Attachment J.20 - Activity_Codes.xlsx
XLSX spreadsheet 19 KB Posted
- Solicitation number
- 75D301-22-R-72142
About this file
This document outlines requirements for the World Trade Center Health Program Clinical Centers of Excellence. NIOSH seeks to competitively award cost-reimbursement contracts of 5 to 8 years to provide various services to 9/11 responders and survivors. Required services include contract management, quality assurance, member services and outreach, care coordination and case management, administering healthcare services, coordination of benefits for survivors, and collecting clinical and operational data. Eligible vendors must regularly check the website for solicitation amendments. Any questions must be submitted in writing by the specified deadline to the identified point of contact. Awards will be made using a best-value tradeoff approach.
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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 .