Attachment J.20 - Activity_Codes.xlsx
XLSX spreadsheet 19 KB Posted
- Attached to
- World Trade Center Health Program Clinical Centers of Excellence (CCE) - Draft Solicitation
- Solicitation number
- Draft_75D301-22-R-72142
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Changes
| Issue | Actions to reduce CCE costs and provide increased oversight | Responsible Person | Mechanism | Complete Y/N | Notes |
| Provide a listing of position titles and their definition that may be billed to each CLIN. | SOW | N | |||
| Is O&M Correctly defined? | SOW | ||||
| Is Member Services and Case Management correctly defined? | SOW | ||||
| How many of each of the activities are being completed in each month? Template in monthly report? | SOW | ||||
| Should a limit be applied to the O&M percentage of the budget? Currently average is about 40% | SOW | ||||
| defined percentage of effort | SOW | Y | |||
| quarterly staffing plan to include activities codes | |||||
| Update language that states that any change to staffing plan, budget, other direct costs, indirect rate, or CLIN will be submitted on a change request form and will not be implemented until approved by the WTC program. (kim) (seems like a lot of the language in the contract is repetitive and we could say this just once?) | Kim | SOW | |||
| A list of providers name and number of services that were submitted on FECA claims. Does it need to be include type of service? | Kim | SOW | |||
| Records Management language from CDC https://www.archives.gov/records-mgmt/policy/records-mgmt-language | Kim | SOW | |||
| Rightsizing Model used to estimate the costs based on workload factors - use in preparing government cost estimate | Roy | IGCE | |||
| Use this rightsizing model to require CCE’s to get costs more in line with the normal - | CO & Contracts Unit | Negotiations | |||
| Facilities and Admin (Indirect rates) – When indirect costs are already being billed (benefits, mgmt. time, utilities, rent) – should these costs be removed? | CO & Contracts Unit | Negotiations | |||
| Gather industry standard labor rates for each labor category in NYC and compare to proposal rates | CO & Contracts Unit | Negotiations | |||
| How many of each of the activities are being completed in each month? Template in monthly report? | COR | Monthly Report | |||
| Log of change requests that identifies the changes in each request. For example change in staff distribution, increase in staff, increase in budget (this one requires a contract modification) | COR | Log under contract | |||
| Controlling/reducing CCE costs and providing sufficient oversight | Provide an invoice format that must be followed. All invoices need to include names, position title, Labor % billed, cost to each CLIN and provided in excel document to allow for reviews within awarded contract | Kim | Invoice Development | ||
| Identify what function under CLIN is being completed by Subcontracts and ODC. | Kim | Invoice Development | |||
| Use updated Staffing Plan format for invoice. | Kim | Invoice Development | |||
| Requiring a list of providers submitting FECA claims for the invoice time period, how many claims did the provider bill? Are those providers being billed in staffing, what %? | Kim | Invoice Development | |||
| Include prior period expenses, current period expense, cumulative expenses for option, Remaining balance (SF1035 form) | Kim | Invoice Development | |||
| Each CCE's checklist will have the approved Staffing plan loaded and kept up to date | COR | Invoice Development | |||
| Each CCE's Checklist will have the approved Subcontracts and other Direct Costs Tab loaded and kept up to date | COR | Invoice Development | |||
| ALL Calculations in determining totals on invoice are verified | Kim/Michele | Invoice Review | |||
| Fed Limit – checking to see if anyone is being paid over fed limit of 199,300. Note: OAS made determination that would be a per contract limit (could be paid on data center also and would not be added together) | Kim/Michele | Invoice Review | |||
| Name % – checking to make sure no one is charged more than 100% | Kim/Michele | Invoice Review | |||
| Name % - checking to make sure total FTE’s billed does not exceed amount on the contract proposal and approved change request forms. | Kim/Michele | Invoice Review | |||
| Subcontracts and other direct expenses are on contract proposal and approved change request forms. | Kim/Michele | Invoice Review | |||
| Other direct costs – documentation provided for all travel and any expense over 5,000 | Kim/Michele | Invoice Review | |||
| Indirect rate matches proposal or have approved change request form. | Kim/Michele | Invoice Review | |||
| CLINS matches invoice | Kim/Michele | Invoice Review | |||
| Salary by Labor Cat – checking to see if annual salary of position aligns with contract negotiated rates. | COR | Invoice Review | |||
| Checking to make sure FTE’s distribution aligns with contract proposal and approved change request forms. | COR | Invoice Review | |||
| FTE by position title to ensure it matches what is on Proposal | COR | Invoice Review | |||
| Are salaries are at the same range for each position as contract award – Do analysis based on proposal and use for negotiations of contract | COR | Invoice Review | |||
| Requiring a list of providers submitting FECA claims for the invoice time period, how many claims did the provider bill? Are those providers being billed in staffing, what %? | COR | Invoice Review | |||
| Provide a listing of position titles and their definition that may be billed (only one person may be listed on each line) (Who will do this?) | COR | Invoice Review |
Activity Code
| Activity Code | Activity (Tasks to be performed in PWS) |
| Note: Time spent on medical appointments are billed through the Fee for Service; only time spent on medical administrative activities such as prior authorizations should be reflected in medical activity code. | |
| 4.1 | Contract Management (Directors only for this activity) |
| 4.1.1 | Training |
| 4.1.1.1 | Training Reporting |
| 4.1.2 | Staffing Requirements |
| 4.1.2.1 | Staffing Report and Wages Report |
| 4.1.3 | Coordination and Participation |
| 4.1.4 | Change Request (CR), Documentation, and Control Log |
| 4.1.5 | Technical Guidance Document Compliance |
| 4.1.6 | Records Management |
| 4.1.7 | Risk and Issue Management |
| 4.1.8 | Fraud Waste and Abuse Compliance |
| 4.1.9 | Quality Assurance Plan |
| 4.1.9.1 | Quality Assurance Internal Audit Report |
| 4.2 | Systems |
| 4.2.1.2 | Member Records |
| 4.2.2 | Cost Tracking and Invoicing |
| 4.2.3 | Operations Manual |
| 4.3.1 | Member Services |
| 4.3.2 | Member Enrollment and Initial Contact |
| 4.3.3 | Member Retention |
| 4.3.4 | Transfers |
| 4.3.5 | Disruptive member and Member in Crisis Protocol |
| 4.3.6 | Benefits Counseling |
| 4.3.6.1 | Social Benefits Functions |
| 4.3.6.2 | Assistance with Workers Compensation and other Healthcare Benefits |
| 4.3.7 | Communication |
| 4.3.7.1 | Translation and Interpretive Services |
| 4.3.7.2 | Retention Activities for Current Members |
| 4.3.7.3 | Outreach and Education for Prospective Members |
| 4.3.7.4 | Establish Formal Mechanism for Consulting with Representative of Eligible Populations |
| 4.3.8 | Administering Health Benefits |
| 4.3.8.1 | Responsibilities of the Medical Director |
| 4.3.8.1.1 | External Providers |
| 4.3.8.2 | Responsibilities of the Mental Health Director |
| 4.3.8.3 | Monitoring and Initial Health Evaluations |
| 4.3.8.3.1 | Initial Health Evaluations |
| 4.3.8.3.2 | Annual Monitoring Exam |
| 4.3.8.3.3 | General Administration for AME/IHE |
| 4.3.8.4 | Diagnostic Services |
| 4.3.8.6 | Cancer Screening |
| 4.3.8.7 | Certifications |
| 4.3.9 | Medical Treatment for Certified Conditions |
| 4.3.9.1 | Authorization of Services |
| 4.3.9.3 | Prior Authorization] |
| 4.3.9.4 | CCE Medical Reviews |
| 4.3.9.5 | Medical Appeals |
| 4.3.9.6 | Telehealth Services |
| 4.3.9.7 | Disaster Preparedness and Public Health Emergencies |
| 4.4 | Comprehensive Care Management (do not use, select sub-category) |
| 4.4.1 | Case Management and Care Coordination |
| 4.4.1.1 | Intensive Case Management |
| 4.4.2 | Utilization Management |
| 4.4.3 | Inpatient Hospital stays |
| 4.4.4 | Lifestyle Medicine |
| 4.5 | Claims submission and Payment |
| 4.5.1 | Legally allowable fee schedule |
| 4.5.2 | Billing for Health Plan Benefits |
| 4.5.3 | Claims Appeals |
| 4.5.4 | Coordination of Benefits (Survivor Cohort Only) |
| 4.6 | Pharmacy Services |
| 4.6.1 | Member Education |
| 4.6.2 | Covered Medication and Restrictions |
| 4.6.3 | Review of Data |
| 4.6.4 | Compliance with State and Federal Law |
| 4.6.5 | Retrospective Reviews and Reporting |
| 4.6.6 | Pharmacy Benefits Quality Assurance and Reporting |
| 4.7.1 | Provider Network |
| 4.7.2 | Licensing and Insurance |
| 4.8 | Transitioning Out |
| 5.1 | Data Management Plan |
| 5.2 | Data Transfer |
| 6 | Performance Metrics |
| 6.1 | Quality Assurance Surveillance Plan |
| 9 | Deliverables |
| 10 | Subcontracting |
| 11 | HIPAA COMPLIANCE AND BUSINESS ASSOCIATE AGREEMENT |
| 12 | Information Security |
| 12.1 | Adequate Security |
| 12.2 | Cyber Incident Reporting Requirement |
| 12.3 | Cyber Incident Report |
| 12.4 | Media Preservation and Protection |
| 12.5 | Audit and Accountability (information security) |
| 12.6 | Information Security Continuous Monitoring |
| 12.7 | Access to Additional Information or Equipment Necessary for Forensic Analysis |
| 12.8 | Cyber Incident Damage Assessment Activities |
| 12.9 | CDC/NIOSH Safeguarding and Use of Contractor Attributional/Proprietary Information (do not use) |
| 12.1 | Use and Release of Contractor Attributional/Proprietary Information Not Created By or For CDC/NIOSH (Do not use) |
| 12.11 | Use and Release of Contractor Attributional/Proprietary Information Created By or For CDC/NIOSH (do not use) |
| 12.12 | Use and Release of Contractor Attributional/Proprietary Information Created By or For CDC/NIOSH (do not use) |
| 12.13 | Other Safeguarding or Reporting Requirements |
| 12.14 | Subcontracts |
File details come from the government source that posted it. Updated .