The file's text, extracted by GovTribe without its formatting.
Section B, Contract Line Item Number (CLIN) Descriptions TRICARE Quality Monitoring Contract (TQMC)
| CLIN | Description: |
| 0001 |
| Transition-in. (Section C paragraph 6.2.1 Transition-in) This CLIN establishes a firm-fixed-price (FFP) in whole dollars with no cents for transition-in tasks. This amount shall include all costs and profit anticipated in the performance of transition-in tasks to accomplish the requirements in the contract, including security (Physical, Personnel and NIST) certifications and shall not include any costs associated with any other CLIN. |
| 0002 |
| Deliverables (DD Forms 1423-1, Contract Data Requirements List (CDRLS)) Not separately priced (NSP) |
| 1001, 2001, 3001, 4001, 5001 |
| Health Plan Clinical Quality Measures. (Section C paragraph 6.3.1) This CLIN establishes an FFP in whole dollars, with no cents, per month for the download, analysis and reporting of MHS outpatient clinical quality data for NCQA HEDIS® measures. The contractor shall furnish all necessary labor and materials to perform the services to meet the requirements in the contract. |
| 1002, 2002, 3002, 4002, 5002 |
| Annual NCQA HEDIS® Validation Audit. (Section C paragraph 6.3.1.4) This CLIN establishes an FFP in whole dollars, with no cents. The contractor shall furnish all necessary labor and materials to perform the services to meet the requirements in the contract. |
| 1003, 2003, 3003, 4003, 5003 |
| National Hospital Quality Measures (NHQM). (Section C paragraph 6.3.2) This CLIN establishes an FFP in whole dollars, with no cents, per quarter for CMS Hospital Compare data retrieval, manipulation, analysis, and reporting. The contractor shall furnish all necessary labor and materials to perform the services to meet the requirements in the contract. T |
| 1004, 2004, 3004, 4004, 5004 |
| Joint Commission ORYX® Hospital Quality Measures. (Section C paragraph 6.3.3). (This CLIN establishes a fixed price in whole dollars, with no cents, for ORYX data abstraction, analysis, and reporting. The contractor shall furnish all necessary labor and materials to perform the services to meet the requirements in the contract. |
SLIN X004AA establishes a fixed price per chart for abstraction (Section C, paragraph 6.3.3.1).
SLIN X004AB establishes a firm, fixed price for the quarterly ORYX data submission to the Joint Commission (Section C, paragraphs 6.3.3.2 through 6.3.3.7).
| 1005, 2005, 3005, 4005, 5005 |
| Institute for Healthcare Improvement (IHI) Global Trigger Tool (GTT). (Section C paragraph 6.3.4). This CLIN establishes a fixed price in whole dollars, with no cents, per direct care inpatient chart. The contractor shall furnish all necessary labor and materials to perform the services to meet the requirements in the contract. |
| 1006, 2006, 3006, 4006, 5006 |
| Reviews of Behavioral Health Facility Applications for Certification. (Section C paragraph 6.4). This CLIN establishes a fixed price in whole dollars, with no cents, per application review. The contractor shall furnish all necessary labor and materials to perform the services to meet the requirements in the contract. |
| 1007, 2007, 3007, 4007, 5007 |
| Onsite Reviews of Behavioral Health Facility Certification. (Section C paragraph 6.4) This CLIN establishes a fixed price in whole dollars, with no cents, per onsite review. The contractor shall furnish all necessary labor and materials to perform the services to meet the requirements in the contract. |
| 1008, 2008, 3008, 4008, 5008 |
| Quality and Utilization Reviews. (Section C paragraph 6.5.1) This CLIN establishes a fixed price in whole dollars, with no cents, for the review of purchased care inpatient charts pursuant to 32 CFR, 199.15. This applies to purchased care inpatient charts reviewed under CLINS: X009, X010, X011, X012, X014, X016, X018, X019. |
| 1009, 2009, 3009, 4009, 5009 |
| Medical Necessity Reconsideration Reviews. (Second Level Appeals) (Section C paragraph 6.5.2) This CLIN establishes a fixed price in whole dollars, with no cents, per review. The contractor shall furnish all necessary labor and materials to perform the services to meet the requirements in the contract. |
| 1010, 2010, 3010, 4010, 5010 |
| Appeals & Hearings Internal Reviews. (Section C paragraph 6.5.3 and Section J, Attachment J-6) This CLIN establishes a fixed price in whole dollars, with no cents, per internal review. The contractor shall furnish all necessary labor and materials to perform the services to meet the requirements in the contract. |
| 1011, 2011, 3011, 4011, 5011 |
| Appeals & Hearings Urgent External Reviews. (Section C paragraph 6.5.3 and Section J, Attachment J-6) This CLIN establishes a fixed price in whole dollars, with no cents, per urgent external review. The contractor shall furnish all necessary labor and materials to perform the services to meet the requirements in the contract. |
| 1012, 2012, 3012, 4012, 5012 |
| Appeals & Hearings Routine External Reviews. (Section C paragraph 6.5.3 and Section J, Attachment J-6) This CLIN establishes a fixed price in whole dollars, with no cents, per routine external review. The contractor shall furnish all necessary labor and materials to perform the services to meet the requirements in the contract. |
| 1013, 2013, 3013, 4013, 5013 |
| Appeals & Hearings. (Section C, paragraph 6.5.3 and Section J, Attachment J-6) This CLIN establishes a fixed price per hour in whole dollars and no cents for medical peer reviewers to serve as expert witnesses for medical appeal administrative hearings and proceedings. The price per hour for each SLIN (X013AA, X013AB, X013AC, X013AD) to accomplish the witness appearance services as described in the contract for pre-hearing, hearing appearance, post-hearing and transcription of expert witnesses. Individual task order. |
| 1014, 2014, 3014, 4014, 5014 |
| Transition Assistance Management Program (TAMP) Benefit Extension Second-Level Reviews. (Section C, paragraph 6.5.4) This CLIN establishes a fixed price in whole dollars, with no cents, per TAMP review. The contractor shall furnish all necessary labor and materials to perform the services to meet the requirements in the contract. |
| 1015, 2015, 3015, 4015, 5015 |
| Standard of Care (SOC) Reviews. (Section C paragraph 6.5.5) This CLIN establishes fixed price in whole dollars, with no cents, per SOC review. The contractor shall furnish all necessary labor and materials to perform the services to meet the requirements in the contract. |
| 1016, 2016, 3016, 4016, 5016 |
| Quality of Care (QOC) Reviews. (Section C paragraph 6.5.6) This CLIN establishes a fixed price in whole dollars, with no cents, per QOC review. The contractor shall furnish all necessary labor and materials to perform the services to meet the requirements in the contract. |
| 1017, 2017, 3017, 4017, 5017 |
| Clinical Quality Improvement Administrative Studies. (Section C, paragraph 6.6.1) This CLIN establishes a fixed price in whole dollars, with no cents, per hour per study (estimated to require 125 hours per study). The contractor shall furnish all necessary labor and materials to perform the services to meet the requirements in the contract. |
| 1018, 2018, 3018, 4018, 5018 |
| Clinical Quality Improvement Abstraction Studies. (Fewer than 2,000 records) (Section C paragraph 6.6.1) This CLIN establishes a fixed price in whole dollars, with no cents, per chart per study. The contractor shall furnish all necessary labor and materials to perform the services to meet the requirements in the contract. |
| 1019, 2019, 3019, 4019, 5019 |
| Clinical Quality Improvement Abstraction Studies. (2000 or more Charts) (Section C paragraph 6.6.1) This CLIN establishes a fixed price in whole dollars, with no cents, per chart per study. The contractor shall furnish all necessary labor and materials to perform the services to meet the requirements in the contract. |
| 1020, 2020, 3020, 4020, 5020 |
| Annual Autism Care Demonstration (ACD) Studies. (Section C paragraph 6.6.2) (Purchased care outpatient) This CLIN establishes a fixed price in whole dollars, with no cents, per chart review. The contractor shall furnish all necessary labor and materials to perform the services to meet the requirements in the contract. |
| 1021, 2021, 3021, 4021, 5021 |
| Long Assessment of Evolving Practices, Devices, Medicines, Treatments, and Procedures. (Section C paragraph 6.7) This CLIN establishes a fixed price in whole dollars, with no cents, per long assessment. The contractor shall furnish all necessary labor and materials to perform the services to meet the requirements in the contract. Individual task order. |
| 1022, 2022, 3022, 4022, 5022 |
| Short Assessment of Evolving Practices, Devices, Medicines, Treatments, and Procedures. (Section C paragraph 6.7) This CLIN establishes a fixed price in whole dollars, with no cents, per short assessment. The contractor shall furnish all necessary labor and materials to perform the services to meet the requirements in the contract. Individual task order. |
| 1023, 2023, 3023, 4023, 5023 |
| Quality Communications. (Section C paragraph 6.8) This CLIN establishes an FFP per month in whole dollars with no cents. The contractor shall furnish all necessary labor and materials to perform the services to meet the requirements in the contract. |
| 1024, 2024, 3024, 4024, 5024 |
| Meeting Attendance. (Section C paragraph 6.1.13) This CLIN establishes a cost-reimbursed (no fee) not-to-exceed amount for meeting attendance in whole dollars with no cents. The contractor shall furnish all necessary labor and materials to perform the services to meet the requirements in the contract. |
| 1025, 2025, 3025, 4025, 5025 |
| Travel. (Section C paragraph 9.0) This CLIN establishes a cost-reimbursed (no fee) not-to-exceed amount for government-authorized travel. |
| 1026, 2026, 3026, 4026, 5026 |
| Deliverables. (DD Forms 1423-1, Contract Data Requirements List (CDRLS)) Not separately priced (NSP). |
| 1027, 2027, 3027, 4027, 5027 |
| Transition-out. (Section C paragraph 6.2.2) This CLIN establishes a firm, fixed-price in whole dollars, with no cents, for transition-out for all necessary labor and materials to perform the services to meet the requirements in the contract. Although priced for each option period, transition-out shall occur only once during the life of the contract. The transition-out period will run concurrently with the last exercised option period of the contract. |
TQMC HT9402-15-R-0005, Section B Page 4 of 4
Defense Health Agency