would the government provide current training modules, if they exist, to use in pricing our response? | The government does not provide the training modules. The task requires the contractor to develop the trainings. | |
| 16 | Attachment G1: p.14 Section 4.3.5 | Would the government provide current call scripts? | The call scripts will be provided during the implementation period after award. | |
| 17 | Attachment G1: p.15 Section 4.3.6 | Please provide a copy of the BEAST. | There are two versions--one for Survivors and one for Responders. Both are attached (BEAST-Survivors and BEAST-Responders). See Attachment G.9 - BEAST_For_Responder_Members and Attachment G.10 - DRAFT_BEAST_For_Survivor_Members_2021_08_13 | |
| 18 | Attachment G1: p.17 Section 4.4.1 | Will the NPN need to issue Member ID cards or will the WTC Health Program issue cards? | The NPN will need to issue Member ID cards. | |
| 19 | Attachment G1: p.21 Section 4.6.3 | How many certifications are performed per week? | See response to Question 12 | |
| 20 | RFP: p.40 E.11 | The "Price Breakout Worksheet" template as (Attachment 2) was not provided with the Solicitation. Will the government be providing a template for submission purposes? | Reference corrected to, "The Offeror shall show traceability with the CLINs/Tasks on their submitted pricing Excel spreadsheet, proposed effort, proposed manning levels, and the prices." | |
| 21 | RFP: p.40 E.11 | To ensure consistency of proposals from various offerors will the Gov't provide a listing of the major activity\ies it expects to see in the price proposal? | The price proposal shall include all the tasks and deliverables in the PWS. | |
| 22 | RFP: p.44 F.2 FACTOR 2 a) | The Gov't states that it will determine if the proposal "contains balanced unit pricing". This RFP is T&M. Can the Gov't please clarify what it means by "balanced Unit Pricing" for this RFP? | Reference removed. | |
| 23 | Attachment G.1: pp.22-23 Section 4.6.7 | Would the government provide an estimate of the number of members who receive such services, their geographic locations (state), and acuity level? | See answer to Question 9. | |
| 24 | Attachment G1: p. 14 Section 4.3.5.1 | Are calls to the toll-free number evenly distributed throughout each day, week of the month, month of the year? If not please provide volume loading patterns by time zone and either week or month | See response to Question 12 | |
| 25 | Attachment G1: p.15 Section 4.3.6 | Please provide the average number of benefits counseling requests per month? | See response to Question 12 | |
| 26 | Attachment G1: p.16 Section 4.3.8 | Please provide the average number of NPN members in each time zone? | Please refer to available data on our website. https://www.cdc.gov/wtc/ataglance.html#enrollmentState and Attachment G.17 - MAP_NPN_Member_Geographic_Distribution_2021-08-13 | |
| 28 | Attachment G1: p.21 Section 4.6.5 | Please provide the average number of Medical Director reviews per month? | See response to Question 12 | |
| 29 | Attachment G1: p.22 Section 4.6.6 | Please provide the number of Prescription audits expected per month | There is currently not a prescribed number of prescription audits monthly for the NPN. CCEs currently perform a pharmacy claims review (PCR) monthly on 5% of cancer formulary prescriptions and 5% of non-cancer treatment plans. The NPN will implement a process for pharmacy claims auditing and PCR that ensures effective review of claims for program appropriateness. | |
| 30 | 30 | Please provide the number of 835 RA per month expected as EDI and as Paper RAs | See tab "RA_Types" | |
| 31 | RFP: p.40 Section E.11 | What is the volume of usage of the provider portal (per day/week/month)? | Average monthly utilization approximately 1,675 | |
| 32 | RFP: p.41 Factor 1, 1. Technical Approach | Since both the Project Plan and Contract Work Breakdown Structure (CWBS) will be detailed and lengthy items, may they be provided as attachments and excluded from the page count? | Yes. | |
| 33 | General | For the purposes of estimating costs, will the Government provide an estimated member population growth rate (including new members and transfers) for each year of the anticipated period of performance? | See Attachment G.16 - New_NPN_Stats_2021_8_16, and tab "NPN Data". | |
| 34 | General | Given that not all WTC NPN beneficiaries are federal employees, should provider reimbursement levels for WTC NPN be based on FECA, a federal employee-only program? | Yes, according to Zadroga our reimbursement is based on FECA for all members (survivors and responders) and has nothing to do with a Federal Employee. | |
| 35 | General | Given that these types of treatment are less common for Workers Compensation injuries, would FECA have fully taken into account the level of provider reimbursement that would be fair and reasonable for oncologists, pulmonologists, hospitals or cancer centers? | FECA pricing is available for nearly all codes. The Program does add RVUs and a conversion factor that increase these prices. Most of the time FECA reimburses more than CMS Medicare. | |
| 36 | General | If hospitals, cancer centers, oncologists, and pulmonologists are unwilling to accept FECA reimbursement (i.e., because it is lower than fair and reasonable reimbursement for these provider types), might it impact the WTC beneficiaries’ ability to get the care that they need? | Access to care due to reimbursement is not currently an issue for the Program with very few exceptions. | |
| 37 | General | If the contractor makes reasonable efforts to contract a provider at FECA but is unsuccessful, would the Department of Labor consider granting a reimbursement exception to compensate providers more than FECA? | DOL does not influence the pricing used by the Program. The fee schedule is set by the Zadroga Act (Law). | |
| 38 | General | In order to ensure continuity of care and to facilitate adequate time to build a new network, would the Government be open to the contractor beginning with an existing commercial network and working to build a FECA-based network over a period longer than four months? If the contractor is unsuccessful in getting providers to accept FECA reimbursement, would the Government grant waivers allowing providers who declined FECA to be reimbursed at non-FECA reimbursement longer-term? | There is little to no flexibility with regard to the FECA fee schedule per Zadroga. Providers need to agree to FECA pricing. | |
| 39 | RFP SF 1449, p. 1 | Given the significance of changes present between this RFP and PWS and the draft PWS that was included in the presolicitation, would the Government consider extending the deadline to allow for a 60 day turn around time? | We will not. The functions have not changed; we have just added additional detail. | |
| 40 | RFP Section C, p. 14; PWS pp. 9-10 | per the solicitation, the Offeror is expected to comply with all requirements of the PWS unless a deviation is authorized for the government. Would the government provide information on how to request such an authorization to allow for greater solution in | See answer to Question 3. | |
| 41 | RFP Section C, p. 18 | Will the CDC-provided records management training be required for our provider network or just internal teams? The statement reads "all contractor employees assigned to this contract who create, work with, or otherwise handle records are required to take the CDC-provided records management training." Our provider network receives/handles records as part of their exam process. | CDC-provided records management training will only be required for those who have active CDC email accounts. | |
| 42 | RFP Section C, p. 25 | Do we need to submit Non-Disclosure Agreements with the proposal; or after contract award? | After contract award. | |
| 43 | RFP Section E, pp. 38-39 | The technical instructions reference a 60-page limit for the technical proposal and but also references a 25-page limit for the technical proposal in the paragraph about the Cross Reference Matrix (CRM). Could the Government please clarify the page limitation for the Technical Volume? | See answer to Question 4. | |
| 44 | RFP Section E.7, pg. 37 | Reps and Certs; E.7 states, "Representations and certifications found in Section K that are not on the SAM website must be completed and submitted in hardcopy format under Tab 3 of business proposal." As there is no Section K, can the agency clarify what, if any, reps and certs they wish the offeror to include outside of sam.gov? | E.7 SUBMISSION OF REPRESENTATIONS AND CERTIFICATIONS has been removed. | |
| 45 | RFP Section E, p. 40 | Section states, "Offerors shall submit a Data Management Plan (DMP)." Does this count toward the 60-page limit? | No. | |
| 46 | RFP Section F, p. 41 | We interpret that Section F provides instructions for the agency's desired outline/arrangement of the proposal, Section 1) Tech Approach, 2) Management Plan, 3) Staffing Plan, 4) Similar Experience (Past Performance), and 5) Phase In/Phase Out Plan, as Section E instructions only provide four categories: general approach, staffing and management plan, organization chart, transition/implementation plan and key deadline dates. We would like to confirm that the agency wishes offerors to follow the Section F Evaluation Criteria outline for the arrangement of the Technical Proposal. | Section F has been corrected. Incorporate organization chart that reflects dedicated teams and functions during different phases of your proposed work plan (i.e., pre-transition, transition, implementation phases, etc.,) including needed timeline for each phase, into appropriate elements in Section E: | |
| 1. | Technical Approach | |||
| 2. | Management Plan | |||
| 3. | Staffing Plan | |||
| 4. | Similar Experience | |||
| 5. | Phase In/Phase Out Plan |
To clarify, Similar Experience is a separate factor from past performance.
47 RFP Section E, p. 42; PWS, p. 39 In the PWS, Section 8 Deliverables/Reporting Schedule, it is stated that the Implementation Plan (Phase in) is due "Within 30 calendar days of contract start date." However in the RFP, Section E.10, it is included in Proposal Contents, "The narrative plan shall include a general approach, a staffing and management plan, organization chart, transition/implementation plan and key deadline dates." It is also included in Section F.2, Factor 1, 1.d. "The Offeror shall provide a draft implementation plan...." Does the Implementation/Transition In plan need to be submitted with the Proposal? If so, is it included in page count? And, does the agency want it included in the Technical narrative or as an Appendix? A Phase In/Phase Out Plan is due as part of the proposal. Factor 1, 1.d. relocated to be part of Factor 1, 5. Phase In/Phase Out Plan. The Implementation Plan in Section 8 is a final deliverable due after award.
The Phase In/Phase Out Plan is excluded from the page count.
48 RFP Section F, p. 42; PWS Section 8 RFP Evaluation Criteria, Section F.1.e states, "The Offeror shall provide a draft Operations Manual that contains a complete set of written Standard Operating Procedures (SOPs) which guide all contract-related services, processes, systems, and activities. The SOPs shall be used to meet the objectives outlined in the PWS and provide the requisite security and process support for the WTC Health Program to include evidentiary documentation for formal federal audits as well as Security Certification and Accreditation of contractor-provided systems for the Program. The NPN Operations Manual shall be aligned with the Administrative Manual for the WTC Health Program and the Zadroga Act (2011, 2015). The key contents of the Operations Manual shall include all requirements and how the Offeror will successfully implement them. See SECTION 8 of the PWS for details." However, PWS Section 8, Deliverables/Reporting Schedule, states that the Operations Manual is due 60 days after contract start date." Is submission of an Operations Manual required with proposal submission? If so, is it excluded from page count? Submission of an Operations Manual is required with proposal submission. It is excluded from the page count.
The manual due in the PWS is the final version of the manual. Any updates are due 60 days after contract award per the deliverables table.
49 PWS Section 4.1, p. 7 "All required services must be successfully implemented for the incoming contractor to begin performance of the contract on the contract start date." Our assumption is this requirement does not apply to Section 4.6.8 Utilization Management because the PWS states, "The NPN contractor shall establish a formal utilization management process with secure documentation platform, nationally recognized evidence-based guidelines, and timeline for initiation and expansion of the UM process." Could the Government please clarify the discrepancy between these two timelines? The RFP states "All required services must be successfully implemented for the incoming contractor to begin performance of the contract on the agreed upon contract ”Go-Live” date." The government does not understand the question.
Go-Live Date: Set date where the NPN is fully operational, independent, and available for use following the implementation period.
| 50 | PWS Section 4.2.1, p. 9 | For the key personnel roles of Senior Account Manager and Program Manager, would the Government consider removing the bachelor's degree requirement and replacing it with 5 or 10 years' experience in an account management or program management role? Or would the Government consider accepting 5+ years of experience in an administrative leadership role on the WTCHP in lieu of a bachelor's degree? | This is one of the most senior personnel to lead a nationwide and highly complex program; therefore, formal education and required experience are needed. Equivalent formal training with relevant credentials will be considered for the Program Manager role. PWS has been updated. |
| 51 | PWS Section 4.2.1, p. 12 | In Section 8, the Staffing Plan is referenced as part of the Operations Manual. If the Government wishes offerors to submit a Staffing Plan, but not an Operations Manual, would it be included in 60-pg limit; and is it preferred in the technical narrative or as an Appendix? | Staffing plan is part of the 60-page limit of the proposed technical approach. |
| 52 | PWS Section 4.2.3, p. 11 | Section 4.2.3 references, "Training shall be tracked and reported as required in SECTION 8." However, no trainings are listed in the Section 8 Deliverables; could the Government please clarify? | This includes participation in trainings delivered by the vendor, as well as compliance with other trainings required by the government. Records should be made available to the government and report in program progress reports, including the monthly report. |
| 53 | PWS Section 4.2.3 and Deliverables, p. 12 | The PWS references a Preferred Provider Group (PPG) in Section 4.2.3 and in the Deliverables. Is this in error or will there be a PPG requirement added to the PWS? | The PPG requirement has been removed from the PWS. |
| 54 | PWS Section 4.2.3, p. 12 and PWS Section 4.5.4, p. 19 | Please resolve provider training obligations between PWS section 4.2.3 ("B. Annual trainings for all enrolled providers") and PWS section 4.5.4 ("Training shall occur at provider enrollment and on an ongoing basis as needed"). Is it the expectation that providers be trained "as needed" or through a formal "annual training"? | Provider network management should cover training plan that should have clearly defined frequencies and competencies to ensure compliance, including training when onboarding, annually and as needed/targeted (i.e., a target group of provider who are not in compliance with COB policy). One of our priorities is to avoid balance billing to our members. 4.7.3.12 |
| 55 | PWS Section 4.2.3, p. 12 | Is it the Government's intention that providers will not be authorized to deliver services if they do not agree to required training? If so, how does the Government intend to require compliance for low volume providers? Are the training requirements the same for providers that perform annual exams v. treatment? Will the time spent in training be reimbursable? | Define your standards and activities to meet Program's requirements in your network management plan. Pricing structure and estimate should be clearly defined and described in your budget proposal. |
| 56 | PWS Section 4.3.4, p. 13 | Please define "in absolute terms." | Measured by itself, not in comparison with other things. |
| 57 | PWS Section 4.3.5 (7), p. 14 | Can the Government please clarify this requirement with respect to "on-call emergency messaging for returned calls?" | Describe your approach to handle emergency calls during and after hours. |
| 58 | PWS Section 4.3.5 (10), p. 14 | Would the Government consider a more cost-effective service standard of answering 80% of calls in 60 seconds with a 3% abandonment rate? These metrics will provide for high member satisfaction with the call center while achieving cost savings. | You may discuss your approach by defining your service levels, average answering speed and QA/QC with key performance indicators and that should reflect in your business proposal. A comparison of different indicators and approach would be welcomed. |
| 59 | PWS Section 4.3.6, p. 16 | Assume this is administered annually | Benefits counseling should be included in your approach to member services and how you assess member needs at point of service or encounter. The BEAST shall be administered in conjunction with each annual monitoring visit, with additional administrations upon request or as appropriate based on changes to member status that may affect benefit eligibility (e.g., certification). PWS has been updated to reflect this. |
| 60 | PWS Section 4.3.9, p. 16 | Can the Government please clarify that the verbiage in Section 8 applies throughout the PWS and RFP? "When a timeframe for completion is specified (for example, “within 45 days”), “days” refers to calendar days unless otherwise stated. If the deadline calculated in this way falls on a weekend or a federal holiday, the contractor may comply with the deadline on the next business day, unless otherwise stated." | Yes; any time a deadline falls on a weekend or a federal holiday, the contractor may comply with the deadline on the next business day, unless otherwise stated. |
| 61 | PWS Section 4.4.3, p. 17 | Please clarify if the requirements listed are accurate as there is no mention of current and prospective members only member retention. | Yes, the requirements are accurate. Retention activities and benchmarks apply to current member. Outreach applies to prospective members. |
| 62 | PWS Section 4.5.1, p. 18 | Will the Government allow provider specialists that are qualified, but not specifically board-certified, to participate in the NPN? | Potentially, please describe enrollment and credential process as part of your network management approach. |
| 63 | PWS Section 4.5.2, p. 18 | Section 4.5.2 refers to "Program approved network agreement." Does this imply that the Government will have legal ownership of the provider agreement? Or, will the contractor own the agreement (with the Government needing to approve the language in the agreement)? | No, the government will not own the provider agreement, but the vendor is responsible for ensuring that the provider agreement is transparent and inclusive of Program's requirements. |
| 64 | PWS Section 4.5.2, p. 18 | Is the Government able to provide the approved network agreement for offerors to review? | The agreement can be discussed upon award. The requirements are clearly described in the PWS for the vendor to sufficiently consider what to include in the proposed agreement. |
| 65 | PWS Section 4.5.4, p. 19 | Could the Government please clarify what the "equivalent standards" for maintaining accreditation of their healthcare network are? | Standards similar to those used by NCQA or URAC. Describe the standards you are using and if they meet or exceed industry standards. |
| 66 | PWS Section 4.6.2, p. 21 | For conditions not due to 9/11 exposure, is it a correct assumption that the contractor would refer the member to a PCP because the contractor would not have knowledge of which providers are in-network for OHI? | Member services and case management services should be considered when referring a member to his or her primary care provider, if any. |
| 67 | PWS Section 4.6.4, p. 21 | Will the Government provide associated reporting requirements for full understanding in order to incorporate into the solution and proposal response? | See https://www.cdc.gov/wtc/ppm.html for eligibility requirements, Attachment G.12 - 003_TGD_QA_and_Internal_Audits_DRAFT, Attachment G.13 - ReportingDataDefinitions_TPA_NPN_CCE_DC, and Attachment G.15 - TGD-009_Essential_Elements_Monthly_Report |
| 68 | PWS Section 4.6.6, p. 22 | Could the Government please confirm that utilization of an e-scribing software by providers is not required? | It is not required for 100% of providers to use it, but we have updated to require at least 70% of the providers to use it. |
| 69 | PWS Section 4.6.7, p. 23 | "The NPN must include case management reporting requirements in the semi-annual and annual reports as described in TGD-003 (to be provided upon award) and the Administrative Manual (https://www.cdc.gov/wtc/ppm.html)." Will the Government provide the case management reporting requirements in the semi-annual and annual reports as described in TGD-003 prior to award so there is a full understanding of the reporting requirements? | See Attachment G.12 - 003_TGD_QA_and_Internal_Audits_DRAFT |
| 70 | PWS Section 4.6.7, p. 23 | Could the Government please confirm if RNs holding licensures based on their regional areas of coverage according to the Case Management Society of America standards of practice (cmsa.org) is required of the incoming contractor to begin performance of the contract? | Incumbent nurses do not currently hold multi-state licensures; the Government will consider allotting time for the vendor to obtain licensure to cover all states, but expect nurse(s) to apply for required licensure as soon as possible from start date. The vendor should include a reasonable timeline for licensure as part of their proposal. |
| 71 | PWS Section 4.6.7, p. 23 | Could the Government please clarify if RNs holding licensures based on their regional areas of coverage according to the Case Management Society of America standards of practice (cmsa.org) applies to US territories as well? | Please validate with CMSA. |
| 72 | PWS Section 4.6.7, p. 23 | Could the Government please clarify that business hours are 8 am - 5 pm local time unless otherwise stated in Section 4.3.8? | This is correct. |
| 73 | PWS Section 4.6.8, p. 23 | "For detailed information on the NPN Utilization Management program requirements, refer to the Case Management/Utilization Management Standard Operating Procedure and applicable TGD’s (to be provided upon award)." Will the Government provide the “applicable TGD’s” for full understanding in order to incorporate into the solution and proposal response? | See response to Question 67 |
| 74 | PWS Section 4.6.8, p. 23 | Could the Government please clarify that the timeframe regarding submission of retrospective reviews should adhere to the contractual requirements of the NPN network provider contracts? | Retrospective reviews in regards to PA3s are subject to requirements of the Admin Manual. Attachment G.14 - 016_TGD_RetrospectiveAuthorizations_TGD_Final |
| 75 | PWS Section 4.6.8, p. 23 | "The NPN shall provide a UM plan as part of the Operations Manual to include the following elements…. #2 states Notification process for members admitted for inpatient hospitalizations, as well as all other levels of care including: Rehab, SNF, etc." Please confirm that the notification is prior to and/or at the time of admission, versus retrospective from claims data. | Correct. Services require pre-authorization; this is not based on claims data. |
| 76 | PWS Section 4.6.8, p. 23 | "The NPN shall provide a UM plan as part of the Operations Manual to include the following elements….#3 Concurrent review and continued stay review processes for IP hospitalizations." Please confirm these processes are required for any/all inpatient hospitalizations beginning at the point of admission through to discharge. Please confirm this includes behavioral health admissions/inpatient stays. | Concurrent review and Continued Stay reviews will be appliable to all inpatient hospitalizations, admission through discharge. Planned admissions should be pre-authorized and related to certified conditions. Behavioral health admissions included. |
| 77 | PWS Section 4.6.8, p. 23 | "The NPN shall provide a UM plan as part of the Operations Manual to include the following elements….#5 Discharge planning." Please confirm scope of discharge planning. Is this for any/all levels of care as listed in #2 for notification processes? Other? Does this include behavioral health admissions? | The concurrent review process shall have a discharge planning component-member should be assessed for an appropriate discharge plan for all inpatient admissions. UM Review nurse will be available to facilitate discharge planning needs (such as identifying in-network providers). Discharge planning shall include Case Manager post-discharge outreach to member to identify any change in member needs. |
| 78 | PWS Section 4.6.8, p. 23 | "The NPN must include utilization management reporting requirements in the semi-annual and annual reports as described in TGD-003 (to be provided upon award) and the Program’s Administrative Manual (https://www.cdc.gov/wtc/ppm.html)." Will the Government provide the reporting requirements in the semi-annual and annual reports as described in TGD-003 prior to award so there is a full understanding of the reporting requirements? | See response to Question 67 |
| 79 | PWS Section 4.7.2, p. 24 | "The contractor shall utilize an existing automated claims processing system to process and adjudicate claims with business rules to apply WTC health program’s distinct benefit coverage plans (To be provided upon award)." Will the Government provide the business rules for WTC prior to award, so there is a full understanding of the scope of the rules for adjudication that must be applied? | Industry standard business rules and edits including NCCI, MUE. Program specific rules and edits such as benefit limits and certain codes will be provided upon award. |
| 80 | PWS Section 4.7.2, p. 25 | Could the Government provide more details around how penalties will be assessed? | It will be based on the QASP. Penalties apply to the contractor's CPARS evaluations. |
| 81 | PWS Section 4.7.2, p. 25 | Could the Government confirm if it is the intention to have NPN claims adjudicated, edited, and priced by the NPN contractor and passed directly to NGS versus the HPS contractor? | Yes, this is the intention. |
| 82 | PWS Section 4.9, p. 30 | Will the Government provide the “applicable TGD’s” for full understanding in order to incorporate into the solution and proposal response? | See additional posted attachments |
| 83 | PWS Section 5, p. 35 | The PWS references a Quality Assurance Surveillance Plan (QASP) that will be used to ensure that the Contractor is performing the services required by this PWS in an acceptable manner. Will the Government provide the QASP for full understanding in order to incorporate into the solution and proposal response? | See Attachment G.11 - DRAFT_QASP_2021_08_13 |
| 84 | PWS Section 5, p. 35 | The PWS indicates that a Performance Based Service Assessment Survey will be used in combination with the QASP to assist the Program in determining acceptable performance levels. Can further clarification be provided regarding the Performance Based Service Assessment Survey and how it will be used? | The Performance Based Service Assessment Survey has been removed from the PWS. |
| 85 | PWS Section 5.1, p. 35 | The PWS indicates that required services will be "selected for incentive and disincentive payments." Could the Government please clarify what the criteria will be for incentives and disincentive payments? | See response to Question 83. Incentive and disincentive payments are not included in this contract and the reference has been removed from the PWS. |
| 86 | PWS Section 5.1, p. 35 | "This QASP is a living document and the Government may review and/or revise it on a regular basis at a minimum of annually." Understanding that the Government may review and/or revise the QASP at any time, no less than annually, could the Government please define the time line for the Contractor to implement the changes from the point of QASP revision to full implementation. | At least 30 calendar days. |
| 87 | PWS Section 8, p. 36 | Will the Government provide a list of Performance Objectives (Service Summary Table previously provided in the draft PWS)? | See response to Question 83. |
| 88 | PWS Section 8, p. 38 - Ad-hoc Reports | Could the Government clarify if there is a maximum number of ad-hoc requests the Program can request in a specified time period? | May be up to two ad hoc reports a quarter, but generally just one a quarter. We will consider complexity, availability of data and information and urgency. |
| 89 | PWS Section 8 , p. 39 (compared to RFP Section D, Deliverables, p. 29) | Deliverable: Roster |
PWS lists Due Date: By effective date of this contract RFP lists Due Date: Within 14 days of the effective date of this contract and monthly thereafter or upon request; Within 14 days of any change to the roster
| Could the Government please clarify the requirements? | PWS corrected to, "Within 14 days of the effective date of this contract and monthly thereafter or upon request; Within 14 days of any change to the roster" | ||
| 90 | PWS Section 8 , p. 39 (compared to RFP Section D, Deliverables, p. 30) | Deliverable: List of Personnel with defined roles and responsibilities |
PWS lists Due Date: Prior to performing any work on behalf of HHS RFP lists Due Date: Prior to performing any work on behalf of HHS/CSC/NIOSH/WCTHP and annually thereafter or upon request; with a change of personnel, roles and responsibilities
| Could the Government please clarify the requirements? | PWS corrected to, "Prior to performing any work on behalf of HHS/CSC/NIOSH/WCTHP and annually thereafter or upon request; with a change of personnel, roles and responsibilities." | ||
| 91 | PWS Section 8 , p. 39 (compared to RFP Section D, Deliverables, p. 30) | Deliverable: If the procurement involves a system or cloud service, Disposition/Decommission Plan |
PWS lists Due Date: At contract expiration RFP lists Due Date: 90 days prior to contract expiration
| Could the Government please clarify the requirements? | PWS corrected to, "90 days prior to contract expiration" | ||
| 92 | PWS Section 8 , p. 39 (compared to RFP Section D, Deliverables, p. 30) | Deliverable: Incident reports (as needed) Incident Response Plan |
PWS lists Due Date: As requested by CDC/NIOSH RFP lists Due Date: Annually and upon request
| Could the Government please clarify the requirements? | PWS corrected to, "Annually and upon request" | ||
| 93 | PWS Section 8 , p. 39 (compared to RFP Section D, Deliverables, p. 30) | Deliverable: Syslog-ng; daily audit logs |
PWS lists Due Date: Daily at minimum/as requested by CDC/NIOSH
| This deliverable was not included in RFP Section D Deliverables; could the Government please clarify the requirement? | Requirement added to RFP Section D. | |||
| 94 | PWS Section 11, p. 41 | Is it feasible for the contractor to use a current Authorization to Operate (ATO) from Health and Human Services as reciprocity for the NIST 800-171 Rev2 requirement in the RFP, or will the Government require the contractor to obtain a separate ATO using a third party assessor post award to receive an ATO? | No, contractor needs to go through NIOSH 800-171 ATO because each federal organization runs their approval process differently. The contractor must still complete the NIOSH System Security Plan and provide all of the required artifacts (i.e. in our evidence listing (i.e. Network Diagrams, Data Flow Diagrams, Hardware Listing, Software Listing, etc.) | |
| 95 | n/a | Will the CDC accept and consider responses from Contractors who cannot provide all services requested? (For example, if we are only interested in providing the Nationwide Provider Network and Claims administration services.) | Vendors may feel free to partner with other vendors or subcontract the work that they cannot provide themselves; however, this solicitation is for the full suite of services outlined in the PWS. | |
| 96 | n/a | Will the CDC provide the annual number of claims expected to be administered and/or a claims file to review? | See response to Question 12 | |
| 97 | n/a | Will the CDC provide the estimated annual call volume that the member services call center would be expected to handle? | See response to Question 12 | |
| 98 | n/a | Will the CDC share the number of providers, by state, that are currently participating in their network? | ChoicePlus is our current network. Public access information can be found here. https://www.uhc.com/employer/health-plans/choice-plus. The number of providers is proprietary information. | |
| 99 | n/a | Does the CDC provide the fee schedule (ceiling rates associated with the FECA) on a routine basis, or would the contractor be responsible for acquiring and maintaining the fee schedule? | The information is publicly available (https://www.dol.gov/agencies/owcp/regs/feeschedule/fee). The contractor should coordinate with the Program for any upcoming changes and effective date. | |
| 100 | n/a | Can the CDC clarify whether the NPN contractor is only responsible for developing a network for members who reside outside the state of New York, or just outside the New York City Metropolitan Area (NYMA)? a. For further clarity, are members inside the NYMA being managed completely separately? b. How many members reside outside the NYMA, but inside the state of New York? | Outside of NYMA. See website and attached stats. https://www.cdc.gov/wtc/ataglance.html | |
| 101 | Attachment G.1 - page 43 | In the staffing plan it mentions security clearances, are they required for key personnel? | Security clearances are not required for any staff. Reference removed from staffing plan language. | |
| 102 | Attachment G.1 - page 7 | Would the CDC accept responses where a vendor requires more than the "estimated (4) four month transition period to become the NPN contractor responsible for completing all required services"? | We would accept proposals from any vendor who can complete the work, and will take into account your approach and transition work plan. | |
| 103 | In Attachment G.4, the Past Performance Questionnaire | Can the CDC clarify this statement: "Submit a copy of the customer’s cover letter with your business proposal to ensure receipt of questionnaire responses." Does this mean the cover letter should be sent to the CDC or to the persons completing the questionnaire? | Cover letter should be sent to both so that the CDC can ensure that we received the questionnaires from who you sent them to. | |
| 104 | RFP, Page 14 and page PWS 9 of 45 | Please confirm the that the Government requires two Key Personnel - Senior Account Manager and Clinical Services Manager as referenced on page 14 of the RFP. We seek this clarification because the Clinical Services Manager is not included on the list of Key Personnel in the PWS Section 4.2.1 - Key Administrative Functions and additional positions, including for example, Program Manager, Medical Director, Business Analyst etc. are included as Key in this section. Also, Section 4.2.1 seems to suggest that there are more than two key personnel position. Please clarify these discrepancies. | See answer to Question 1. | |
| 105 | SF 1449 | Please confirm the time the response is due on 8/26/2021. | Response date and time has been updated in the RFP. | |
| 106 | RFP, Page 38 and page 39 | Please clarify the page limit for the technical proposal is 60 pages. We seek this clarification because E.10, first paragraph in (a) refers to limiting the technical proposal to 60 single-spaced pages of text. But, the seventh paragraph in that same section refers to "the CRM not counting against any of the proposal 25 page limitation". Please confirm. | See answer to Question 4. | |
| 107 | RFP, Page 37, 38, and 40 regarding the Data Management Plan (DMP) | Please confirm that the DMP is exempt from the page count limitations. | See answer to Question 45. | |
| 108 | RFP, E11, c (page 40) | The instructions indicate that there should be an Attachment 2 - Price Breakout Worksheet. This was not included with the Solicitation. Please provide. | See answer to Question 20. | |
| 109 | RFP, Section F.1 regarding Technical Evaluation, specifically F.1.1.e (page 43) requires a Draft Operations Manual. | Would the government consider submission of a draft operations plan within 10 days of the kick off meeting and a final within 7 days of receiving feedback. | See answer to Question 11. | |
| 110 | PWS, Section-4, page-7 | Would the government consider a phased implementation over a 6-month period conditioned on the ability to transition from the incumbent in 4 months. | See answer to Question 102. | |
| 111 | Section 4.2.6-Systems - page 13 (#5) | Does the NPN currently accept/push a member record feed from the HPS contractor? If so, please provide details | Yes, member records are being exchanged through various mechanisms. | |
| 112 | Section 4.3.5-Member Services-Member Call Center-page-14 | Please provide NPN annual inbound and outbound call center volume data, including volumes directed to help desk and support. This should include language identifiers. | See answer to Question 12. | |
| 113 | Section 4.6.7 - Case Management - page 23 | Please provide number of NPN members under case management by month and year. | See answer to Question 9. | |
| 114 | Section 4.7.2-Claims Processing & Payment - page 24 | Is there a specific data format/layout to be used to submit fully adjudicated claims to NGS? | There are two files that we send to NGS each week. One is the D7 which has the claims information and a Remittance File which has the remittant advice. | |
| 115 | Section 4.7.2-Claims Processing & Payment - page 25 | Can you provide the required data fields for WTCHP claims processing? Is this a standard 837/835 process? | It is a standard 835/837 process. | |
| 116 | Section 4.7.2-Claims Processing & Payment - page 25 | Please confirm the current claims clearinghouse vendor? | OptumInsight | |
| 117 | Section 4.7.2-Claims Reporting - page 24 | Please provide annual claim volume data the last 3 years. Data elements should include: date of service, provider TIN, ICD 9/10, CPT Codes, modifiers, clean claims, duplicate claims, non-covered claims, denied claims, and paper claims received | See answer to Question 12. | |
| 118 | Section 5.1 - QASP - page 35 | Please provide draft NPN QASP. | See answer to Question 83. | |
| 119 | Section 4.6.7 Case Management page 22-24 | For case management interactions, what percentage are currently or projected RN's, social services, and non clinical staff? | See Question 9 for a snapshot of members requiring case management. The vendor should propose appropriate staffing ratios in accordance with industry standard. | |
| 120 | Section 4.6.7 Case Management page 22-24 | Please provide current criteria for members requiring case management? | Level "0"-for those members newly assigned to CM and/or pending assessment to determine CM needs. Level "1"- Members clinically stable requiring CM outreach at least every 6-12 months; minimal coordination of services needed. Level "2"-Members intermittently clinical instability; moderately ill requiring CM outreach at least every 3-5 months; moderate coordination of services needed. Level "3"-Clinically unstable, severely ill, declining; CM outreach weekly/biweekly but no less than every 1-2 months; member non-compliant, needs frequent coordination of services. | |
| 121 | Section 4.6.7 Case Management page 22-24 | Please provide current classification of acuity levels for the Program? | See answer to Question 120. | |
| 122 | Section 4.6.7 Case Management page 22-24 | What percentage of cases fall in each level of acuity? | See answer to Question 9. | |
| 123 | Section 4.6.7 Case Management page 22-24 | Please provide geographic distribution of your members, preferably by state and zip code? | See answer to Question 26. | |
| 124 | PWS Section 8 - Deliverables/Reporting Schedule table, page-39 - Computer software, including the source code, if applicable | Is it acceptable to provide the source code via escrow? | Yes, that would be acceptable. | |
| 125 | PWS Section 8 - Deliverables/Reporting Schedule table, page-39 - Other source code, if applicable. | Is it acceptable to provide the source code via escrow? | See answer to Question 124 | |
| 126 | RFP - E.6-page-36 - 508 Compliance | Do all applications (internal/external) need to be Section 508 compliant or only the applications that are customer/client facing? | Everything public as well as deliverables to the government should be accessible. | |
| 127 | SECTION 4.7.2 – Claims Processing and Payment -PG 27 | Does the government require or prefer web service technology for close to real time processing or the of use flat files based on a set frequency? | No requirement. Preference for web service. | |
| 128 | SECTION 4.7.4 – Paper Claims -PG 29 | Please provide approximate volume of paper claims vs electronic claims that we should expect? | See response to Question 30. | |
| 129 | Section E, E.7, page 37 of RFP | Page 37 of the solicitation states that “Representations and certifications found in Section K that are not on the SAM website must be completed and submitted in hardcopy format under Tab 3 of business proposal” however Section K is not available in SAM or in the RFP attachments. Please inform us how best to proceed. | See answer to Question 44 | |
| 130 | RFP Section B, p. 3 | The qty/unit listed in Section B indicates “1 job.” Could the Government please clarify if the basis for the T&M rate is per labor hour? | The unit for 1 job is for the entirety of the labor hours and ODCs for the CLIN. | |
| 131 | RFP Section B, p. 3 | Will there be a separate CLIN for Other Direct Costs other than travel? | Offerors are free to propose separate CLINs for ODCs or include ODCs in the same CLINs as the labor hours. | |
| 132 | RFP Section B, p. 3 | Is it the Government’s expectation that the offeror provides a "not to exceed" amount for each CLIN based on hourly rate or based on total unit incurred? | The Not to Exceed amount for each CLIN should be based on the total of all labor hours and ODCs estimated for each CLIN. | |
| 133 | RFP Section B.1, p. 5 | The RFP indicates this is a T&M contract in section B.1. Will the Government provide a list of labor categories that should be priced? | See "Estimated Labor Categories." Offerors are encouraged to propose their own solutions for the tasks. | |
| 134 | RFP Section B.1, p. 5 | If the Government will not provide a list of labor categories, is it the Government’s expectation that a single T&M rate will be offered per CLIN? | It is the Government's expectation that a total not to exceed amount will be offered per CLIN. See answer to question 132. The business proposal should include the offeror's proposed labor categories, labor rates, and labor hours. |
RA_Types
NPN_Data
| Data to be provided for RFQ |
| New NPN Data |
| Core functions and subcategories |
| Operations and Management | ||||
| Projection | 2021 | 2022 | 2023 | 2024 |
| Networks management (w/at least 1 claim) | 12,105 | 13,529 | 14,954 | 17,804 |
| Historical data from the most recent quarters | ||||
| By quarter | Quarter 1 | Quarter 2 | Quarter 3 | Quarter 4 |
| Member Certifications | ||||
| Total certified members | 9,651 | 9,794 | 9,926 | 10,049 |
| Total certified conditions | 26,896 | 27,198 | 27,464 | 27,758 |
| Certifications per member | 3 | 3 | 3 | 3 |
| Annual and Initial Exams | ||||
| Monitoring Services | 2,086 | 721 | 2,195 | 2,543 |
| Annual Monitoring & Initial Health Exams Services | 471 | 225 | 656 | 769 |
| Attempted scheduling by calls # | 6944 | 5643 | 3150 | 4675 |
| Attempted scheduling by member # | 4009 | 3658 | 2276 | 3735 |
| Type of appoitnments | ||||
| Diagnostic Appointments | ||||
| Completed Appointments | 461 | 579 | 616 | 687 |
| Total Members with Completed Appts | 316 | 360 | 379 | 411 |
| Treatment Appointments | ||||
| Completed Appointments | 1,798 | 1,792 | 1,737 | 1,633 |
| Total Members with Completed Appts | 1,020 | 1,013 | 977 | 934 |
| Member services | Average | Total in 12 months | ||||
| Completed diagnostic by appointment # | 423 | 409 | 394 | 401 | 407 | 2,033 |
| Completed diagnostic by members # | 298 | 298 | 294 | 291 | 295 | 1,475 |
| Completed treatment by appointment # | 2,070 | 1,864 | 1,740 | 1,731 | 1,852 | 9,258 |
| Completed teatment by member # | 1,088 | 1,022 | 978 | 984 | 1,018 | 5,090 |
| Certification process | ||||||
| Non-Cancer Certification Requests | Average | Total in 12 months | ||||
| Completed | 266 | 130 | 124 | 207 | 182 | 908 |
| Total members | 210 | 110 | 103 | 177 | 150 | 749 |
| Cancer Certification Requests | ||||||
| Completed | 161 | 125 | 107 | 191 | 146 | 730 |
| Total members | 141 | 112 | 96 | 174 | 131 | 654 |
| Certifications per Health Condition | |||||
| Upper Airway | 5,558 | 5,745 | 5,886 | 6,071 | At the point of time |
| Lower Airway | 5,262 | 5,460 | 5,595 | 5,734 | |
| Mental Health | 4,870 | 5,042 | 5,150 | 5,271 | |
| Gastrointestinal | 4,579 | 4,827 | 4,996 | 5,157 | |
| Musculoskeletal | 89 | 92 | 97 | 100 | |
| Cancer | 4,661 | 5,272 | 5,740 | 6,226 |
| Transfer | Average | Total in 12 months | ||||
| Transfer in | 36 | 36 | 36 | 32 | 35 | 175 |
| Transfer out | 10 | 10 | 9 | 9 |
| Case management and Care Coordination | |||||
| Total members in case management | 3,310 | 3,332 | 3,312 | 3,239 | At the point of time |
| Members in Intensive Case Management | 186 | 186 | 186 | 186 | |
| Members in case managaement > 6 months | 91 | 112 | 155 | 205 | |
| Benefit couseling and social services | 974 | 949 | 636 | 466 |
| Call center and customer services | ||||
| Inbound # of calls | 4,774 | 5,520 | 5,871 | 5,914 |
| Outbound # of calls | 5,311 | 6,018 | 6,424 | 6,197 |
Estimated Labor Categories
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