ATTACHMENT A - HCCH I Questions.docx

EXHIBIT A

Request for Information (RFI) Questioner Health Care Clearing House (HCCH) Revenue Transactions Processing

Required Knowledge, Skills & Abilities for providing Revenue Transactions Processing Please provide a detailed narrative for each technical question below that demonstrates how your firm currently possesses the capabilities to deliver the following revenue transaction processing requirements as specified and in the estimated quantities.

Your responses should provide: Existing demonstrated capability, demonstrated capacity, demonstrated knowledge and expertise, and demonstrated past experience in the following areas:

RFI QUESTIONS:

NAICS code(s) : 518210 Data Processing, Hosting, and Related Services

1. Is your organization a healthcare electronic data interchange (EDI) clearinghouse?

2. As the “prime” vendor do you own and operate the physical EDI information systems/data processing centers and equipment that will be used conduct the actual EDI transactions listed in the PWS?

3. Does your company have the ability to support and process the following batch/real-time transactions and relevant code sets?

Batch Transaction: VA Proprietary file formats.

Real-Time Transaction: VA Proprietary file formats Real-Time Transaction: HIPAA 270/271 Healthcare Eligibility Inquiry and Response Batch Transaction: Insurance Coverage Discovery Real-Time Transaction: Insurance Coverage Discovery

4. Does your company have the ability to support and process the following batch/real-time transactions and relevant code sets at the current estimated annual volumes listed below?

Estimated Annual Provider Transaction Volumes

5. Is your organization a fully Accredited Healthcare Network (HNAP-EHN) by the Electronic Healthcare Network Accreditation Commission (EHNAC) or can you reasonably demonstrate the certification process has begun, and full accreditation will be obtained by the effective date of this contract? (Reference: https://accreditation.directtrust.org/programs/healthcare-networks)

a. Alternately, has your organization’s information system (software platform) been processed through the Veterans Administration (VA) Assessment and Authorization (A&A) processes as a FISMA-High security system and obtained a VA Authority To Operate (ATO) or can you reasonably demonstrate the certification process has begun and a full ATO would be granted by the effective date of this contract? (Reference: VA Handbook 6500 https://www.va.gov/vapubs/viewPublication.asp?Pub_ID=1254)

6. Is your organization certified by DataSpring powered by Council for Affordable and Quality Healthcare (CAQH) as a Committee on Operating Rules for Information Exchange (CORE) Phase II Certified trading partner for both batch and real-time HIPAA 5010 X12 270/271 Health Care Eligibility Benefit Inquiry and Response transactions or can you reasonably demonstrate the certification process has begun and full certification will be obtained by the effective date of this contract? (Reference: https://www.dataspring.com/core/operating-rules)

7. Small business concerns: The batch/Realtime EDI transactions are considered the greater preponderance of the work outlined in the PWS. As such, please discuss how your company would meet the 50 percent rule outlined below.

52.219-14 Limitations on Subcontracting.

As prescribed in 19.104-3(c), insert the following clause:

LIMITATIONS ON SUBCONTRACTING (DEVIATION DATE)

(a) This clause does not apply to the unrestricted portion of a partial set-aside.

(b) Definition. Similarly situated entity, as used in this clause, means a first-tier subcontractor, including an independent contractor, that—

(1) Has the same small business program status as that which qualified the prime contractor for the award (e.g., for a small business set-aside contract, any small business concern, without regard to its socioeconomic status); and

(2) Is considered small for the size standard under the North American Industry Classification System (NAICS) code the prime contractor assigned to the subcontract.

(c) Applicability. This clause applies only to—

(1) Contracts that have been set aside for any of the small business concerns identified in 19.000(a)(3);

(2) Part or parts of a multiple-award contract that have been set aside for any of the small business concerns identified in 19.000(a)(3);

(3) Contracts that have been awarded on a sole-source basis in accordance with sections 19.105, 19.106, 19.107, and 19.108;

(4) Orders expected to exceed the simplified acquisition threshold and that are set aside for small business concerns under multiple-award contracts, as described in 8.4 and 16.5;

(5) Orders, regardless of dollar value, that are set aside in accordance with sections 19.105, 19.106, 19.107, and 19.108 under multiple-award contracts, as described in 8.4 and 16.5; and

(6) Contracts using the HUBZone price evaluation preference to award to a HUBZone small business concern unless the concern waived the evaluation preference.

(d) Independent contractors. An independent contractor shall be considered a subcontractor.

(e) By submission of an offer and execution of a contract, the Contractor agrees that in performance of a contract assigned a North American Industry Classification System (NAICS) code for—

(1) Services (except construction), it will not pay more than 50 percent of the amount paid by the Government for contract performance to subcontractors that are not similarly situated entities. Any work that a similarly situated entity further subcontracts will count towards the prime contractor's 50 percent subcontract amount that cannot be exceeded. When a contract includes both services and supplies, the 50 percent limitation shall apply only to the service portion of the contract;

(2) Supplies (other than procurement from a nonmanufacturer of such supplies), it will not pay more than 50 percent of the amount paid by the Government for contract performance, excluding the cost of materials, to subcontractors that are not similarly situated entities. Any work that a similarly situated entity further subcontracts will count towards the prime contractor's 50 percent subcontract amount that cannot be exceeded. When a contract includes both supplies and services, the 50 percent limitation shall apply only to the supply portion of the contract;

(3) General construction, it will not pay more than 85 percent of the amount paid by the Government for contract performance, excluding the cost of materials, to subcontractors that are not similarly situated entities. Any work that a similarly situated entity further subcontracts will count towards the prime contractor's 85 percent subcontract amount that cannot be exceeded; or

(4) Construction by special trade contractors, it will not pay more than 75 percent of the amount paid by the Government for contract performance, excluding the cost of materials, to subcontractors that are not similarly situated entities. Any work that a similarly situated entity further subcontracts will count towards the prime contractor's 75 percent subcontract amount that cannot be exceeded.

(f) The Contractor shall comply with the limitations on subcontracting as follows:

(1) For contracts, in accordance with paragraphs (c)(1), (2), (3) and (6) of this clause— [Contracting Officer check as appropriate.]

□ By the end of the base term of the contract and then by the end of each subsequent option period; or

□ By the end of the performance period for each order issued under the contract.

(2) For orders, in accordance with paragraphs (c)(4) and (5) of this clause, by the end of the performance period for the order.

(g) A joint venture agrees that, in the performance of the contract, the applicable percentage specified in paragraph (e) of this clause will be performed by the aggregate of the joint venture participants.

(1) In a joint venture comprised of a small business protégé and its mentor approved by the Small Business Administration, the small business protégé shall perform at least 40 percent of the work performed by the joint venture. Work performed by the small business protégé in the joint venture must be more than administrative functions.

(2) In an 8(a) joint venture, the 8(a) participant(s) shall perform at least 40 percent of the work performed by the joint venture. Work performed by the 8(a) participants in the joint venture must be more than administrative functions.