SummaryofChangesCompInstateRFPs.doc

Summary of Changes (9th Scope of Work) Special Notice Due to the volume of questions and resulting RFP amended sections, QIOs are encouraged to thoroughly read the amended version of the RFP as there may be items which were amended that were not included in this summary.

Table of Contents ~Typographic errors in spelling were corrected.

~Section H.21. Section 508 was added

~Section J Attachments were updated ~Section M.12 Performance Risk Assessment was removed

Section B ~Section B.4.D.1. is amended to add the word “between”

Section C Numerous changes were made. QIOs should thoroughly read the amended version of Section C. An overview of changes is provided below but may not be all inclusive of every change.

Section C.6.1.

Beneficiary Protection Theme Changes

The Beneficiary Protection Theme was revised to include language that references recovery audit contractors (RACs) in relation to collaborative efforts and prospective review for cataract surgery as a required type of review. Other additions include RHQDAPU Contract Evaluation Criteria and the requirement for a system-wide change quality improvement activity (QIA). In the general requirements, as a result of case review data analysis, QIOs must conduct at least one QIA that focuses on system-wide change for every fifty (50) confirmed quality of care concerns. The requirement in Section C.6.1B, Sub-Task 2 to analyze data from all QIAs was modified to include health disparities.

Section F deliverables were revised to provide evaluation criteria for deliverable #21, which is the report for quality improvement activity as a result of case review data analysis. The due date for deliverable #22, report of completed physician acknowledgement monitoring, was clarified to be annual. The deliverable for report of documented collaboration with the QIO beneficiary satisfaction survey contractor, FIs, MACs, RACs, qualified independent contractors (QICs), the OIG has been modified to read as 2 deliverables, one is specific to the entities as listed above (deliverable #23a) and one is specific to report of documented collaboration with State Survey Agencies (deliverable #23b). Deliverables for Quality data reporting have been clarified to require updating the PRS on a quarterly basis (deliverable #25) and to provide CMS with a diary of contacts between the QIO and all hospitals participating in the RHQDAPU program (deliverable #26). All needed “Deliverable Changes”.

Section C.6.2.

Patient Safety Theme Changes

The Patient Safety Theme of the 9th Statement of Work was revised to increase accuracy within each of the specified tasks, clarify and coordinate related activities and to more clearly define the measure specifics, improvement targets and evaluation approach in response to questions received. Some specific changes include the addition of the J-17 attachment which lists the providers from which QIOs can choose to work and related instructions for recruitment; deleting reference to “70% ABC” for evaluation of measures affecting Pressure Ulcers, Physical Restraints, MRSA, and Drug Safety and restructuring those criteria; the addition of a study related to healthcare disparities among nursing home residents; clarification on the MRSA measures and the replacement of SCIP Inf 7 with HF-3.

Section C.6.3.

Prevention Theme Changes

The revisions for the RFP Prevention Theme clarify the overall content and requirements. Specifically, the revisions include an expansion of the task description; clarification of the practice eligibility requirements; addition of electronic health record measures; elimination of the Office System Survey (SS) task; addition of the 18th and 28th month evaluation criteria; and clarification of data collection and submission methods.

Section C.7.1.

Prevention Theme: Disparities Changes

Pages 64 and 67 of the RFP SOW contained unnecessary description/explanation of claims data lags/issues, and of DQIP (diabetes quality improvement project). Therefore, changes were made to eliminate these references in the SOW. They are not relevant to the contract.

The following language was added to page 65 of RFP SOW:

“To optimally assess the effectiveness of the DSME programs, actual lab results and clinical data measures results would yield the highest evidence of efficacy. These measures are HbA1c, Lipids, Weight, and BP. It is the intention of CMS to create one additional reporting mechanism to include these measures. CMS will operationalize this through a separate data contractor. Data will flow from the PPs to this contractor. CMS expects that technical support to the practices will be provided by this data contractor, with minimal technical support to the practices from QIOs. Each QIO working in this subtask is required to cooperate with this contractor. CMS will be providing further guidance.”

Table 2, page 68 and 69 in the RFP SOW was clarified to state recruitment and utilization data, which is claims data, and BP column was clarified to state it is PQRI data.

Page 69 of RFP SOW was clarified to distinguish between PQRI and FFS Claims Data.

Section C.7.2.

Patient Pathways/Care Transitions Theme Changes

Clarified the meaning of the three intervention topic areas within the Intervention Plan and clarified data expectations and provisions, deliverables and corrected the performance threshold for I-5 to reflect the number of implemented interventions vs. the transitions.

Section C.7.3.

Prevention Theme: Chronic Kidney Disease Changes

The sub-national Theme 7.3 Chronic Kidney Disease RFP was revised to remove the “optional task” sections. The optional tasks that were deleted are “Support for companion CMS quality initiatives” and “HIT.” The optional “Disparities” work has been relocated within Theme 7.3 and changed to required work. QIOs should address any CKD disparities in their state and describe planned interventions in the proposal. Extra considerations and extra points for the CKD proposals addressing the optional tasks were deleted along with the optional tasks. The two deleted optional tasks are approaches to achieving improvements in CKD care. QIOs that are interested in the CKD work are encouraged to use approaches, such as supporting companion CMS quality initiatives and HIT activities, as well as any other interventions that they believe will be effective and efficient in meeting the CKD improvement targets.

Theme 7.3 CKD in Section C has received minor edits to increase accuracy and to more clearly define improvement targets in response to questions received. The proposal page limits are provided in Section L (Volume 7) and the criteria listed in this section have been edited to increase clarity. Section F deliverables were revised to clarify the provider recruitment targets that shall be met at the end of first year quarters two, three, and four; and to specify that the partner and provider surveys would be administered by a third party.

Section F

Section F contains numerous changes to correct typographical errors, clarify deliverables, revise deliverables and add previously omitted deliverables. It is recommended that QIOs thoroughly review the amended version of Section F.

Section G ~Section G.2.A.1. corrected Special Projects to read Section C.8.

~Section G.2.A.1.a revised to further clarify the Executive Salaries (Corporate Management) billing

~Section G.3.D. amended provisional rate submission process for proposal submission

~Section G.4. revised

~Section G.7. amended Key Personnel to remove CEO and add Individual Theme Program Managers

~Section G.12.E. added final report due July 31, 2011

~Section G.19 notes updated

~Section G.20 corrected Special Projects to read Section C.8

~Section G.24 updated

~Section G.25.b. added “…60% of the QIOs book of business.”

Section H ~Section H.11.D.1. corrected reference from (d)(2) to D.2 ~Section H.11.D.1. added item (g) ~Section H.11.F added

~Section H.11.G added

~Section H.11 added deliverable numbers for clarification

~Section H.21 added Section 508 requirements

Section I ~Section I.1.A. added FAR 52.203-13 contract clause

Section J ~Section J, Attachment J-10 revised ~Section J, Attachment J-11 GFP Listing by State issued with this amendment

~Section J, Attachment J-16 removed, marked as Reserved

~Section J, Attachment J-17 note removed

~Section J, Attachment J-20 issued with this amendment,note removed ~Section J, Attachment J-21 added Model CDAC Subcontract

Section K ~Section K.2 corrected NAICS to read 541618

~Section K.9 added HHSAR 352.204 Certification of Filing and Payment of

Federal Taxes

Section L Numerous changes were made to Section L. QIOs should thoroughly read Section L.

Section M Numerous changes were made to Section M. QIOs should thoroughly read Section M.

TOPS/SDPS/QNET Memos These memos are being provided for informational purposes only.

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