FBO_RFI_Appendix_1.pdf

REQUEST FOR INFORMATION

APPENDIX 1

Performance Work Statement Synopsis

Health Insurance Portability and Accountability Act (HIPAA) Electronic Standards Program Coordination and Analysis

Description of services/introduction: The contractor shall provide all personnel, equipment, supplies, facilities, transportation, tools, materials, supervision, and other items and non-personal services necessary to perform HIPAA Electronic Standards Program Coordination and Analysis Support as defined in this Performance Work Statement (PWS) except for those items specified as government furnished property and services. The contractor shall perform to the standards in this PWS.

Background: The (HIPAA of 1996, Public Law 104-191 was enacted on August 21, 1996. The Act required the Department of Health and Human Services (HHS) to issue several Final Rules establishing health industry standards for a number of health care administrative transactions, code sets and identifiers. So far HHS has issued Rules specifying standards for several transactions (HIPAA X12 versions 4010 and 5010, as well as National Council on Prescription Drug Programs (NCPDP) versions) and , code sets (e.g., ICD-10), and identifiers (e.g., Employer Identifier, and National Provider Identifier (NPI)). HHS plans to issue Rules for other electronic standards to include Claims Attachments, new versions of existing HIPAA electronic transactions, use of Device Identifiers (DI), and transactions compliance certification. There will also be updates to existing and future electronic standards. In addition to the HIPAA standards, HHS continues to identify additional electronic standards that will be mandated and employed for federal agencies toward U.S. healthcare interoperability.

The Military Health System (MHS) is required as a HIPAA covered health plan and/or payer entity to comply with all the HIPAA adopted electronic standards. As a HIPAA covered provider entity, the MHS has implemented many of the electronic transaction standards but work continues to implement others and make improvements in the use of the electronic standards based on applicability to associated business processes.

This PWS is to furnish assistance to the Defense Health Agency (DHA) for functional analysis and coordination of the tasks and activities required to prepare for, achieve, and help manage compliance with the electronic standards requirements of HIPAA to achieve business process improvements and simplification.

The following are the draft requirements for this effort:

5.1 Task Management

The Contractor shall provide sufficient management to ensure that this contract is performed efficiently, accurately, on time, and in compliance with the requirements of this document.

Specifically, the Contractor shall designate a manager and alternate manager to oversee this task and supervise staff assigned to this task.

5.1.1 Monthly Progress Report (MPR)

The Contractor shall ensure that a Monthly Progress Report (MPR) (Deliverable 1) is submitted outlining the expenditures, billings, progress, status, problems and/or issues encountered in the performance of this task, and recommendations in accordance with best commercial practices.

The MPR shall be submitted 5 days before the submission of monthly invoices.

5.1.2 Subcontractor Expenditures Report

If applicable, the Contractor shall prepare and deliver a Subcontract Expenditures Report (Deliverable 2) that discloses actual subcontract expenditures by company name, business size standard (i.e. Women Owned Business, Veteran Owned Business), and other socioeconomic programs (i.e. Indian Incentive Program, Historically Black Colleges and Universities and Minority Institutions).

5.1.3 Transition Support

a. Incoming Transition Plan

The Contractor shall provide a plan for one (1) month of incoming transition from contract to contract. The Contractor shall coordinate with the Government in planning and implementing a complete transition to the Contractor's support model. The Contractor shall collaborate with the Government to develop and deliver an Incoming Transition Plan (Deliverable 3). The Government will designate a transition period for the incoming Contractor to coordinate and work with the incumbent Contractor. This transition plan shall include the following items as applicable:

• Coordination with Government representatives;

• Review, evaluation and transition of current support services;

• Transition of historic data to new Contractor system;

• Government-approved training and certification process;

• Transfer of hardware warranties and software licenses;

• Transfer of all System and/or Tool documentation to include, at a minimum: user manuals, system administration manuals, training materials, disaster recovery manual, requirements traceability matrix, configuration control documents and all other documents required to operate, maintain and administer systems and tools;

• Transfer of compiled and uncompelled source code, to include all versions, maintenance updates and patches;

• Orientation phase and program to introduce Government personnel, programs, and users to the Contractor's team, tools, methodologies, and business processes;

• Distribution of Contractor purchased Government owned assets, including facilities, equipment, furniture, phone lines, computer equipment;

• Transfer of Government Furnished Equipment (GFE) and Government Furnished Information (GFI), and GFE inventory management assistance;

• Applicable DHA briefing and personnel in-processing procedures and

• Coordinate with the Government to account for government keys, ID and/or access cards, and security codes.

b. Option Item: Outgoing Transition Plan

The Contractor shall provide an Outgoing Transition Plan (Deliverable 4) for one (1) month of outgoing transition for transitioning work from an active task order to a follow-on contract and/or order or Government entity. This transition may be to a Government entity, another Contractor or to the incumbent Contractor under a new contract and/or order. In accordance with the Government-approved plan, the Contractor shall assist the Government in planning and implementing a complete transition from this Contract and/or orders issued under this Contract to a successful provider. This shall include formal coordination with Government staff and successor staff and management. It shall also include delivery of copies of existing policies and procedures, and delivery of required metrics and statistics. This transition plan shall include:

• Coordination with Government representatives;

• Review, evaluation and transition of current support services;

• Transition of historic data to new Contractor system;

• Government-approved training and certification process;

• Transfer of hardware warranties and software licenses;

• Transfer of all necessary business and/or technical documentation;

• Transfer of compiled and uncompelled source code, to include all versions, maintenance updates and patches;

• Orientation phase and program to introduce Government personnel, programs, and users to the Contractor's team, tools, methodologies, and business processes;

• Disposition of Contractor purchased Government owned assets, including facilities, equipment, furniture, phone lines, computer equipment;

• Transfer of Government Furnished Equipment (GFE) and Government Furnished Information (GFI), and GFE inventory management assistance;

• Applicable DHA debriefing and personnel out-processing procedures

• Turn-in of all government keys, ID and/or access cards, and security codes.

5.1.4 Program Management Plan

The Contractor shall develop a Program Management Plan (Deliverable 5) that shall require Government approval. It will be used to manage, track and evaluate the Contractor’s performance. The Program Management Plan shall consist of control policies and procedures in accordance with standard industry practices for project administration, execution and tracking.

The Program Management Plan shall include the following:

• Identification of milestones where Government information and/or activity is required and timeline dependencies for subsequent Contractor activities;

• A detailed staffing plan.

5.1.5 Contingency Operations Plan

The Contractor shall prepare and submit a Contingency Operations Plan (Deliverable 6) to the Government. The Contingency Operations Plan shall document Contractor plans and procedures to maintain DHA support during an emergency. The Contingency Operations Plan shall include the following:

• A description of the Contractor’s emergency management procedures and policy

• A description of how the Contractor will account for their employees during an emergency

• Planned temporary work locations or alternate facilities

• How the Contractor will communicate with DHA during emergencies

• A list of primary and alternate Contractor points of contact, each with primary and alternate:

• Telephone numbers

• E-mail addresses

• Procedures for protecting Government furnished equipment

• Procedures for safeguarding sensitive and/or classified Government information

5.1.7 Operations During Emergency Situations

Individual contingency operation plans shall be activated immediately after determining that an emergency has occurred, shall be operational within twelve (12) hours of activation, and shall be sustainable until the emergency situation is resolved and normal conditions are restored or the contract is terminated, whichever comes first. In case of a life threatening emergency, the

COR will immediately make contact with the Contractor Task Managers to ascertain the status of any Contractor personnel who were located in Government controlled space affected by the emergency. When any disruption of normal, daily operations occur, the Contractor Task Manager shall promptly open an effective means of communication with the COR and verify:

• Key points of contact (Government and Contractor)

• Temporary work locations (alternate office spaces, telework, virtual offices)

• Means of communication available under the circumstances (e.g. email, webmail, telephone, FAX, courier)

• Essential work products expected to continue production by priority

The Contractor Task Manager, in coordination with the COR, shall make use of the resources and tools available to continue DHA contracted functions to the maximum extent possible under emergency circumstances. The Contractor shall obtain approval from the COR and Contracting Officer prior to incurring costs over and above those allowed for under the terms of this contract. Regardless of contract type, and of work location, Contractors performing work in support of authorized tasks within the scope of their contract shall charge those hours accurately in accordance with the terms of this contract.

5.2. HIPAA Electronic Standards Program Coordination (Deliverable 7)

The Contractor shall provide program coordination for all aspects of the HIPAA Electronics Standards Program.

The Contractor shall maintain close contact with the Chief, Business Information Management in the execution of this task. The coordination shall include: planning and preparing; budgeting and funds execution; developing functional capabilities; facilitating and contributing to integrated project team (IPT) or workgroup efforts; developing and tracking annual goals and performance measures; developing and coordinating requirements and related changes to private sector care-related TRICARE manuals; communicating with and assisting HIPAA related stakeholders; drafting and tracking correspondence; providing meeting and workgroup support;

tracking and resolving issues; and facilitating and tracking implementation and compliance.

Progress and activities related to this task shall be documented in the Monthly Progress Report.

Actual deliverables produced for this task shall include briefings, project plans, timelines, spreadsheets, white papers, other information papers, and status reports. In addition, the Contractor shall supply a deliverable that presents and describes findings and lessons learned as a result of tasks performed in support of the HIPAA Electronics Standards Program.

(Deliverable 8)

5.3 Analytical Assistance (Deliverable 9)

The Contractor shall perform analysis of HIPAA electronic standards and their potential or actual functional use in and application to the MHS and TRICARE Program. In addition to HIPAA mandated standards, similar analysis may be required for other federally mandated electronic standards. This analysis shall include: developing new business practices and identifying issues (business, technical and policy) that may impact the use of the standards. The Contractor shall track and assist with resolving the issues. This analysis may be performed in all phases of the Program and for multiple standards. Analysis shall be required during industry development of new standards, evaluation of proposed standards, development of requirements and system designs, IPT or workgroup activities, testing, implementation and deployment, and post-deployment. The Contractor shall prepare white papers, reports, and briefings as required to describe issues, alternatives for resolving issues and detailed resolution plans.

5.4 HIPAA Implementation and Compliance Tracking (Deliverable 10)

The Contractor shall facilitate and perform preparatory work and then track and monitor the MHS’ and TRICARE Program’s implementation of and compliance with the HIPAA electronic standards, code sets and identifiers. The implementation and Compliance Tracking shall include understanding and articulation of existing and emerging compliance requirements, responding to questions about implementation or compliance, providing mechanisms and processes for monitoring implementation or compliance, and supporting related activities and efforts in participation and supporting IPTs or workgroups, effort and activities. The Contractor shall ensure that uses of HIPAA transactions, and associated data required by HIPAA transactions, are documented in the MHS Enterprise Architecture. The Contractor shall constantly look for opportunities to simplify and improve the MHS and TRICARE business by the MHS more effectively using the HIPAA electronic standards, code sets and identifiers, as well as other federally mandated standards. The Contractor shall document this information in spreadsheets, briefings, reports, white papers or other means as appropriate.

5.5 Standards Development Assistance (Deliverable 11)

As directed by the Chief, Business Information Management, the Contractor shall assist the Government with its participation in industry Standards Development Organizations (SDO). The primary SDO developing the HIPAA electronic standards is the Accredited Standards Committee (ASC) X12N. This assistance shall include: reviewing and commenting on draft standards;

assisting workgroups develop standards that consider the needs of the MHS and TRICARE Program; coordinating education and review of the draft standards by the functional business owners; coordinating the participation at the SDOs by the Managed Care Support Contractors;

and attending and participating in the SDO meetings. Deliverables shall be white papers, briefings, information papers, status reports, and trip reports.

5.6 HIPAA Website Content Management

The Contractor shall manage the content on the public-facing and internal TRICARE HIPAA web site pages and contribute to the IM webpages and ensure that the information is kept current, accurate and complete. This may include making changes to the layout, organization of information, content updates, and other changes as required. The Contractor shall be proactive in their approach to recommending posting of relevant information on the website. Activities related to the website shall be documented in the Monthly Progress Reports (Deliverable 2).

5.7 HIPAA Educational Assistance (Deliverable 12)

The Contractor shall prepare periodic HIPAA Newsletters containing news briefs that are targeted at a particular audience and for specific HIPAA initiatives. For example, one news brief might be targeted in support of MTF staff as related to the impacts of a particular electronic standard, code set, or identifier. Another news brief might be targeted at MTFs’ billing offices as related to use of the HIPAA adopted electronic claims transactions. The contractor shall prepare news briefs for the Newsletter and also incorporate news briefs prepared by other parties involved with HIPAA implementation. As required, the Contractor shall also develop other educational materials, including briefings, information papers, and posters. Once approved by the Government, the Contractor shall ensure that the Newsletters and other materials are published to the DHA HIPAA web site pages in a newsletter format and distributed as appropriate.

5.8 Functional Requirements IPT or Workgroup Assistance (Deliverable 13)

The Contractor shall participate in and contribute to IPT or Workgroup efforts and activities when there is potential for HIPAA electronic standards involvement. Support shall include:

• Contribute to the development, maintenance and management of the functional requirements in the MHS Requirements Repository IAW the approved MHS Requirements Repository Configuration Management Plan and assist with the preparation of the associated documentation for functional requirements;

• Contribute to the maintenance and management of the MHS IM/IT Investment and Sustainment Capabilities and associated documentation, such as Capability Description Sheets in the MHS Portfolio Management Tool (ProSight) IAW the approved MHS Portfolio Configuration Management Plan;

• Contribute to the preparation of life-cycle and project level functional requirements documents required by DoDI 5000.75 Business Systems Requirements and Acquisition;

• Assist the relevant stakeholders and Defense Health Agency in preparation of functional requirements for information management capabilities that are approved for funding and prepare capability descriptions for information management capabilities approved or pending funding decisions and;

• Contribute to the management of the user functional requirements and associated artifacts in accordance with the approved requirements process.