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SECTION F
DELIVERIES OR PERFORMANCE
F.1. FAR 52.242-15 STOP-WORK ORDER. (AUG 1989).
F.2. PERIOD OF PERFORMANCE. Transition-in Period (Date of Award to the start of healthcare delivery): The contractor shall begin transition-in activities and complete specific activities by the timelines specified in Section C; TOM Chapter 24, Section 1; and CDRL P110, Transition In Plan.
F.2.1. Base Period/Transition-In: September 1, 2020 – August 31, 2021
F.2.2. Options 1 through 7 (if exercised) will be:
| • | Option Period 1: September 1, 2021 – August 31, 2022 |
| • | Option Period 2: September 1, 2022 – August 31, 2023 |
| • | Option Period 3: September 1, 2023 – August 31, 2024 |
| • | Option Period 4: September 1, 2024 – August 31, 2025 |
| • | Option Period 5: September 1, 2025 – August 31, 2026 |
| • | Option Period 6: September 1, 2026 – August 31, 2027 |
| • | Option Period 7: September 1, 2027 – August 31, 2028 |
F.2.3. Transition Out period: The transition out period may be exercised during any one of the health care delivery periods specified above. The contractor will begin transition out activities upon transition out option exercise and complete the timelines as specified in TOM Chapter 24, Section 1.
F.3. PLACE OF POSTAL DELIVERY AND PROCEDURES.
F.3.1. All certified and overnight mail for 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 Overseas Program (TOP), 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’s Representative (COR) shall be addressed to the Defense Health Agency, Attention: COR, TRICARE Overseas Program, 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.4. NOTICE REGARDING LATE DELIVERY. In the event the contractor anticipates difficulty in complying with the delivery schedule, the contractor shall immediately notify the CO or the 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 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.
F.5. REPORTS AND PLANS.
F.5.1. Unless otherwise specified, the 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, and TOM Chapter 24, Section 15 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.
Daily Reports.
D010 Pass Through Contractor Payment/Check Issue Data
Weekly Reports.
| W010 |
| Transition-In Status Report |
| W020 |
| Transition-Out Status Report |
Monthly Reports.
| M010 |
| Case Management Report |
| M030 |
| CQM Quality Intervention Report |
| M040 |
| Global Monthly Summary Report |
| M050 |
| HIPAA Privacy Complaint Report |
| M060 |
| Medical Evacuation Report |
| M070 |
| Preauthorizations/Authorizations and Referral Timeliness/Accuracy Report |
| M090 |
| Active duty Service Member(ADSM) Claims Report - Pended or Denied Claims |
| M100 |
| Network Adequacy/Inadequacy Report |
| M110 |
| Overpayment Cases Against VA Facilities |
| M120 |
| Overseas Currency Report |
| M130 |
| Paid Claims and Current Inventory Report (All Beneficiaries) |
| M140 |
| Non-Financially Underwritten Accounts Receivable Summary Report (Government Medicare Dual Eligible) |
| M150 |
| Non-Financially Underwritten Accounts Receivable Summary Report (Government TRICARE Only Eligible) |
| M160 |
| Non-Financially Underwrtten Accounts Receivable Summary Rprt(Non-Government Medicare Dual Eligible |
| M170 |
| Non-Financially Underwritten Accounts Receivable Summary Rprt (Non-Government TRICARE Only Eligible) |
| M180 |
| Reconciliation Report (Non-Accrual Fund Eligible) |
| M190 |
| Non-Financially Underwritten Bank Account Reconciliation Report (MERHCF/Accrual Fund Eligible) |
| M200 |
| Pass Through Bank Account Statement Report (Medicare Dual Eligible) |
| M210 |
| Pass Through Bank Account Statement Report (TRICARE Only Eligible) |
| M220 |
| Pass Through Bank Cleared Payment Data |
| M230 |
| TOP Prime Remote PCM/Enrollment Report |
| M240 |
| TRICARE Premium Activity Report |
| M250 |
| Comprehensive Autism Care Demonstration Report (M) |
| M260 |
| Integrated Disability Evaluation System(IDES) Memorandum of Agreement(MOA) Claims Without Authorization |
| M270 |
| Advanced Rehabilitation Center Referrals |
Quarterly Reports.
| Q010 |
| Appeals Quality Assessment Report |
| Q020 |
| Internal Quality Management/Quality Improvement Report |
| Q040 |
| Fraud and Abuse Summary Report |
| Q050 |
| Remote ADSM Dental Report |
| Q060 |
| Mental Health Counselor Status Report |
| Q070 |
| Comprehensive Autism Care Demonstration Report (Q) |
| Q080 |
| Retrospective Review Validation Report |
Semi-Annual Reports.
| SA010 |
| Agency for Healthcare Research and Quality(AHRQ) Patient Safety Indicators(PSIs) Report |
| SA020 |
| Comprehensive Autism Care Demonstration Report (SA) |
Annual Reports.
| A010 |
| Risk Assessment Letter of Assurance |
| A020 |
| Service Organization Control Report (SOC1) - Statement on Standards for |
Attestation Engagements, SSAE No. 18 (Prime with Subservice Organization)
| A030 |
| Bridge Letter in Support of Service Organization Control Report (SOC1) - |
Statement on Standards for Attestation Engagements, SSAE No. 18 (Prime with Subservice Organization)
| A040 |
| Service Organization Control Report (SOC1) - Statement on Standards |
for Attestation Engagements, SSAE No. 18 (Subservice Organization)
| A050 |
| Bridge Letter in Support of Service Organization Control Report (SOC1) - |
Statement on Standards for Attestation Engagements, SSAE No. 18 (Subservice Organization)
| A060 |
| Third Party Recoveries for Fiscal Year Report |
| A070 |
| NIST Certification of Compliance Report |
| A080 |
| Disaster Recovery Test Results Report |
| A090 |
| MOU with East Region Contractor |
| A100 |
| MOU with West Region Contractor |
| A110 |
| Clinical Quality Management Program (CQMP) Report |
| A120 |
| IDME Ratios for Children's Hospitals Report |
| A130 |
| Contract Releasable under FOIA |
| A140 |
| MOU with Uniformed Services Family Health Plan (USFHP) Designated Providers |
| A150 |
| Fraud Detection and Prevention Strategy and Internal Procedures |
| A160 |
| MOU with TRICARE Claims Review Contractor (TCRS) |
| A170 |
| MOU with Global Nurse Advice Line Contractor (GNAL) |
Plans.
| P010 |
| Clinical Quality Management Program/Clinical Quality Oversight Plan |
| P020 |
| Medical Management(MM)/Utilization Management(UM) Plan |
| P030 |
| Network Implementation Plan |
| P040 |
| Continuity of Operations Plan (COOP) |
| P050 |
| Case Management Plan |
| P060 |
| COCOM Contingency Support Pan |
| P070 |
| Contingency Program Plan |
| P080 |
| Contractor Owned Facilities Mitigation Plan |
| P100 |
| Internal Quality Management/Quality Improvement Program Plan |
As Required Plans/Reports.
| R020 |
| Appeals Processing Guidelines, Desk Instructions and Reference Materials |
| R030 |
| Responsibilities Assignment Matrix (RAM) |
| R040 |
| Inpatient Admission/Notification of Case Report |
| R050 |
| Malpractice Insurance and Licensure/Certification Requirements |
| R060 |
| Serious Reportable Events |
| R070 |
| Program Integrity Standard Operating Procedures (Desk Procedures) |
| R090 |
| DSMO Meeting Summary Report |
| R110 |
| MTF Notification of Active Duty Service Member (ADSM) Pended or Denied Claims |
| R120 |
| Declaration of Transfer and Destruction of Records |
| R130 |
| Fraud/Abuse Patient Harm-Initial Notification Checklist |
| R140 |
| Program Integrity Random Sample Audit Worksheet |
| R150 |
| DHA/MTF Fraud & Abuse Referral Cover Sheet |
| R160 |
| SOR with TAO Eurasia-Africa Director |
| R170 |
| SOR with TAO Latin America & Canada Director |
| R180 |
| SOR with TAO Pacific Director |
| R190 |
| SOR with Military Treatment Facility (MTF) |