HT9402-15-R-0001_DRAFT_RFP.pdf

HT9402-15-R-0001

SOLICITATION, OFFER AND AWARD

4. TYPE OF SOLICITATION2. CONTRACT NUMBER 3. SOLICITATION NUMBER

7. ISSUED BY CODE 8. ADDRESS OFFER TO (If other than Item 7)

ORDER UNDER DPAS (15 CFR 700)

6. REQUISITION/PURCHASE NUMBER

NOTE: In sealed bid solicitations "offer" and "offeror" mean "bid" and "bidder".

NEGOTIATED (RFP)

SEALED BID (IFB)

5. DATE ISSUED

1. THIS CONTRACT IS A RATED RATING PAGE OF PAGES

1 90

C. E-MAIL ADDRESS

EXT.NUMBERAREA CODE

B. TELEPHONE (NO COLLECT CALLS)A. NAME

10. FOR

INFORMATION

CALL:

CAUTION: LATE Submissions, Modifications, and Withdrawals: See Section L, Provision No. 52.214-7 or 52.215-1. All offers are subject to all terms and conditions contained in this solicitation.

(Date)(Hour) local timeuntildepository located in copies for furnishing the supplies or services in the Schedule will be received at the place specified in Item 8, or if hand carried, in the

SOLICITATION

9. Sealed offers in original and

PART IV - REPRESENTATIONS AND INSTRUCTIONS

OTHER STATEMENTS OF OFFERORS

EVALUATION FACTORS FOR AWARD

INSTRS., CONDS., AND NOTICES TO OFFERORS

REPRESENTATIONS, CERTIFICATIONS AND

LIST OF ATTACHMENTS

CONTRACT CLAUSES

PART III - LIST OF DOCUMENTS, EXHIBITS AND OTHER ATTACH.

I

J

K

L

M SPECIAL CONTRACT REQUIREMENTS

CONTRACT ADMINISTRATION DATA

DELIVERIES OR PERFORMANCE

INSPECTION AND ACCEPTANCE

PACKAGING AND MARKING

DESCRIPTION/SPECS./WORK STATEMENT

SUPPLIES OR SERVICES AND PRICES/COSTS

SOLICITATION/CONTRACT FORM

PART II - CONTRACT CLAUSESPART I - THE SCHEDULE

H

G

F

E

D

C

B

A

SEC. DESCRIPTION PAGE(S) (X) DESCRIPTION SEC. (X)

11. TABLE OF CONTENTS

18. OFFER DATE17. SIGNATURE

SUCH ADDRESS IN SCHEDULE.

IS DIFFERENT FROM ABOVE - ENTER

15C. CHECK IF REMITTANCE ADDRESS

EXT.NUMBERAREA CODE

15B. TELEPHONE NUMBER

(Type or print)AND

ADDRESS

OF

OFFEROR

CODE FACILITY

16. NAME AND TITLE OF PERSON AUTHORIZED TO SIGN OFFER15A. NAME

DATEAMENDMENT NO.DATEAMENDMENT NO.

and related documents numbered and dated):

amendments to the SOLICITATION for offerors

(The offeror acknowledges receipt of

14. ACKNOWLEDGEMENT OF AMENDMENTS

CALENDAR DAYS (%)30 CALENDAR DAYS (%)20 CALENDAR DAYS (%)10 CALENDAR DAYS (%)

(See Section I, Clause No. 52.232.8)

13. DISCOUNT FOR PROMPT PAYMENT

designated point(s), within the time specified in the schedule.

by the offeror) from the date for receipt of offers specified above, to furnish any or all items upon which prices are offered at the price set opposite each item, delivered at the

12. In compliance with the above, the undersigned agrees, if this offer is accepted within ______________ calendar days (60 calendar days unless a different period is inserted

NOTE: Item 12 does not apply if the solicitation includes the provisions at 52.214-16, Minimum Bid Acceptance Period.

OFFER (Must be fully completed by offeror)

IMPORTANT - Award will be made on this Form, or on Standard Form 26, or by other authorized official written notice.

28. AWARD DATE

(Signature of Contracting Officer)

27. UNITED STATES OF AMERICA

25. PAYMENT WILL BE MADE BY

26. NAME OF CONTRACTING OFFICER (Type or print)

CODE 24. ADMINISTERED BY (If other than Item 7)

ITEM

(4 copies unless otherwise specified)

23. SUBMIT INVOICES TO ADDRESS SHOWN IN

41 U.S.C. 253 (c) ( 10 U.S.C. 2304 (c) (

22. AUTHORITY FOR USING OTHER THAN FULL AND OPEN COMPETITION:

21. ACCOUNTING AND APPROPRIATION20. AMOUNT19. ACCEPTED AS TO ITEMS NUMBERED

AWARD (To be completed by government)

CODE

X

HT9402

DEFENSE HEALTH AGENCY

DEFENSE HEALTH AGENCY-AURORA

16401 E CENTRETECH PARKWAY

AURORA CO 80011

1200 MS

JACK DIEMER 303

JACK.DIEMER@DHA.MIL

676-3664

X

X

X

X

X

X

X

X

X

X

X

X

X

PAGE(S)

TODD M. YOUNG

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition is unusable

STANDARD FORM 33 (Rev. 9-97)

Prescribed by GSA - FAR (48 CFR) 53.214(c)

2-14

C1-C12 D1 E1 F1-F3 G1-G5 H1-H3

I1-I12

J1

K1-K13

L1-L17

M1-M8

303-676-3675

TODD.YOUNG@dha.mil

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

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CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

HT9402-15-R-0001

(A) (B) (C) (D) (E) (F)

TRICARE Dental Program (TDP) Delivery Location Code: HT9402

DEFENSE HEALTH AGENCY

DEFENSE HEALTH AGENCY-AURORA

16401 E CENTRETECH PARKWAY

AURORA CO 80011-9066 USA

Period of Performance: 02/01/2016 to 01/31/2023

0001 Transition-In (Excluding NIST and Physical and 1 LT Personnel Security) (Firm Fixed Price)

Period of Performance: 02/01/2016 to 01/31/2017

0002 Transition-In NIST and Physical and Personnel 1 LT Security (Firm Fixed Price)

Period of Performance: 02/01/2016 to 01/31/2017

0003 Reports, Contract Data Requirements (DD Form 1423) 1 LT (Not Separately Priced)

Period of Performance: 02/01/2016 to 01/31/2017

1001 Single Enrollment Premium 3792000 EA

- Enrollee Share -- 40%

- Government Share -- 60%

- Total Premium -- (Fixed Unit Price) (Option Line Item)

Period of Performance: 02/01/2017 to 01/31/2018

1002 Family Enrollment Premium 5592000 EA

- Enrollee Share -- 40%

- Government Share -- 60%

- Total Premium -- (Fixed Unit Price) (Option Line Item)

Period of Performance: 02/01/2017 to 01/31/2018

Continued ...

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(A) (B) (C) (D) (E) (F)

1003 Survivor Benefit-Single Enrollment Premium 24960 EA

- Government Share -- 100% (Fixed Unit Price) (Option Line Item)

Period of Performance: 02/01/2017 to 01/31/2018

1004 Survivor Benefit-Family Enrollment Premium 40680 EA

- Government Share -- 100% (Fixed Unit Price) (Option Line Item)

Period of Performance: 02/01/2017 to 01/31/2018

1005 Reimbursement for Costs in Excess of Allowable 1 LT Charges for OCONUS Claims (Cost Reimbursable, No Fee) (Option Line Item)

Period of Performance: 02/01/2017 to 01/31/2018

1006 Reimbursement for Cost Shares and Additional 1 LT Allowable Charges for Orthodontic Costs Charge for OCONUS Claims (Cost Reimbursable, No Fee) (Option Line Item)

Period of Performance: 02/01/2017 to 01/31/2018

1007 NIST and Physical & Personnel Security 12 MO (Sustainment Costs) (Firm Fixed Price) (Option Line Item)

Period of Performance: 02/01/2017 to 01/31/2018

1008 Incentives 1 LT (Reference Section H.4. which outlines criteria for earning Incentive monies. The Total Amount shown reflects the maximum incentive available.)

(Option Line Item)

Period of Performance: 02/01/2017 to 01/31/2018

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(A) (B) (C) (D) (E) (F)

1009 Reports, Contract Data Requirements List 1 LT (DD Form 1423) (Option Line Item) (Not Separately Priced)

Period of Performance: 02/01/2017 to 01/31/2018

1010 Eurasia/Africa/Latin America/Canada Dental 1 LT Support Services (Firm Fixed Price)

CLIN Include all costs associated with the support service requirements described in Section J, Attachment J-12, Eurasia/Africa/Latin America/Canada and OCONUS Pacific Dental Support Operations (Option Line Item)

Period of Performance: 02/01/2017 to 01/31/2018

1011 OCONUS Pacific Dental Support Services 1 LT (Firm Fixed Price)

CLIN Include all costs associated with the support service requirements described in Section J, Attachment J-12, Eurasia/Africa/Latin America/Canada and OCONUS Pacific Dental Support Operations (Option Line Item)

Period of Performance: 02/01/2017 to 01/31/2018

1012 Transition-out 1 LT (Firm Fixed Price) (Option Line Item)

Period of Performance: 02/01/2017 to 01/31/2018

2001 Single Enrollment Premium 3792000 EA

- Enrollee Share -- 40%

- Government Share -- 60%

- Total Premium -- (Fixed Unit Price) (Option Line Item)

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(A) (B) (C) (D) (E) (F)

Period of Performance: 02/01/2018 to 01/31/2019

2002 Family Enrollment Premium 5592000 EA

- Enrollee Share -- 40%

- Government Share -- 60%

- Total Premium -- (Fixed Unit Price) (Option Line Item)

Period of Performance: 02/01/2018 to 01/31/2019

2003 Survivor Benefit-Single Enrollment Premium 24960 EA

- Government Share -- 100% (Fixed Unit Price) (Option Line Item)

Period of Performance: 02/01/2018 to 01/31/2019

2004 Survivor Benefit-Family Enrollment Premium 40680 EA

- Government Share -- 100% (Fixed Unit Price) (Option Line Item)

Period of Performance: 02/01/2018 to 01/31/2019

2005 Reimbursement for Costs in Excess of Allowable 1 LT Charges for OCONUS Claims (Cost Reimbursable, No Fee) (Option Line Item)

Period of Performance: 02/01/2018 to 01/31/2019

2006 Reimbursement for Cost Shares and Additional 1 LT Allowable Charges for Orthodontic Costs Charge for OCONUS Claims (Cost Reimbursable, No Fee) (Option Line Item)

Period of Performance: 02/01/2018 to 01/31/2019

2007 NIST and Physical & Personnel Security 12 MO (Sustainment Costs) (Firm Fixed Price)

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(A) (B) (C) (D) (E) (F)

Period of Performance: 02/01/2018 to 01/31/2019

2008 Incentives 1 LT (Reference Section H.4. which outlines criteria for earning Incentive monies. The Total Amount shown reflects the maximum incentive available.)

(Option Line Item)

Period of Performance: 02/01/2018 to 01/31/2019

2009 Reports, Contract Data Requirements List 1 LT (DD Form 1423) (Option Line Item) (Not Separately Priced)

Period of Performance: 02/01/2018 to 01/31/2019

2010 Eurasia/Africa/Latin America/Canada Dental 1 LT Support Services (Firm Fixed Price)

CLIN Include all costs associated with the support service requirements described in Section J, Attachment J-12, Eurasia/Africa/Latin America/Canada and OCONUS Pacific Dental Support Operations (Option Line Item)

Period of Performance: 02/01/2018 to 01/31/2019

2011 OCONUS Pacific Dental Support Services 1 LT (Firm Fixed Price)

CLIN Include all costs associated with the support service requirements described in Section J, Attachment J-12, Eurasia/Africa/Latin America/Canada and OCONUS Pacific Dental Support Operations (Option Line Item)

Period of Performance: 02/01/2018 to 01/31/2019

2012 Transition-out 1 LT (Firm Fixed Price)

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(A) (B) (C) (D) (E) (F)

Period of Performance: 02/01/2018 to 01/31/2019

3001 Single Enrollment Premium 3792000 EA

- Enrollee Share -- 40%

- Government Share -- 60%

- Total Premium -- (Fixed Unit Price) (Option Line Item)

Period of Performance: 02/01/2019 to 01/31/2020

3002 Family Enrollment Premium 5592000 EA

- Enrollee Share -- 40%

- Government Share -- 60%

- Total Premium -- (Fixed Unit Price) (Option Line Item)

Period of Performance: 02/01/2019 to 01/31/2020

3003 Survivor Benefit-Single Enrollment Premium 24960 EA

- Government Share -- 100% (Fixed Unit Price) (Option Line Item)

Period of Performance: 02/01/2019 to 01/31/2020

3004 Survivor Benefit-Family Enrollment Premium 40680 EA

- Government Share -- 100% (Fixed Unit Price) (Option Line Item)

Period of Performance: 02/01/2019 to 01/31/2020

3005 Reimbursement for Costs in Excess of Allowable 1 LT Charges for OCONUS Claims (Cost Reimbursable, No Fee) (Option Line Item)

Period of Performance: 02/01/2019 to 01/31/2020

3006 Reimbursement for Cost Shares and Additional 1 LT Allowable Charges for Orthodontic Costs Charge

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(A) (B) (C) (D) (E) (F) for OCONUS Claims(Cost Reimbursable, No Fee) (Option Line Item)

Period of Performance: 02/01/2019 to 01/31/2020

3007 NIST and Physical & Personnel Security 12 MO (Sustainment Costs) (Firm Fixed Price) (Option Line Item)

Period of Performance: 02/01/2019 to 01/31/2020

3008 Incentives 1 LT (Reference Section H.4. which outlines criteria for earning Incentive monies. The Total Amount shown reflects the maximum incentive available.)

(Option Line Item)

Period of Performance: 02/01/2019 to 01/31/2020

3009 Reports, Contract Data Requirements List 1 LT (DD Form 1423) (Option Line Item) (Not Separately Priced)

Period of Performance: 02/01/2019 to 01/31/2020

3010 Eurasia/Africa/Latin America/Canada Dental 1 LT Support Services (Firm Fixed Price)

CLIN Include all costs associated with the support service requirements described in Section J, Attachment J-12, Eurasia/Africa/Latin America/Canada and OCONUS Pacific Dental Support Operations (Option Line Item)

Period of Performance: 02/01/2019 to 01/31/2020

3011 OCONUS Pacific Dental Support Services 1 LT (Firm Fixed Price)

CLIN Include all costs associated with the support service requirements described in Section

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(A) (B) (C) (D) (E) (F)

J, Attachment J-12, Eurasia/Africa/Latin America/Canada and OCONUS Pacific Dental Support Operations (Option Line Item)

Period of Performance: 02/01/2019 to 01/31/2020

3012 Transition-out 1 LT (Firm Fixed Price) (Option Line Item)

Period of Performance: 02/01/2019 to 01/31/2020

4001 Single Enrollment Premium 3792000 EA

- Enrollee Share -- 40%

- Government Share -- 60%

- Total Premium -- (Fixed Unit Price) (Option Line Item)

Period of Performance: 02/01/2020 to 01/31/2021

4002 Family Enrollment Premium 5592000 EA

- Enrollee Share -- 40%

- Government Share -- 60%

- Total Premium -- (Fixed Unit Price) (Option Line Item)

Period of Performance: 02/01/2020 to 01/31/2021

4003 Survivor Benefit-Single Enrollment Premium 24960 EA

- Government Share -- 100% (Fixed Unit Price) (Option Line Item)

Period of Performance: 02/01/2020 to 01/31/2021

4004 Survivor Benefit-Family Enrollment Premium 40680 EA

- Government Share -- 100% (Fixed Unit Price) (Option Line Item)

Period of Performance: 02/01/2020 to 01/31/2021

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(A) (B) (C) (D) (E) (F)

4005 Reimbursement for Costs in Excess of Allowable 1 LT Charges for OCONUS Claims (Cost Reimbursable, No Fee) (Option Line Item)

Period of Performance: 02/01/2020 to 01/31/2021

4006 Reimbursement for Cost Shares and Additional 1 LT Allowable Charges for Orthodontic Costs Charge for OCONUS Claims (Cost Reimbursable, No Fee) (Option Line Item)

Period of Performance: 02/01/2020 to 01/31/2021

4007 NIST and Physical & Personnel Security 12 MO (Sustainment Costs) (Firm Fixed Price) (Option Line Item)

Period of Performance: 02/01/2020 to 01/31/2021

4008 Incentives 1 LT (Reference Section H.4. which outlines criteria for earning Incentive monies. The Total Amount shown reflects the maximum incentive available.)

(Option Line Item)

Period of Performance: 02/01/2020 to 01/31/2021

4009 Reports, Contract Data Requirements List 1 LT (DD Form 1423) (Option Line Item) (Not Separately Priced)

Period of Performance: 02/01/2020 to 01/31/2021

4010 Eurasia/Africa/Latin America/Canada Dental 1 LT Support Services (Firm Fixed Price)

CLIN Include all costs associated with the support service requirements described in Section J, Attachment J-12, Eurasia/Africa/Latin

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(A) (B) (C) (D) (E) (F)

America/Canada and OCONUS Pacific Dental Support Operations (Option Line Item)

Period of Performance: 02/01/2020 to 01/31/2021

4011 OCONUS Pacific Dental Support Services 1 LT (Firm Fixed Price)

CLIN Include all costs associated with the support service requirements described in Section J, Attachment J-12, Eurasia/Africa/Latin America/Canada and OCONUS Pacific Dental Support Operations (Option Line Item)

Period of Performance: 02/01/2020 to 01/31/2021

4012 Transition-out 1 LT (Firm Fixed Price) (Option Line Item)

Period of Performance: 02/01/2020 to 01/31/2021

5001 Single Enrollment Premium 3792000 EA

- Enrollee Share -- 40%

- Government Share -- 60%

- Total Premium -- (Fixed Unit Price) (Option Line Item)

Period of Performance: 02/01/2021 to 01/31/2022

5002 Family Enrollment Premium 5592000 EA

- Enrollee Share -- 40%

- Government Share -- 60%

- Total Premium -- (Fixed Unit Price) (Option Line Item)

Period of Performance: 02/01/2021 to 01/31/2022

5003 Survivor Benefit-Single Enrollment Premium 24960 EA

- Government Share -- 100% (Fixed Unit Price)

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(A) (B) (C) (D) (E) (F)

(Option Line Item)

Period of Performance: 02/01/2021 to 01/31/2022

5004 Survivor Benefit-Family Enrollment Premium 40680 EA

- Government Share -- 100% (Fixed Unit Price) (Option Line Item)

Period of Performance: 02/01/2021 to 01/31/2022

5005 Reimbursement for Costs in Excess of Allowable 1 LT Charges for OCONUS Claims (Cost Reimbursable, No Fee) (Option Line Item)

Period of Performance: 02/01/2021 to 01/31/2022

5006 Reimbursement for Cost Shares and Additional 1 LT Allowable Charges for Orthodontic Costs Charge for OCONUS Claims (Cost Reimbursable, No Fee) (Option Line Item)

Period of Performance: 02/01/2021 to 01/31/2022

5007 NIST and Physical & Personnel Security 12 MO (Sustainment Costs) (Firm Fixed Price) (Option Line Item)

Period of Performance: 02/01/2021 to 01/31/2022

5008 Incentives 1 LT (Reference Section H.4. which outlines criteria for earning Incentive monies. The Total Amount shown reflects the maximum incentive available.)

(Option Line Item)

Period of Performance: 02/01/2021 to 01/31/2022

5009 Reports, Contract Data Requirements List 1 LT (DD Form 1423)

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(A) (B) (C) (D) (E) (F)

(Not Separately Priced)

Period of Performance: 02/01/2021 to 01/31/2022

5010 Eurasia/Africa/Latin America/Canada Dental 1 LT Support Services (Firm Fixed Price)

CLIN Include all costs associated with the support service requirements described in Section J, Attachment J-12, Eurasia/Africa/Latin America/Canada and OCONUS Pacific Dental Support Operations (Option Line Item)

Period of Performance: 02/01/2021 to 01/31/2022

5011 OCONUS Pacific Dental Support Services 1 LT (Firm Fixed Price)

CLIN Include all costs associated with the support service requirements described in Section J, Attachment J-12, Eurasia/Africa/Latin America/Canada and OCONUS Pacific Dental Support Operations (Option Line Item)

Period of Performance: 02/01/2021 to 01/31/2022

5012 Transition-out 1 LT (Firm Fixed Price) (Option Line Item)

Period of Performance: 02/01/2021 to 01/31/2022

6001 Phase-out (Option Period 1) 1 LT The Government intends to only exercise one phase out CLIN in the performance of this contract.

The CLIN (6001-6005) exercised will be dependent upon the final period of performance exercised for the contract.

(Firm Fixed Price) (Option Line Item)

Period of Performance: 02/01/2018 to 01/31/2019

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6002 Phase-out (Option Period 2) 1 LT The Government intends to only exercise one phase out CLIN in the performance of this contract.

The CLIN (6001-6005) exercised will be dependent upon the final period of performance exercised for the contract.

(Firm Fixed Price) (Option Line Item)

Period of Performance: 02/01/2019 to 01/31/2020

6003 Phase-out (Option Period 3) 1 LT The Government intends to only exercise one phase out CLIN in the performance of this contract.

The CLIN (6001-6005) exercised will be dependent upon the final period of performance exercised for the contract.

(Firm Fixed Price) (Option Line Item)

Period of Performance: 02/01/2020 to 01/31/2021

6004 Phase-out (Option Period 4) 1 LT The Government intends to only exercise one phase out CLIN in the performance of this contract.

The CLIN (6001-6005) exercised will be dependent upon the final period of performance exercised for the contract.

(Firm Fixed Price) (Option Line Item)

Period of Performance: 02/01/2021 to 01/31/2022

6005 Phase-out (Option Period 5) 1 LT The Government intends to only exercise one phase out CLIN in the performance of this contract.

The CLIN (6001-6005) exercised will be dependent upon the final period of performance exercised for the contract.

(Firm Fixed Price)

Period of Performance: 02/01/2022 to 01/31/2023

SECTION C

DESCRIPTION/SPECIFICATIONS/WORK STATEMENT

HT9402-15-R-0001 Page C1 of C12

C.1. MISSION

The Department of Defense (DoD) through the Defense Health Agency (DHA) has a mission to offer dental care services to eligible TRICARE beneficiaries. In order to fulfill DHA’s mission, the contractor shall provide comprehensive dental care services worldwide to eligible TRICARE beneficiaries under the TRICARE Dental Program (TDP).

C.1.2 Scope

The TDP offers worldwide coverage to all eligible family members of Uniformed Service active duty personnel and to members of the Selected Reserve and Individual Ready Reserve (IRR) and their eligible family members. The TDP geographic area of coverage for the Continental United States (CONUS) includes the 50 United States, the District of Columbia, Puerto Rico, Guam and the U.S. Virgin Islands. Outside the Continental United States (OCONUS) service area includes Canada, all other countries, island masses and territorial waters.

C.2 APPLICABLE DIRECTIVES

The following documents form an integral part of this contract and have the same force and effect as if set forth in full text. The TRICARE Manuals provide instruction, guidance and responsibilities to establish contractual requirements for implementation of federal statutes and regulations. When a statute, regulation, or manual changes, the contract requirements will not change until the Contracting Officer changes the contract by modification to the contract. In the event of a conflict between the manuals and either statue and/or regulation, the statute and/or regulation takes precedence. If there is a conflict between the manuals, the order of precedence is (1) TRICARE Policy Manual (TPM); (2) TRICARE Systems Manual (TSM); and (3) TRICARE Operations Manual (TOM). The TRICARE Manuals are located at http://manuals.tricare.osd.mil/ . If the contractor believes that a conflict exists between the incorporated documents, the contractor shall inform the Contracting Officer. Where the TRICARE Manuals state "TRICARE Management Activity" or "TMA" it shall be understood that the name references mean the same as "Defense Health Agency" or "DHA".

C.2.1. Title 10, U.S.C., Chapter 55.

C.2.2. 10 U.S.C. 1076a, 10 U.S.C. 10143 (Selected Reserve), 10 U.S.C. 10144(a) (Individual Ready Reserve (IRR) other than Special Mobilization Category), and 10 U.S.C. 10144(b) (IRR Special Mobilization Category).

C.2.3. 32 CFR Part 199.3, 199.6, 199.9, 199.10 and 199.13.

C.2.4. 36 CFR Part 1222 (data created or received and maintained for the Government by contractors).

C.2.5. 45 CFR Parts 160, 162 and 164 (the Health Insurance Portability and Accountability Act of 1996 (HIPAA) security and privacy standards, transaction and code set standards, National Provider Identifier (NPI) requirements and implementation specifications).

HT9402-15-R-0001 Page C2 of C12

C.2.6. National Institute of Standards and Technology (NIST) Special Publications (SP) 800-53 and 800-53A.

C.2.7. TRICARE Policy Manual (TPM) 6010.57-M, February 1, 2008 (through change XX).

The following TPM chapters apply:

• Chapter 8, Section 13.1 Adjunctive Dental Care

• Chapter 8, Section 13.2 Dental Anesthesia

C.2.8. TRICARE Operations Manual (TOM) 6010.56-M, February 1, 2008 (through change XX). The following TOM chapters apply:

• Chapter 1, Section 1 - Organization of the TRICARE Management Activity Section 2 - Contract Administration and Instructions (excluding paragraph 4.0) Section 4 - Management (excluding paragraphs 2.2, 2.3, 2.4, 3.1, 3.2, 3.4 and 4.

Section 5 - Compliance with Federal Statutes Section 6 - Legal Matters

• Chapter 2, Records Management

• Chapter 11, Section 8 - Grievances and Grievance Processing

Addendum A TRICARE Logo

• Chapter 12, Appeals and Hearings

• Chapter 13, Program Integrity

• Chapter 14, Section 2 - Reports and Plans

• Chapter 19, Health Insurance Portability and Accountability Act (HIPAA) of 1996

• Chapter 24, Section 12 - TRICARE Overseas Program (TOP) Point of Contract (POC)

Program

• Appendix A, Acronyms and Abbreviations

• Appendix B, Definitions

C.2.9. TRICARE Systems Manual (TSM) 7950.2-M, February 1, 2008 (through change XX).

The following TSM chapters apply:

• Chapter 1, General Automated Data Processing (ADP) Requirements (Section 1.1, paragraphs 3.4, 3.5 through 3.5.1.7, and 6.0 do not apply to TDP. Paragraph 3.5.2 is optional. Paragraph 11.5.5 does not apply. See Attachment J-5 for further guidance.)

• Chapter 3, Defense Enrollment Eligibility Reporting System (DEERS) (Section 1.4 does not apply to TDP)

C.3 PERFORMANCE REQUIREMENTS

The following section specifies the performance objectives and related tasks for the contract.

C.3.1. The contractor shall sustain or increase enrollment percentage for eligible beneficiaries.

HT9402-15-R-0001 Page C3 of C12

C.3.1.1. The contractor shall offer multiple avenues of access for continuous and portable open enrollment.

The definition for portable is members’ enrollment can transfer between active duty, Selected Reserve and IRR status (see Attachment J-3 and J-5). Minimum avenues of access will be telephone, paper, and on-line enrollment.

Performance Standards

a) STD: Enrollment actions shall be processed and monitored in accordance with the TSM Chapter 3, Section 1.5 and Section J, Attachment J-5 AQL: 99% of entries are accurate and complete

b) STD: If an application and premium payment are received after the 20th day of the month, enrollment will begin on the first day of the second month after the month in which the contractor received the application.

AQL: 95% of applications will be processed timely

Deliverables M010 Management Report M080 Enrollment and Fee Reconciliation Analysis Report Q030 Enrollment Activity Summary Report S050 Survivor Covered Lives and Utilization Report

C.3.1.2. The contractor shall inform and educate beneficiaries and providers about program benefits.

Performance Standards

a) STD: Compliant with contractor's education plan in accordance with Section J, Attachments J- 5 and J-6a.

AQL: 100% compliance, any deviations must be approved by the DHA Dental Care Office 30 calendar days prior to implementation.

Deliverables AP010 Beneficiary and Provider Education Plan R120 MOU with DHA Communications

C.3.2. The contractor shall increase utilization for diagnostic and preventive services.

C.3.2.1. The contractor shall educate beneficiaries about the benefit of utilizing diagnostic and preventive services.

Performance Standards

a) STD: Compliant with contractor's education plan in accordance with Section J, Attachment J- 5.

AQL: 100% compliance, any deviations must be approved by the DHA Dental Care Office 30 calendar days prior to implementation.

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Deliverables AP010 Beneficiary and Provider Education Plan S010 Utilization by Uniformed Services Active Duty (AD) Report S020 Utilization by Uniformed Services National Guard Reserve (NGR) Report

C.3.2.2. The contractor shall educate sponsors/guardians about the benefits of utilizing dental services by one to four year olds.

Performance Standards

a) STD: Compliant with contractor's education plan in accordance with Section J, Attachment J- 5.

AQL: 100% compliance, any deviations must be approved by the DHA Dental Care Office 30 calendar days prior to implementation.

Deliverables AP010 Beneficiary and Provider Education Plan S010 Utilization by Uniformed Services Active Duty (AD) Report S020 Utilization by Uniformed Services National Guard Reserve (NGR) Report

C.3.3 The contractor shall provide cost-effective dental care services for enrollees.

C.3.3.1 The contractor shall comply with the most current version of American Dental Association's (ADA) Current Dental Terminology (CDT) manual for covered services and update their systems.

Performance Standards

a) STD: Within 30 calendar days of the release of the new version, the contractor shall provide the DHA Dental Care Office with a synopsis of their recommended changes for Section J, Attachment J-2, including CDT codes to be added, deleted and/or updated.

AQL: Submitted within 30 calendar days 100% of the time.

b) STD: The contractor shall update their systems to reflect the DHA Dental Care Office’s approved CDT code changes no later than January 1st of the effective year.

AQL: System updates will be completed 100% of the time.

C.3.3.2. The contractor shall provide and maintain access to general and specialty network providers for enrollees.

Performance Standards

a) STD: Establish networks for general dental care in the United States, the District of Columbia, Puerto Rico, Guam and the U.S. Virgin Islands in accordance with 32 CFR 199.13.

AQL: 95% of enrollees shall have access to a general dentist within 35 driving miles and 21 days of requesting an appointment.

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b) STD: Develop, maintain and make available to enrollees, providers and Government representatives an up-to-date list of network providers. List posted on contractor’s Web site that will allow for searches by multiple criteria.

AQL: Update monthly.

Deliverables M030 Provider Network Access Report

C.3.3.3. The contractor shall develop agreements with TRICARE OCONUS Preferred Dentists (TOPDs).

Performance Standards

a) STD: Compliant with Section J, Attachment J-6a.

Deliverables Q040 OCONUS Utilization by Provider Location Report Q050 Location of TRICARE OCONUS Preferred Dentist (TOPD) Agreements

C.3.3.4. The contractor shall process claims to completion for enrollees and providers.

Process to Completion is defined in the TOM, Appendix B. Not less than 60 days prior to the start work date, the contractor shall provide the DHA Dental Care Office a copy of the definition and methodology employed for computing claims payment accuracy.

Performance Standards

a) STD: Process claims to completion in accordance with Section J, Attachments J-5 and J-6a.

AQL: CONUS Claims 95% within 14 business days of receipt 98% within 30 business days of receipt 100% within 60 business days of receipt

OCONUS Claims 95% within 14 business days of receipt 98% within 30 business days of receipt 100% within 60 business days of receipt

b) STD: Claim Payment Accuracy in accordance with Section J, Attachments, J-2, J-5 and J-6a.

AQL: 97% are accurately paid

c) STD: Claims errors shall be corrected within 10 calendar days of identification of the error.

AQL: 99% corrected.

Deliverables M010 Management Report M040 OCONUS Payment Report M060 Worldwide Incurred/Paid Claims Report

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Q060 OCONUS Denied Services Report S010 Utilization Report by Uniformed Services AD S020 Utilization Report by Uniformed Service NGR S030 Utilization Report CONUS/OCONUS Frequency & Dollar S040 Utilization Report CONUS/OCONUS Denied Services S050 Survivor Covered Lives and Utilization Report A010 Actual Average Allowed Charges Report

C.3.3.5. The contractor shall process appeals to completion for enrollees and providers.

a) STD: Appeals shall be processed in accordance with 32 CFR 199.22(k) and the TOM, Chapter 12 (Use Section J, Attachment J-9 in place of Figure 12.A-2 of the TOM).

b) STD: Non-expedited medical necessity and factual reconsiderations to completion.

AQL: 95% within 60 calendar days of receipt 100% within 90 calendar days of receipt

c) STD: Process to completion determinations reversed by appeals.

AQL: 100% within 21 calendar days of receipt

Deliverables M020 Appeals Report R140 Appeals Processing Guidelines, Desk Instructions and Reference Materials

C.3.3.6. The contractor shall process grievances to completion for enrollees and providers.

a) STD: Grievances shall be processed to completion in accordance with the TOM, Chapter 11, Section 8.

AQL: 95% within 60 calendar days of receipt

Deliverables M010 Management Report

C.3.3.7. The contractor shall provide readily accessible comprehensive customer service for beneficiaries and providers.

Performance Standards

a) STD: Provide customer service in accordance with Section J, Attachment J-5.

AQL: Telephone answered by Automated Response Unit - 100% within 20 seconds.

Telephone answered by Customer Service Representative (CSR) - 80% within 30 seconds of selection by caller.

Telephone Call Blockage Rate - 5% or less at all times (measured, at a minimum, hourly) Telephone Call Resolution - 80% during the initial call; 99.9% within 3 business days.

Priority Written and E-mail Correspondence (final response) - 95% within 7 business days of receipt; 99.9% within 20 business days of receipt.

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Non-priority Written and E-mail Correspondence - 85% within 10 business days; 99.9% within 25 business days.

b) STD: Maintain overall customer satisfaction, which is measured on an annual basis. The measurement will be based on the average of the quarterly customer satisfaction phone surveys conducted by DHA, Defense Health Cost Assessment and Program Evaluation (DHCAPE). The results will be provided to the contractor within 30 calendar days of completing each of the quarterly surveys.

AQL: 95% overall customer satisfaction with TDP.

Deliverables M010 Management Report

C.3.3.8. The contractor shall process orthodontic treatment plan reviews to completion.

This requirement applies only if CLINs X010 and X011 are exercised.

a) STD: Orthodontic treatment plan reviews shall be processed to completion in accordance with Section J, Attachment J-12.

AQL: 95% within 10 business day of receipt.

Deliverables M010 Management Report

C.4. Additional Requirements

The following sub-sections provide details of additional requirements for this contract.

C.4.1. System Security

The contractor shall acquire, develop and maintain processes for safeguarding unclassified sensitive DoD information on all contractor/subcontractor systems/networks that store, process or access Government sensitive information in accordance with TSM, Chapter 1, Section 1.1 and Section J, Attachment J-5. The contractor shall implement a minimum level of enhanced safeguarding for unclassified DoD information as defined in the NIST SP 800-53 and 53A, Privacy Act Program Requirements (DoD 5400.11-R), and the Personnel Security Program (DoD 5200.2-R). Government acknowledgement of the contractor's Annual Checklist and Certification for Minimum Level of Enhanced Safeguarding for Unclassified DoD Information (also known as the "Checklist") is required prior to accessing DoD data or interconnectivity with the Government system and testing.

Deliverables M090 Employee Access to DoD IS/Networks Report A050 DoD/NIST Certification Report A080 Disaster Recovery Test Results Report AP020 Continuity of Operations Plan (COOP) R020 Identification of Systems of Records Report

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R130 Privacy Impact Assessment

C.4.2. Health Insurance Portability and Accountability Act (HIPAA).

The contractor shall comply with the HIPAA requirements of TOM, Chapter 19.

Deliverables M050 HIPAA/Privacy Complaint Report A060 Privacy and Security Risk Assessment Letter of Assurance A070 Privacy and Security Program Evaluation Letter of Assurance R010 Preliminary Incident Report (PHI/PII) R080 Designated Standards Maintenance Organization (DSMO) Meeting Summary Report OT010 Initial Privacy and Security Risk Assessment and Action Plan OT020 Initial Privacy and Security Program Evaluation and Action Plan

C.4.3. Transition

The transition-in, transition-out and phase-out of this contract will be conducted according to the requirements stated in Section J, Attachment J-11.

Deliverables W010 Transition-In Status Report W020 Transition-Out and Phase-Out Status Report R030Transition-In Plan R040 Transition-Out and Phase-Out Plan

C.4.4. Government Furnished Materials

C.4.4.1. The Government will furnish an electronic flat file listing of the names and addresses of all known sponsors. The electronic flat file listing will be provided to the contractor no later than the date initial education materials are approved. The contractor must comply with the security requirements stated in C.4.1 prior to receiving the data. Thereafter, a list of newly identified sponsors will be furnished quarterly every Option Period.

C.4.4.2. The Government will provide the contractor the appropriate application software required to access the Defense Manpower Data Center's (DMDC) Defense Eligibility Enrollment Reporting System (DEERS) to perform eligibility inquiries and enrollments. The Government will grant the contractor access to DEERS only after the contractor's staff and all subcontractors' staff, that utilize systems which access and maintain TDP data, are compliant with the safeguarding methods for unclassified DoD information, personnel security and clearance requirements stated in C.4.1. The contractor and its subcontractors must be in compliance with C.4.1, no later than 120 days after award.

C.4.4.3. The Government will print and provide to the contractor educational documents as identified in Section J, Attachment J-5.

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C.4.5. Records Management

All contractor records generated under this contract shall be maintained in accordance with 36 CFR 1222 and the TOM, Chapter 2.

C.4.6. Management Strategies.

The contractor shall establish and maintain effective management strategies, staff education and training programs, lines of authority, and reporting and coordination interfaces with the Government. The contractor shall comply with the management guidance in the TOM, Chapter 1, Sections 1, 2 (excluding paragraphs 4.0 and 5.0), 4 (excluding paragraphs 2.2, 2.3, 2.4, 3.1, 3.2 and 3.4), 5, and 6.

Deliverables A040 Contract Releasable Under FOIA R020 Identification of Systems of Records Report

C.4.7. Quality

The following sub-sections provide details of the quality control components of this contract.

C.4.7.1. Quality Control Program (QCP)

C.4.7.1.1. The contractor shall develop and implement a QCP in accordance with the TOM, Chapter 1, Section 4 (excluding paragraph 2.2, 2.3, 2.4, 3.1, 3.2, 3.4 and 4.0). The contractor shall maintain a QCP that ensures that services are performed in accordance with the contract.

The contractor shall develop and implement procedures to identify, prevent, and correct problems for the duration of the contract.

Deliverables Q010 Quality Control Program (QCP) Report AP30 Quality Control Program (QCP) Plan

C.4.7.1.2. The contractor shall also provide a Web based dental health plan report card that monitors outcome measures for the program. This report card will, at a minimum, monitor access and satisfaction, use of services, effectiveness of care, utilization, membership, utilization of prophylaxes of pregnant and diabetic enrollees, utilization of scaling and root planning of diabetic enrollees, and utilization of the dental accident coverage. The data will be updated on a monthly basis and summarized quarterly.

C.4.7.2. Quality Assurance Surveillance Plan (QASP)

The Government shall monitor the contractors’ performance under this contract in accordance with the Government’s QASP.

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C.4.8. Disaster Action Plan

The contractor shall develop a Disaster Action Plan to be implemented when the President of the United States declares an area of the United States or any U.S. territory with a provider network to be a "National Disaster Area" (see Section J, Attachment J-5).

Deliverables R050 National Disaster Action Report

C.4.9. Fraud and Abuse

C.4.9.1. The contractor shall implement a Fraud and Abuse program in accordance with TOM, Chapter 13.

Deliverables Q020 Fraud and Abuse Summary Report A020 Letter of Assurance (Internal Management Control Reviews) A030 Annual OCONUS Summary Report AP040 Fraud Detection and Prevention Strategy and Internal Procedures Plan R060 Terrorist/Beneficiary/Provider Threats Report R070 Free Commerce Interference Report R100 Standard Operating Procedures (Desk Procedures)

C.4.9.2. Potential Fraud and Abuse Cases. The contractor shall refer to DHA potential cases that involve more than a $10,000 loss to the Government or cases with any loss where patient harm has occurred. See TOM, Chapter 13, Section 2 for further requirements.

C.4.9.3. Post Payment Utilization Reviews. When performing post payment utilization reviews, the contractor shall consider high volume beneficiaries as those beneficiaries whose charges exceed $25,000 during a 12 month reporting period. High volume providers are considered institutional providers whose payments exceed $750,000; individual providers whose payments exceed $100,000; group/clinics whose payments exceed $100,000 (the threshold average is $25,000 per professional provider within the group) during a 12 month reporting period. See TOM, Chapter 13, Section 4 for further requirements.

C.4.10. Required Data

C.4.10.1 The contractor shall provide the Government with access to their full TDP data set including, but not limited to network providers, non-network providers, enrollment information, claims processing, claims payment, enrollee care and service data.

C.4.10.1.1. The contractor shall work with the Government during transition on the report formats (see Section J, Exhibit A). The contractor shall work with the Government to fully describe the format/data elements (i.e., field descriptions, field lengths, list of allowed entries for each field) to be used for each report and to build/test the reports to be forwarded to the Government. During the term of the contract the Government may require additional changes to

HT9402-15-R-0001 Page C11 of C12 the makeup of these reports (e.g., add or delete data elements or change the format) and the contractor shall implement these changes at no change to the contract price.

C.4.10.2. Military Health System (MHS) Data Repository (MDR). The contractor shall work with the DHA Dental Care Office and DHA, Defense Health Services Systems (DHSS) in developing a TDP Interface Control Document (ICD) describing the data exchange to the MHS(MDR. The purpose of the TDP ICD is to describe the interface that provides the TDP records from the contractor's automated information systems in support of the TDP.

C.4.10.2.1. The contractor shall submit the claims and provider data in accordance with the ICD and Section J, Attachment J-10.

Deliverables M070 MDR Data Claims and Provider Files

C.4.10.2.2. The contractor shall protect the data in accordance with the C2-level protection standards mandated for all "Sensitive Unclassified Systems" as required in the DoD Directive

5200.28 since the data exchanged in this interface contains protected patient level identifiable information and the aggregate data being transmitted by DHSS becomes part of a database that contains sensitive data.

C.4.10.2.3. The contractor shall perform validation checks such as record counts, file formats, source stamps, and date-time stamps on data transferred from the contractor to the MDR as defined in the MDR ICD. When errors are discovered in the data exchange, the contractor will be notified immediately by DHSS operations personnel. If there are systemic problems, Interface Working Group (IWG) counterparts will be contacted by DHSS to work the issues.

C.4.10.3. If data submission mistakes are discovered (e.g., the manner in which the data is submitted leads to incorrect data reporting) during the term of the contract, the contractor shall correct the mistakes within 30 calendar days of notification.

C.4.11. Government and Contractor Visits/Meetings

Generally, a 14 calendar day notice will be provided for all meetings hosted by DHA. The Government anticipates up to three meetings per year. These meetings are in addition to those stated Section J, Attachment J-11. All contractor travel costs associated with any of these meetings shall be the responsibility of the contractor.

C.4.12. Special Request Reports.

C.4.12.1. Ad Hoc Reports. The Government may request the contractor to submit up to four ad hoc reports per option period at no additional cost.

Deliverables R090 Ad Hoc Management Reports

HT9402-15-R-0001 Page C12 of C12

C.4.12.2. Consolidated Historical Data File. The Government may request the contractor to submit a historical data file up to two times over the life of the contract.

Deliverables R110 Consolidated TDP Historical Data File

C.5. Reports and Plans

The contractor shall provide all reports and plans in accordance with Section F.5.

SECTION D

PACKAGING AND MARKING

HT9402-15-R-0001 Page D1 of D1

D.1. PACKAGING

Preservation, packaging, and packing for shipment or mailing of all work delivered hereunder, by other than electronic means, shall be in accordance with good commercial practice and adequate to insure acceptance by common carrier and safe transportation at the most economical rate(s).

D.2. MARKING

Each package, report or other deliverable shall be accompanied by a letter or other document which:

D.2.1. Identifies the contract by number under which the item is being delivered.

D.2.2. Identifies the deliverable Item Number or Report Requirement which requires the delivered item(s).

D.2.3. Indicates whether the contractor considers the delivered item to be a partial or full satisfaction of the requirement.

(End of Section)

SECTION E

INSPECTION AND ACCEPTANCE

HT9402-15-R-0001 Page E1 of E1

E.1. FAR 52.246-4 Inspection of Services - Fixed-Price. (AUG 1996)

E.2. DFAR 252.246-7000 Material Inspection and Receiving Report. (MAR 2008)

E.3. INSPECTION AND ACCEPTANCE

The final acceptance authority for the government shall be:

Department of Defense Defense Health Agency Contracting Officer Representative (COR) Dental Care Branch 16401 E. Centretech Parkway Aurora, CO 80011-9066

E.4. INSPECTION LOCATION

Inspections may be conducted electronically or by physical inspection. Inspections will be conducted either at Defense Health Agency, the contractor’s and/or subcontractor’s facilities, or other locations where work is performed. Inspection and acceptance of services provided hereunder shall be accomplished by the COR; or in the COR’s absence the Contracting Officer.

Inspections may include, but are not limited to, payment record audits, performance audits, program integrity audits, and contractor/DHA quality assurance audits.

E.5. QUALITY ASSURANCE SURVEILLANCE PLAN (QASP)

The role of the Government is to design, implement and conduct adequate contract surveillance and quality assurance to ensure contract requirements and standards are satisfactorily performed.

For these purposes, the Government will be utilizing a QASP. An updated version will be provided to the contractor as revisions occur.

SECTION F

DELIVERIES OR PERFORMANCE

HT9402-15-R-0001 Page F1 of F3

F.1. FAR 52.242-15 Stop-Work Order. (AUG 1989)

F.2. PERIOD OF PERFORMANCE

Transition-in Period (Date of Award through start of dental healthcare delivery): The contractor shall begin transition-in activities and complete specific activities by the timelines specified in Section J, Attachment J-11. All transition-in activities shall be completed by the date specified in the contractor’s Transition Plan.

F.2.1. Base Period/Transition-In: 02/01/2016 to 01/31/2017

F.2.2. Options 1 through 6 (if exercised) will be:

Option Period 1: 02/01/2017 to 01/31/2018 Option Period 2: 02/01/2018 to 01/31/2019 Option Period 3: 02/01/2019 to 01/31/2020 Option Period 4: 02/01/2020 to 01/31/2021 Option Period 5: 02/01/2021 to 01/31/2022 Option Period 6: 02/01/2022 to 01/31/2023

F.3. PLACE OF POSTAL DELIVERY AND PROCEDURES

F.3.1. All certified and overnight mail for Defense Health Agency (DHA) is to be delivered to:

Defense Health Agency, 16401 E. Centretech Parkway, Aurora, CO 80011-9066. DHA Normal Delivery Hours are 7:30 a.m. to 4:00 p.m. (local time), Monday through Friday, excluding Federal Holidays.

F.3.2. All mail directed to the Contracting Officer (CO) shall be addressed to the Defense Health Agency, Attention: Contracting Officer, COD-A, TRICARE Dental Program, 16401 E.

Centretech Parkway, Aurora, CO 80011-9066. DHA Normal Delivery Hours are 7:30 a.m. to 4:00 p.m. (local time), Monday through Friday, excluding Federal Holidays.

F.3.3. All mail directed to the Contracting Officer Representative (COR) shall be addressed to the Defense Health Agency, Attention: COR, DCB, TRICARE Dental Program, 16401 E.

Centretech Parkway, Aurora, CO 80011-9066. DHA Normal Delivery Hours are 7:30 a.m. to 4:00 p.m. (local time), Monday through Friday, excluding Federal Holidays.

F.4. NOTICE REGARDING LATE DELIVERY

In the event the contractor anticipates difficulty in complying with the delivery schedule, the contractor shall immediately notify the Contracting Officer (CO) or the Contracting Officer Representative (COR), in writing, giving pertinent details, including the date by which it expects to make delivery. This notification shall be informational only in character and that receipt of it shall not be construed as a waiver by the Government of any contract delivery schedule, or any rights or remedies provided by law or under this contract.

HT9402-15-R-0001 Page F2 of F3

F.5. REPORTS AND PLANS

F.5.1. Unless otherwise specified, contractors shall electronically submit all deliverables in a format approved by the Government to include Microsoft Office Excel, Word, PDF, or other specified format. Unless otherwise specified, all deliverables shall be submitted to DHA via the eCommerce Extranet (https://tma-extranet.csd.disa.mil/logon/privacystatement.cfm). See the TOM, Chapter 14, Section 2 for report submission requirements.

F.5.2. The contractor is accountable for assuring that reports contain accurate and complete data.

The contractor shall prepare written procedures describing the source of information as well as the specific steps followed in the collection and preparation of data for each report. All reports must be supported with sufficient documentation and audit trails. The reports shall be titled as listed. The contractor shall submit a negative report if there is no data to report.

F.5.3. The contractor shall provide all the following reports and plans that are specified in Section J, Exhibit A, CDRLs.

F.5.3.1. Weekly Reports W010 Transition-In Status Report W020 Transition-Out and Phase-Out Status Report

F.5.3.2. Monthly Reports M010 Management Report M020 Appeals Report M030 Provider Network Access Report M040 OCONUS Payment Report M050 HIPAA/Privacy Complaint Report M060 Worldwide Incurred/Paid Claims Report M070 MDR Data Claims and Provider Files M080 Enrollment and Fee Reconciliation Analysis Report M090 Employee Access to DoD IS/Networks Report

F.5.3.3. Quarterly Reports Q010 Quality Control Program (QCP) Report Q020 Fraud and Abuse Summary Report Q030 Enrollment Activity Summary…