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TQMC HT9402-15-R-0005
DHA Responses to Solicitation Questions
| No: |
| Solicitation Citation & Paragraph |
| Question/Comment |
| DHA Response |
Is this a follow-on requirement? If so, could you please provide the incumbent contract number for this opportunity?
If not, is this a new requirement?
TQMC: HT9402-10-D-0001
Clinical Quality Management Support (CQMS) Task Order: W81XWH-08-D-0039, Task Order 0016
| 1. Given that the pre-proposal conference leaves just two weeks following the information provided at the conference for the proposal to be received, will DHA extend the proposal due date? |
| DHA posted the solicitation on May 19 and identified the date for the pre-proposal conference and the proposal due date at that time. DHA has not identified a reason to extend the proposal due date. |
| This RFP provides a cap on the contract dollars ($65 million). Was there a cap on the dollars in the prior RFP? |
| The $65 million is stated in accordance with FAR 16.504(a)(4). |
| 4 |
| Section C - 4.0 Government Furnished Information (GFI) |
| The RFP states: “The contractor shall use government provided laptop computers…..” |
Should the respondent include the government provided laptops in the pricing proposal as Pass-through costs?
No.
DHA will provide these to the successful offeror.
| 5 |
| Section C - 4.0 Government Furnished Equipment (GFE) and Information (GFI) |
| Will TRICARE be providing laptops for all proposed/budgeted staff across all CLINS?” |
| Section C 4.0 paragraph is “GOVERNMENT FURNISHED INFORMATION (GFI)” |
No. DHA will provide laptop computers for the contractor personnel who will “access MTF electronic medical records either remotely or onsite for data abstraction.”
| 6 |
| Section C - 6.3.3 Joint Commission ORYX Hospital Quality Measures (Direct Care) 6.3.3.1 |
| What is the historical percentages of ORYX abstraction that was done onsite? |
| At the start of Option Year 1 of the MHS-CQMS task order, the incumbent contractor abstracted 100% of ORYX data abstraction onsite. During the last 12-months, the incumbent abstracted 100% of ORYX data via remote access. |
| 7 |
| Section C - 6.3.4 Institute for Health Improvement (IHI) GTT (Direct Care) |
| What is the historical percentages of Global Trigger Tool abstraction that was done onsite? |
| The Global Trigger Tool is a new requirement in this solicitation. There is no historical data. |
| 8 |
| Section C - 6.5.1 Quality and Utilization Reviews (Purchased Care) |
| What is the methodology in which the Quality and Utilization Review charts are selected? |
| Quality and utilization reviews are performed on any inpatient purchased care medical record reviewed by the TQMC for any reason. See Section C paragraphs 6.5.1 and 6.6.1.2 |
| 9 |
| Section C - 6.5.1 Quality and Utilization Reviews (Purchased Care) |
| Must the medical records requested for Quality and Utilization review be connected to a Quality Improvement Study, or are the Medical Reviews separate from the Quality Improvement Study reviews? |
| Please see response to question 8. |
| 10 |
| Section C - 6.6.1 Clinical Quality Improvement Studies (Direct and Purchased Care) |
| How does the 500 hours in CLIN 1017 relate to the 4000 charts in 1018 and the 6000 charts in 1019? Is it a different study? Or the administrative work for the studies in 1018 and 1019 |
| Yes, these are different studies. |
Per Section G, paragraph 3.1 Quality Improvement Studies: (Section C, paragraph 6.6). The COR will notify the contractor of the approved study topics and the applicable CLIN (X017, X018 or X019, and X008 if applicable) for the study. Prior to starting the study, the contractor shall provide an estimate of the number of hours required or charts it anticipates it will review to complete the study.
Per Section C, paragraph 6.6.1 “Clinical Quality Studies may be performed using data obtained via administrative means utilizing DHA databases and/or medical record abstraction (See Section J, Attachment J-5, Clinical Quality Improvement Study Examples).”
See Section L Exhibits L-6 and L-7 for historical information.
| 11 |
| Section C - 6.6.1 Clinical Quality Improvement Studies (Directed and Purchased Care) |
| DHA has stated that only 2 clinical quality studies will be approved annually. If both studies fall under CLIN 1018, does that mean CLIN 1019 will not be exercised? Or vice versa? |
| CLINs are exercised in conjunction with exercising each option year in a unilateral modification. See Section G, paragraph 3.1, Quality Improvement Studies. This is an IDIQ contract. See FAR Clause 52.216-22, Indefinite Quantity. Section B, TQMC Option Year 1 states, “The schedule quantities are estimated except for CLINs 1001, 1002, 1003, 1023, 1024, 1025, 1026 and 1027.” |
DHA estimates it will order two clinical quality studies per year. The Not to Exceed (NTE) amount in Column C of Section B allows DHA to order more than two. DHA may order fewer than two or up to the NTE quantities shown in Column C of Section B.
| 12 |
| Section L 7.0 – Volume III, Past Performance Information (Factor 2, Past Performance |
Section M 5.2, 5.3, 5.4 & 5.5 – 5.2 Recency, 5.3 Relevancy, 5.4 Quality, & 5.5 Performance Confidence Assessment
| Will DOD retrieve previous vendor evaluations from the CPAR system vs a completed L-2 document? |
| PPQs are required per Section L, paragraph 7.7. |
DHA will evaluate past performance in accordance with Section M, paragraph 5.0. See paragraph 5.5.
| 13 |
| Section L – 4.3 |
| Is the header and footer information allowed within the 1” inch margin? |
| Yes, See Section L, paragraph 4.3. The header and footer information falls within the 1” margin. |
| 14 |
| Section L – 4.3 |
| When mailing the volumes – Can the separate volumes be mailed within the same box? |
| Yes. |
| 15 |
| Section L- 4.2 |
| Can the required CDs be placed in the box within the original binder for each volume? |
| Yes. |
| 16 |
| SF33 Pages 1-23 |
| Will DHA provide a LOE for each CLIN or a minimum required staffing? |
| No. This is a fixed price performance-based services contract, not a level of effort contract. DHA will not prescribe how potential offerors accomplish the solicitation requirements. |
| 17 |
| Section C Paragraph 1.2.1.3 |
| How would you like the clinical quality measures data displayed? What level of dash boarding would DHA prefer (e.g. internal dashboard and separate public facing dashboard)? |
| DHA would expect the TQMC to display data trends on the internal website in the manner described in Section C paragraph 1.2.1.3 and in CDRLs Q010, Q020, and Q060, There will also be a separate public site to support DoD transparency initiatives as stated in Section C, paragraph 6.3.1.3. |
| 18 |
| Section C Paragraph 1.4.3 |
| What is the historical level of participation in the monthly interactive web-based seminars? Please provide the average length of the seminars. |
Please provide details on the level of interaction facilitated by the webinar.
The current contract does not require interactive web-based seminars, but it does require other types of knowledge development. CDRL M070, Knowledge Development provides additional information on this requirement.
| 19 |
| Section C Paragraph 6.1.12 |
| Will the noted meetings be in Aurora, Falls Church or both? |
| See Section C, paragraph 6.1.12, Section G, paragraph 5.6, and Section J, Attachment J-6. Meetings may be in Aurora, CO, or Falls Church, VA. Hearings are usually held within the continental United States |
| 20 |
| Section C Paragraph 6.2.1.3 |
| This section refers to “coordinate with the incumbent contractor” – aren’t there currently two incumbent contractors? Please clarify. |
| Yes, there are two incumbent contractors. See response to question 1. |
| 21 |
| Section C Paragraph 6.3.1.2 |
| Please provide an estimate and frequency of granting access to the Government secure website referenced that the contractor is to maintain. |
| There are approximately 475 active users of the Government secure website. The frequency of granting access varies monthly. |
| 22 |
| Section C Paragraph 6.3.2.1.4 |
| What timeliness standards are the MTFs required to meet in terms of providing medical records for chart abstraction? |
| Per Section C, paragraphs 4.0, 6.1.13 and 6.6.1.7, the contractor is responsible for accessing MTF records remotely or onsite. The contractor is not to use MTF staff to provide MTF medical records. Therefore, there is no timeliness standard for MTF records. |
| 23 |
| Section C Paragraph 6.6.1.1 |
| In order to avoid duplication, please provide a list of quality improvement study topics proposed for the last three years. |
| Historical information may not be relevant. Due to the merging of the direct and purchased care contracts, topics that were once considered inappropriate for one or the other sector of the MHS in isolation might now be more appropriate for study when looking at the entire MHS. |
See Section L Exhibit L-7 for direct care studies completed.
| 24 |
| Section C Paragraph 6.1.13 |
| Regarding- To minimize travel costs, the contractor shall establish remote access to both inpatient and outpatient direct care medical records to the fullest extent practicable. Remote access is currently available for all outpatient records. The contractor shall make good faith efforts to obtain remote access to all MTFs. |
Question- Please describe how the contractor will access the data. What technology would a vendor use to access the system remotely? Is this system web accessible? Will the Medical Treatment Facility (MTF) allow a network communication using an internet site secure VPN tunnel for accessing the system?
DoD will create the clinical system account for the contractor who will then utilize the CAC-enabled Government laptops to access the MTF records via DOD VPN and specific DOD services for remote access.
| 25 |
| Section C Paragraph 6.2.1.3 and Paragraph 6.8.3 |
| The contractor shall coordinate with the incumbent contractor to transfer website content and all active files including, but not limited to National Committee for Quality Assurance (NCQA) Healthcare Effectiveness Data and Information Set (HEDIS®), the JC ORYX®, behavioral health facility certification files. |
MHS CQM Website: The contractor shall maintain and enhance the functionality of the MHS CQM secure website (https://www.mhs-cqm.info) as a “one stop” web-based access for all of the MHS clinical quality management information. The contractor shall provide this website with secure log-in and security protections compliant with DOD standards (see Section H, paragraph 2). The contractor shall also provide public access to the site to support MHS transparency initiatives.
Question- Please provide number of accesses in a given period (daily, weekly, monthly) of the MHS CQM website that is to be provided by the contractor. What is the volume of “traffic” for this website?
There are approximately 225 log-ins to the Government secure website per month.
See response to question 21.
| 26 |
| Section C Paragraph 6.3.1.1 |
| The MHS Population Health Portal (MHS PHP) contains MHS clinical quality data for outpatient performance measurement. Each month the contractor shall download MHS PHP data and then analyze and report health plan clinical quality measure data for all MTFs and purchased care network providers (CDRL Q010, Health Plan Data Reporting). |
Question- Please describe how the contractor will access the data.
Please confirm the portal is web accessible.
Please provide more details on the access method, permissions, etc. for the MHS Population Health Portal (MHS PHP).
The portal is web-based, and data can be downloaded and exported directly from the site. After award, the successful offeror will submit an application to the COR for access to the MHS-PHP. Once access has been granted, the contractor will be granted access to the site from a CAC-enabled computer with a “.mil” e-mail address.
| 27 |
| Section C Paragraph 6.3.2.1.1 |
| Each quarter the contractor shall download NHQM data for all participating civilian facilities from the CMS Hospital Compare website, https://data.medicare.gov/data/hospital-compare. |
Question- Please provide more details on the access method, permissions, etc. for downloading NHQM data.
The contractor will download NHQM data directly from the CMS Hospital Compare website. Instructions for download are available from the CMS site.
| 28 |
| Section C Paragraph 6.8.2 |
| Where are the DHA clinical quality management committees and sub-working groups typically held? |
| The DHA committee meetings are typically held at the DHA headquarters in Falls Church, VA. |
| 29 |
| Section F Paragraph 3.1 |
| This section lists two DHA points of contact for items that cannot be submitted via email. Please advise which items are to go to which address? |
| Per Section F, paragraph 3.1 “The contractor will submit the majority of TQMC deliverables and correspondence via email or the DHA web-based E-Commerce Performance Assessment Tool (PAT) (see Section F, paragraph 6.0).” If the contractor cannot submit an item via email or the PAT, it will contact the COR for direction. |
| 30 |
| Section H Paragraph 5.0 |
| Can the Defense Health Agency (DHA) support SFTP (ftp over ssh) for secure data transmission of the Contractor Manpower Reporting? |
| As stated in Section H, offerors may direct questions to the eCMRA Help Desk at: http://www.ecmra.mil. |
| 31 |
| Section J; Attachment J-5, Focused Study Examples Section 5 |
| Is the TQMC contractor responsible for the Data Validation review referenced in this section? If so, what CLIN should these be included in for pricing? |
| No. See Section C, paragraph 6.6, and Section G, paragraph 3.1 |
| 32 |
| Section L Paragraph 2.2.3-2.2.5 |
| Would an entity that serves as a subcontractor to a TRICARE Managed Care Support Contractor possess an organizational conflict of interest for the TQMC contract which could not be mitigated? |
| DHA cannot comment on hypothetical situations. See FAR 9.5 as supplemented, Section H, paragraph 4.0 and Section L, paragraph 2.2, 2.3. Please note the list provided is not exhaustive, and each offeror shall use sound business judgment and determine the significance of any OCI. |
| 33 |
| Section L Paragraph 2.2.3-2.2.5 |
| If the response to Question above (question 16) is that a subcontractor’s OCI may be capable of mitigation, are there specific functions which, if performed by a subcontractor to a Managed Care Support Contractor, would create an OCI that would not be susceptible to mitigation? |
| See response to question 32. |
| 34 |
| Section L Paragraph 2.2.3-2.2.5 |
| Would an entity that has a significant contractual relationship with a TRICARE Managed Care Support Contractor, which is not directly related to TRICARE, possess an organizational conflict of interest for the TQMC contract which could not be mitigated? |
| See response to question 32. |
| 35 |
| Section L Paragraph 2.2.3-2.2.5 |
| Would an entity that has a prime contract with DHA to support the DHA Electronic Health Record Team possess an organizational conflict of interest for the TQMC contract which could not be mitigated? |
| See response to question 32. |
| 36 |
| Section L Paragraph 2.2.3.1 |
| Are the list of companies with actual or potential organization conflicts of interest considered exhaustive? For example, health plans currently providing TRICARE services are not included in the list. |
| See response to question 32. |
| 37 |
| Section L Paragraph 5.5.2 |
| Will offers who meet or exceed the Small Business Goals receive preference points? If so, how will such points be evaluated? |
| Small Business Participation will be evaluated on an Acceptable/Unacceptable basis. See Section M, paragraph 7.1 |
| 38 |
| Section L Paragraph 6.4.1 |
| Please provide a definition of “timely medical reviews by the appropriate qualified medical personnel.” |
| Per Section C, Paragraph 6.5.1. and Section J, Attachment J-6. |
| 39 |
| Section L, Exhibit L-11 |
| The TQMC Solicitation, Section L (Exhibit L-11) Price Proposal Template, only requests pricing by contract line item number (CLIN) or CDRL. Will the Government require/provide supplemental pricing sheets for pricing build-up? |
| No. See Section L paragraphs 8.4, 8.5 and 8.6 |
| 40 |
| General |
| The TQMC solicitation does not specified the period of time required for the transition. Will the Government please provide this information |
| See SF 30, page 2 of 127 which states “Period of Performance: 08/01/2015 to 09/30/2020.” DHA estimates 60 days for the base period/transition-in. Also see Section B, Period of Performance: Date of Award to 09/30/2015. Section C, paragraph 6.2.1, Transition-In, Section F, paragraph 2.0; Section L, paragraphs 6.2.8 and 6.2.9. and Section M, paragraphs 4.2.8 and 4.2.9 |
J-24 HA Policy Memo for MHS Care Quality Assurance Data Transparency
| Please specify the security requirements for the system beyond those given in the J-24 HA Policy Memorandum” |
| See Section H, Paragraph 2.0; Section I, DFARS 252.204-7012, Section J, Attachment J-22, ADP Requirements and CAC Instructions; and CDRL A020, NIST Certification of Compliance Report. |
CLINS X008
| Please explain how the Contractor will be compensated for Quality and Utilization Reviews. That is, will they be paid for the review of a Lot of 6,500 cases? Or, will the payment be for each record as the review is completed? |
| Per Section B, CLINs X008, the unit of issue is “each,” not “lot.” See Section B CLIN description X008, and Section G, paragraph 6.6.5 |
Quality and Utilization Reviews
| Please explain how the Contractor will be compensated for Quality and Utilization Reviews. That is, will they be paid for the review of a Lot of 6,500 cases? Or, will the payment be for each record as the review is completed? |
| See response to question 42. |
| 44 |
| Section B, Page 2 and Section C, 6.5.1.1. to 6.5.10 |
Quality and Utilization Review
| Please confirm that the quality and utilization reviews for Purchased Care are only performed on cases reviewed under CLINS X009, X0010, X0011, X0012, X0014, X0016, X0018 and X0019, and include all of these requirements including conducting a DRG validation review on inpatient cases (6.5.1.4)? |
| DHA isn’t clear what the offeror is asking since the question blends several citations into its question. |
Quality and utilization reviews are performed per Section C paragraphs 6.5.1 and 6.6.1.2. CLIN X008 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.
Per Section C, paragraph 6.5.1.4, “If the case reviewed is covered by the Diagnostic Related Group (DRG) payment system or the Skilled Nursing Facility (SNF) Prospective Payment System, the contractor shall review the medical record to determine if the diagnostic and procedural information match the discharge status per TRM, Chapter 8, Section 2.”
See Section G paragraphs 3.1 and 6.6.5.
See response to question 49.
Standard of Care Reviews
| How will the Contractor get its workload/work assignments for Standard of Care Reviews? Will the workload be assigned by batch or monthly allotment? |
| See Section C, paragraph 6.5, Section G, paragraph 3.0, and Section J, Attachment J-6. |
Joint Commission ORYX Hospital Quality Measures
CLIN 1004A
| Does the Government intend to have this CLIN priced per record or level of effort to complete? |
| See Section B, CLIN Descriptions, X004. 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).
6.1 Program Management
| Will the Government considered adding an administrative CLIN to cover the Contractor’s administrative costs associated with managing this contract? |
| This is a fixed price contract. DHA considered CLIN structure prior to issuing the solicitation and will not add a separate CLIN for program management. |
Medical Reviews
6.5.1.9 and 6.5.10
| How does the Contractor get compensated for the quarterly analysis required in this section? Should there be a separate analysis reporting CLIN covering the various types of medical review activities? |
| Section B, CLIN Descriptions, CLIN X008 is designated for the tasks specified under Section C paragraph 6.5.1, Quality and Utilization Reviews (Purchased Care). |
Medical Reviews 6.5
| Is the Contractor responsible for translating medical records subject to quality of care reviews if they are not recorded in English? |
| No. See Section C, Paragraph 6.5.2.3. |
Medical Reviews 6.5
| For bidding purposes, please provide the record count for the Purchased Care System, by country, that should be anticipated for medical reviews. This information is important for pricing purposes? |
| Historical workload information is provided in Section L, Exhibit L-6. Specific information on overseas medical review volumes is not available. However DHA anticipates a very low volume of record reviews for outside the continental US (OCONUS) care. |
Program Management Paragraph 6.1.3.1
| Because of the importance that the physician reviewers of various specialty types will be required as the need arises by various claim types, is it necessary that physician reviewers have NIST clearances? |
| NIST certification does not apply to physician credentialing; DHA does not anticipate physician reviewers accessing DoD data systems. |
Clinical Quality Improvement Abstraction Studies Paragraph xx17
| Clinical Quality Improvement Administrative Studies are “estimated to require 125 hours per study.” |
| See response to questions 11 and 55 |
| 53 |
| Section L6, Line 40 |
| “Focus Studies (completion value = total staff hours” shows a value of 307 in the “total” column. |
| Correct reference is Section L Exhibit L-6. See response to question 55 |
Item 1017 and XX17 “Option Year 1 Clinical Quality Improvement Administrative Studies (Section C paragraph 6.6.1) Fixed price per hour. Not to exceed 500 Hr.”
Which of these three incongruent estimates is correct?
All numbers are correct for the data they report. DHA estimates Clinical Quality Improvement Administrative Studies (CLIN X017) required 125 hours per study. Section L Exhibit L-6 shows 618 actual hours in 2012, 307 actual hours in 2013 and 534 actual hours in 2014 to complete the studies.
Based on this historical data, DHA set 500 hours as the NTE. See Section B, CLIN Descriptions, Section G, paragraph 3.1 and responses to questions 10 and 11.
Paragraph 6.6;
Attachment J-5
| Also, the studies described in Section C, para 6.6 and Attachment J-5 would typically require more than even 500 hrs., in total man-hours per study, to propose and conceptualize then “collect, measure, synthesize, analyze, report findings and formulate recommendations based on prevailing healthcare standards and evidence based practices,” after which the contractor must “produce a study report comparable to the quality of performance improvement studies presented in professional medical healthcare literature….” |
| See response to question 55 |
Attachment J-5 are samples of study topics.
TQMC Draft RFP Questions 5-20-15, Question 187
| This paragraph requires the contractor to award CME for developed electronic educational materials based on studies that have not received IRB approval, per response 187. However, DoD policy reportedly prohibits dissemination of study results outside of DoD when the studies have not received prior IRB approval. How can fact sheets and other educational materials reporting non-IRB-approved study results be disseminated to purchased care providers and others without violating DoD’s own policies? Was response 187 in error? |
| An IRB is not required for performance improvement studies because they are not considered to be research. The results of performance improvement studies can only be disseminated within DoD. However, educational information related to the study topic can be disseminated to both DoD and non-DoD providers. Likewise, a fact sheet regarding the study can be released to the public as long as it shares general information. These fact sheets are currently posted to the MHS-CQM website. CME/CEU can be awarded for the general educational information related to the study. |
Paragraph 6.6.1
| Paragraph C 6.6.1 does not set a specific limit on how many abstraction studies may be selected per year. |
| See Sections B and G. See responses to questions 10 and 11. |
XX19, XX20
| Section B specifies two items: “Clinical Quality Improvement Abstraction Studies (Fewer than 2000 records)” and “Clinical Quality Improvement Abstraction Studies (2000 or more Charts)” Both further specify “This CLIN establishes a fixed price in whole dollars, with no cents, per chart per study.” |
| See Sections B and G. See response to questions 11, 55, and 60. |
Items 1018, 1019, and later XX18 and XX19 Pg 5 (and later) of the SF33 lists the same description with the quantity “4,000 EA” for CLINs xx18 and quantity “6000 EA” for CLINs xx19.
Is the 4000 count for CLINs xx18 intended to mean two smaller chart abstraction studies will be performed each year? Is the 6000 count for CLINs xx18 meant to imply that there could be as many as three larger 2000-chart studies per year? This is important because there are significant additional fixed costs involved in planning the studies, analyzing the data, and preparing the reports. A single large study has a net smaller cost per chart than two smaller studies. Studies should be priced in terms of man-hours, divided into abstraction man-hours, and analytical/other man-hours in order to receive accurate bids. The number of charts is of little value in abstraction cost estimation without knowing the complexity of the study questions and the amount of data needed to be gathered and analyzed.
See Section B, Section G, paragraph 3.1. See responses to questions 10 and 11 and Pre-proposal Conference PowerPoint Slides.
Based on estimates (Section L Exhibit L-6 and L-7 CLIN X018 NTE 4000 means DHA may order small abstraction studies for up to 4000 charts.
Based on historical numbers in Section L Exhibits L-6 and L-7, CLIN X019 NTE 6000 means DHA may order larger abstraction studies for up to 6000 charts.
For pricing CLINs X017, X018 and X019, while one offeror may determine that it will price its studies in terms of man-hours divided into abstraction man-hours, and analytical/other man-hours, it is up to each offeror to determine what economies of scale can be achieved based on the size of the study to price these CLINS. See Section L, paragraph 8.0.
Instructions, Conditions, and Notices to Offerors,
| Per section 4.3. page 8 of 21, it states that The font for both CD ROM and paper submissions shall be Times New Roman, and at least 12 points with normal spacing and kerning. We consider the CD design as art (an illustration) so may we use 8 point Times New Roman here as well? |
| No. Font shall be Times New Roman, and at least 12 points. Per Section L, paragraph 4.3. “Elaborate brochures or documentation, binding, detailed artwork, or other embellishments shall not be submitted.” |
| 61 |
| Section L, 2.2.3.1 Page 5, |
| “Due to the nature of their performance with DHA, DHA has determined that the following companies have an actual or potential organizational conflict of interest, which must be avoided, neutralized, or mitigated.” |
Can the Government provide examples of situations that, even with a mitigation plan/approach, a contractor could be eliminated from the solicitation?
See response to question 32
| 62 |
| Section C, 6.0 Technical Requirements, 6.6 Quality Improvement Studies, 6.6.2 Autism Care Demonstration (ACD) Study (Purchased Care), paragraph 6.6.2.2.2 |
| How are children enrolled in the Autism Care Demonstration identifiable for the purposes of this study? Is there a variable in the TRICARE administrative files for enrollment in the ACD, or is there a separate ACD enrollment list with a TRICARE identification number that can be supplied? |
| Any child receiving Applied Behavioral Analysis (ABA) therapy (identified by the appropriate CPT codes) is included in the demonstration and can be included in the sampling pool. |
| 63 |
| Section C, 6.0 Technical Requirements, 6.6 Quality Improvement Studies, 6.6.2 Autism Care Demonstration (ACD) Study (Purchased Care), paragraph 6.6.2.2.2 |
| Will purchased care contractors be required to supply the TQMC contractor the requested ACD records at no cost, or will there be an associated fee? |
| It is a requirement of the purchased care contractors to provide these records at their expense when requested by the TQMC. |
| 64 |
| Section C, 6.0 Technical Requirements, 6.6 Quality Improvement Studies, 6.6.2 Autism Care Demonstration (ACD) Study (Purchased Care), paragraph 6.6.2.2.2 |
| Is the Autism Care Demonstration only administered through the three managed care support contractors and the Overseas Program, or do other purchased care contractors administer the program as well? |
“The purchased care system provides care through private sector contractors, including the Designated Providers (DP) under the Uniformed Services Family Health Plan (USFHP), the three managed care support contractors (MCSCs), the TRICARE Overseas Program (TOP) contractor, the TRICARE Dual Eligible Fiscal Intermediary Contract (TDEFIC), TRICARE Dental Program (TDP) and the pharmacy contractor.”
The Autism Care Demonstration applies to the three MCSCs and the six Designated Providers. The demonstration is not applicable to the TRICARE Overseas Program or TRICARE Dual-eligible Fiscal Intermediary Contract (TDEFIC).
| 65 |
| Section C, 6.0 Technical Requirements, 6.6 Quality Improvement Studies, 6.6.2 Autism Care Demonstration (ACD) Study (Purchased Care), paragraph 6.6.2.2.2 |
| Will the Overseas Program be included in the ACD study? |
| See response to question 64. |
| 66 |
| Section C, Technical Requirements, 6.6 Quality Improvement Studies, 6.6.1.8 |
| How many QI studies will require a CME/CEU educational presentation? |
| See response to question 57. |
| 67 |
| Section L, 4.0 Proposal Preparation: 4.4.1 |
| Will the resumes count in the page limit? |
| Yes. If an offeror chooses to include resumes in its technical proposal, they are included in the page limit. See Section L, paragraph 4.4. |
| 68 |
| Section C – Paragraph 6.2.5.1.1 |
| “The contractor shall review medical, surgical, and mental health cases to determine the medical necessity and appropriateness of care.” |
Does the TQMC require the contractor to use a nationally recognized criteria such as Interqual or McKesson and if so, is it the contractor’s responsibility to purchase that criteria?
There is no Section C, paragraph 6.2.5.1.1.
Section C, paragraph 6.5.1.1 states the contractor shall review medical, surgical, and mental health cases to determine the medical necessity and appropriateness of care. To carry out this review, the contractor shall use generally accepted healthcare standards, norms and criteria for medical necessity appropriateness.
The Government did not prescribe the specific criteria the contractor will use.
Yes. it the contractor’s responsibility to purchase any criteria it uses per Section C, paragraph 5.0, CONTRACTOR FURNISHED ITEMS
| 69 |
| Section C – Paragraph 6.2.5.1.1 |
| Is DRG review required for all Purchased Care cases? |
| There is no Section C, paragraph 6.2.5.1.1. |
No. Per Section C, paragraph 6.5.1, Quality and Utilization Reviews (Purchased Care): apply to all purchased-care inpatient medical record reviews.
Per Section C, paragraph 6.5.1.4, If the case reviewed is covered by the Diagnostic Related Group (DRG) payment system or the Skilled Nursing Facility (SNF) Prospective Payment System, the contractor shall review the medical record to determine if the diagnostic and procedural information match the discharge status per TRM, Chapter 8, Section 2.
| 70 |
| Section C – Paragraph 6.5.1.7 |
| Is the Resident Assessment Validation and Entry (RAVEN) System used for skilled nursing facility cases to determine the Resource Utilization Groups (RUGs)? |
| Yes. |
| 71 |
| Section C - Paragraph 6.3.4 |
| Was the IHI trigger analysis required in the present scope of work? Does the TQMC anticipate an increase in the number of inpatient charts per MTF over the course of this contract? |
| No. The IHI Global Trigger Tool is a new requirement in this solicitation. |
This is an IDIQ contract. The quantity is indefinite. DHA established a NTE quantity in Section B Column C. See response to question 10.
| 72 |
| Section C, 6.2.1.3 & 6.3.1.1 |
| Will the historical data and code used to calculate the measures be included in the transition from the incumbent contractor? |
| Yes. |
| 73 |
| Section C, 6.3.1.1 |
| What programming language is the contractor currently using to calculate the HEDIS measures quarterly? |
| The contractor is not responsible for calculating HEDIS measure results. The contractor will download HEDIS measure data from the MHS Population Portal. |
| 74 |
| Section C, 6.3.1.1 |
| The contractor is to download the MHS PHP data monthly. Is the contractor expected to roll up the claims to a final claim or will this roll up process already have been completed within the MHS PHP? |
| See response to question 73. The contractor is responsible for |
1) downloading the data monthly and
2) rolling up the data, analyzing, and submitting a quarterly report.
| 75 |
| Section C, 6.3.3.1.1 |
| Will DHA consider alternate methods for MTFs to upload medical records to a secure web portal in situations where the medical information is not available through electronic means? |
| See response to question 22. |
| 76 |
| Section C, 6.3.3.1 |
| Does DHA have a plan for inpatient MTF Quality Measures at the time the CMS Hospital Compare and the Joint Commission ORYX measures migrate to eMeasures only? |
| DHA is currently in the planning phase for this transition. |
| 77 |
| Section C, 6.3.3.1 |
| How many measure sets is DHA considering revising/replacing compared with the 14 sets in use today? |
| Per Section C, paragraph 6.3.3.3 the contractor is responsible for reviewing the Joint Commission’s (JC) release of any new national hospital measure sets for applicability for inpatient MTFs. The DHA does not revise measure sets; the JC revises measure sets. |
| 78 |
| Section C, 6.5.1 |
| Is the contractor expected to run a monthly sample or will DHA provide a list of records? |
If the contractor identifies the cases for review, what are the selection criteria?
Per section C, paragraph 6.5.1, contractors are expected to review any medical record provided to them from a purchased care contractor for any reason.
| 79 |
| Section C, 6.8.1 |
| Must each monthly Quality Webinar be associated with CME/CEU credits? Or, is the accrediting of the Quality Webinars a PRN (as needed) activity, depending on the topic and its content? |
| Per Section C, paragraph 6.8.1.1, not every webinar has to be associated with CME/CEU credits. |
| 80 |
| Section B, Clinical Quality Improvement Administrative Studies. |
| Does the 125 hour estimate incorporate all task requirements, with exception of medical record reviews (e.g., sample design, descriptive and inferential analysis, fact sheet and presentation)? |
| See response to questions 11, 55, and 60 |
| 81 |
| Section C, 6.1.13 |
| Full implementation of remote inpatient medical record access may initially require monthly on-site visit at a number projected to be fewer than seven sites. Please indicate how many months of on-site visits you would anticipate for these sites before remote access replaces on-site visits. Please identify the domestic and overseas sites to assume for travel planning and cost purposes? |
| See response to question 24. The incumbent contractor currently has remote access to all 54 inpatient MTFs. The successful offeror will need to establish remote access with each of the 54 MTFs during transition. If remote access has not been established at the start of work, on-site visits would be required to meet the requirements for data abstraction. It is therefore not possible to identify specific sites as requested. |
Per Section H, paragraph 8.0.
| 82 |
| Section C, 6.6.2.2 |
| Is the vendor allowed to use existing data sources, in addition to claims and medical records, if applicable? |
| The contractor will utilize claims data to identify a statistically valid sample. The contractor will then review the medical records for individuals within that sample to fulfill the requirements stated under 6.6.2. |
| 83 |
| Section C, 6.6.2.2 |
| Does the government anticipate that IRB review will be required? |
| No. |
| 84 |
| Section C, 6.8.3 |
| Does DHA have any plans to migrate the mhs-cqm.info website to a .mil platform? |
| Yes. |
| 85 |
| Section C, 6.8.3 |
| What content management software does DHA use to manage the mhs-cqm.info website (e.g., Sitecore)? |
| The Government cannot provide this information at this time. |
| 86 |
| Section C, 6.8.3 |
| Is the contractor expected to provide content site only? Or is the contractor expected to provide support for the underlying framework/infrastructure of the site? |
| Content only. |
| 87 |
| Section F, 2.0, Period of Performance |
| Please provide periods of performance that reflect the incumbent contract’s extension, potentially through March 2016? |
| See response to question 40. |
| 88 |
| Attachment J6 6.c |
| Are time frames based on contractor receipt of the complete information? |
| Yes. |
| 89 |
| Attachment J6 7.a |
| Where are the hearings held? |
| See Section C, paragraph 6.5.3, Section G, paragraph 3.3.2. Section J, Attachment J-6. The task order will note the location of the hearing. Hearings are conducted in the continental United States. |
| 90 |
| Attachment J6 7.c |
| What is frequency of the DHA conferences and where are they held? |
| Per Section J, Attachment J-6, conferences are held infrequently, i.e., not more than once a year and not less than once every 5 years. The task order will note the location of the conference. |
| 91 |
| Section L, 4.3, Proposal Preparation |
| May offerors use a font other than Times New Roman for graphics to enhance readability? |
| No, Section L, paragraph 4.3 gives explicit instructions on formatting. |
| 92 |
| Section L, 4.4.1, Technical Proposal Page Limits |
| If the offeror includes resumes, are they excluded from the 100-page limit, as they routinely are? |
| No. See response to question 67. |
| 93 |
| Section L, Instructions, condition and notices to offerors, Vol IV Price Proposal 8.10 |
| What is the definition of a “professional employee”? |
| See FAR 22.1102, Definition for professional employee. |
| 94 |
| Section L, Instructions, condition and notices to offerors, Vol IV Price Proposal 8.10 |
| Please confirm that all submitted spreadsheets cannot be sent in a pdf format, but must include the original formulas. |
| See Section L, paragraph 8.5. |
| 95 |
| Section M, 5.4.1.1, Past Performance Quality Ratings |
| Are the Ratings in Table D comparing how performance meets contractual requirements and exceeds many to the Government’s benefit to the proposed effort? Comparing how the past performance meets or exceeds in relation to this RFP? |
If not, how will the government determine if past performance exceeds many contractual requirements to the [client/’s] benefit?
No. Section M paragraph 5.4 does not refer to any comparison with the solicitation requirements.
Per Section M, paragraph 5.4.1.1 Table D, Past Performance Quality Ratings, “gives the Quality ratings which the Government will assign to each offeror’s past performance contracts.” These ratings are based upon the Quality of the past performance effort, as determined by the Government through information such as CPARS ratings and the PPQ ratings.
| 96 |
| General |
| What is the acceptable protocol(s) (FTPS, VPN, etc…) to use for downloading data form MHS data warehouse and/or move between TQMC databases? |
| See Section C, paragraph 4.1, and response to question 24. The contractor will not be responsible for MHS database storage requirements (M2, MDR, PEPR, TPOCs). See Section C paragraph 5.0. |
| 97 |
| General |
| What is the rough order of magnitude for the storage requirements for the TQMC database(s)? |
| See response to question 96. See Section C paragraph 5.0. |
| 98 |
| General |
| Has an analysis for deltas between TQMC data and MHS databases such as (M2, MDR, PEPR, TPOCs) been completed? If so, is this information available to the contract awardee? |
| No. |
| 99 |
| Section C of the RFP |
| Paragraph 6.3.4.6 states that there are approximately 54 inpatient MTFs. The file “24_Attachment_J-14_MTF-Clinic_Listing.xlsx” has 57 locations listed as “Hosp” for Facility type. Is it accurate to assume that this is the same count referred to in 6.3.4.6 as inpatient MTFs? |
| There are approximately 54 inpatient MTFs. See Attachment J-17, Inpatient Military Treatment Facilities. |
| 100 |
| Section C, PWS |
| Paragraph 6.1.13 identifies a maximum of 7 locations that may require travel to support remote access implementation. Section H, para 8.2.1 contains a similar reference to trips for remote access implementation. Are these two instances referring to the same requirement? Can the government provide an estimate of the level of travel outside the US anticipated for this contract? |
| Yes, they are referring to the same requirement. |
See response to question 81.
| 101 |
| General |
| Can the government provide the number of purchased care facilities affected by this contract? Approximate numbers would be helpful? |
| DHA does not have this information. |
Section G, paragraph 6.6.3
Section G, paragraph 6.6.3 Institute for Healthcare Improvement (IHI) Global Trigger Tool, should reference X005. This does not affect proposal preparation, so it will be corrected at award.
Section L, Exhibit L-2
Past Performance Questionnaire: Past Performance Quality Ratings Table: For non-government past performance contracts, “Government” also refers to the contracting “client.”
For example: For the past performance rating “Exceptional,” the definition is “Performance meets contractual requirements and exceeds many to the Government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor was highly effective.”
TQMC HT9402-15-R-0005 Responses to Solicitation Questions Page 1 of 19
Defense Health Agency