Final CPD Expansion RFI Industry Questions to Gov Combined 19 Aug 2024.pdf

# Question Government Response Supporting Information

Given Congressional guidance on an expedite expansion of the CPD program beyond the initial two sites, when does DHA plan to announce the selection of those sites?

Site selections will be released with the RFP. The timeline will be released at a later date.

2 Will DHA have a small business goal or academia requirement anticipated as a part of its procurement plan?

No academia requirement. Small Business requirements will be IAW Federal Acquisition Regulation Part 19.

3 Can DHA provide the number of eligible TRICARE beneficiaries by county and zip code?

Yes, at time of RFP release.

4 Will CPD contractors be required to coordinate with MTFs? Yes, in cases of Emergency care or pharmacy services provided to CPD enrollees, the MTFs will initiate that coordination.

What life events or exceptions will be provided for beneficiaries to qualify for a special enrollment period outside the annual enrollment period?

Details will be provided when the draft RFP is released.

Will a separate contractual agreement be needed between the CPD contractor and the EEE contractor to facilitate the arrangement, shared responsibilities, and obligations between the two entities?

Details will be provided when the draft RFP is released.

Will the CPD contractor be required to integrate information and resources within the Digital Front Door initiative?

Details will be provided when the draft RFP is released.

What criteria will be used to select the three additional markets for the CPD expansion, and how will local demographics influence these decisions?

The Government is considering all options. The criteria has not yet been established. However we will not consider any BRAC sites.

What performance metrics will be used to evaluate the success of the CPD contractors, including clinical quality measures, patient satisfaction scores, and cost-efficiency metrics, and how often will these metrics be reviewed and updated?

Details will be provided when the draft RFP is released.

10 How will the DHA support contractors during the transition periods?

Details will be provided when the draft RFP is released.

Does DHA have any data on the estimated population of complex care patients in Regions (defined by DOD) which will help offerors address unique requirements for these patient families?

Any specific process details regarding the governance of the CPD will be explicitly detailed in the forthcoming DRAFT RFP and Final RFP.

Will the Military One staff / offices on Defense installations have information regarding the option for qualified personnel to participate in the CPD program? If so, how will we interact with them to ensure information is accurate and updatable?

Details of who is qualified for CPD participation will be included in the

RFP.

Could CPD contractors submit a bid that includes coordination/optimizing MTFs?

Any specific process details regarding the governance of the CPD will be explicitly detailed in the forthcoming DRAFT RFP and Final RFP.

HT9402-24-RFI-0217

Define regional and state concept: Are the expansion locations solely in Prime Service Areas or is the intent of this expansion to include non Prime Service areas? Will the government require contiguous zip codes across regional or multi-state areas? Statewide or regional may include non Prime Service Areas.

The Government is considering all CONUS options including PSAs and Non-PSAs.

What are the PSA zip codes for future potential CPD sites and when will they be made available? Zip codes are required to fully determine capability and capacity to serve various statewide and/or regional service areas.

The Government will provide zip codes when the RFP is issued.

Is the government willing to waive the original CPD RFP requirement to utilize the TPHARM contract, C.7.5.9. Pharmacy Benefit and allow the CPD to provide pharmacy?

Any specific process details regarding the governance of the CPD will be explicitly detailed in the forthcoming DRAFT RFP and Final RFP.

Is the government willing to waive the requirement for the CPD to utilize the TRICARE Formulary?

Any specific process details regarding the governance of the CPD will be explicitly detailed in the forthcoming DRAFT RFP and Final RFP.

Is the government willing to include pharmacy in the risk adjusted capitation and require the MCE utilize their pharmacy, the previous CPD RFP, G.2.1.1 excluded pharmacy from the risk adjusted capitation?

Any specific process details regarding the governance of the CPD will be explicitly detailed in the forthcoming DRAFT RFP and Final RFP.

If the Pharmacy Benefit is excluded from the capitation rate, can the government provide additional detail on any pharmaceuticals that would be included under the capitation rate (e.g., vaccines, infusion drugs, etc.)

Any specific process details regarding the governance of the CPD will be explicitly detailed in the forthcoming DRAFT RFP and Final RFP.

Will the government require future CPD Contractors to follow existing CPD operating requirements or does the government plan any changes. Would the government consider exemptions from specific requirements that would better support a statewide or regional approach?

Any specific process details regarding the governance of the CPD will be explicitly detailed in the forthcoming DRAFT RFP and Final RFP.

Will this expansion include a mix of APM and FFS or strictly APM? H.6 allows for Cat 2,3,4 HT9402-23-R-0001

Any specific process details regarding the governance of the CPD will be explicitly detailed in the forthcoming DRAFT RFP and Final RFP.

Is the government considering updating the CPD requirements to allow for a fully integrated MTF and CPD model?

No

Does MTF Lockout still apply if CPD market areas contain MTFs within PSA?

Any specific process details regarding the governance of the CPD will

CPD Contractors often have pre-existing relationships with local MTFs and Defense Health Networks (DHNs) for GME and readiness purposes. Given the MTF Lockout provisions within the initial CPD requirements, will expanded CPD locations be able to develop MTF specific MOUs that enable CPD contractors to integrate services with regional MTFs for readiness or optimization purposes?

Any specific process details regarding the governance of the CPD will be explicitly detailed in the forthcoming DRAFT RFP and Final RFP.

Will reporting requirements for expanded CPDs be changed? Any specific process details regarding the governance of the CPD will be explicitly detailed in the forthcoming DRAFT RFP and Final RFP.

When will the government provide the risk adjusted capitation methodology, including risk, age, gender and regional adjustments? Will methodology include all CPD eligible beneficiary categories? Active Duty, Non Active Duty, and Retiree. RFP HT9402-23-R-0001, Exhibit L-1A. Build-up of Preliminary PMPM Capitation Rates for Input to Total Evaluated Price: Atlanta, does not include retirees.

This will be included in the RFP.

How will transition costs be factored into the proposal evaluation criteria?

Any specific process details regarding the governance of the CPD will be explicitly detailed in the forthcoming DRAFT RFP and Final RFP.

If CPD Contractors integrate select services with the MTF for the purposes of supporting readiness, how might the capitated rate be adjusted to account for care delivered at the MTF for CPD enrolled beneficiaries?

Any specific process details regarding the governance of the CPD will be explicitly detailed in the forthcoming DRAFT RFP and Final RFP.

How will CPDs be compensated for transition costs that are required to comply with CPD requirements for the exclusive benefit of the TRICARE beneficiaries (e.g., TRICARE benefits build) and the government (e.g., government required reporting)?

Any specific process details regarding the governance of the CPD will be explicitly detailed in the forthcoming DRAFT RFP and Final RFP.

What is the governments intent with regard to CPD enrollees using the TRICARE Prime Travel benefit (PTB)?

1) Assuming MCSC network is carved out from CPD, will the CPD be authorized to direct beneficiaries to medically necessary specialized services outside of PSA?

2) If TRICARE beneficiaries travel outside of PSA for highly specialized, medically necessary services(Transplant) with CPD Contractor approval, will they be eligible for DHA PTB?

3) Who is administrating PTB? CPD vs DHA

Any specific process details regarding the governance of the CPD will

Will CPD Contractors be authorized to direct TRICARE beneficiaries to CPD determined Centers of Excellence outside of the established CPD 100 mile radius of PCM zip code? If so, will these beneficiaries be eligible to utilize the Prime Travel Benefit?

Any specific process details regarding the governance of the CPD will be explicitly detailed in the forthcoming DRAFT RFP and Final RFP.

Will the specific details surrounding EEE and Data Integrator capabilities and interoperality with the CPDs be shared, if so when?

This will be shared in the forthcoming Request for Proposal (RFP).

What is meant of Commercial vs non-Commercial service contract?

Federal Acquisition Regulation (FAR) Part 12 versus FAR Part 15.

Would CPD Contractor be allowed to administer the TRICARE benefit in a manner consistent with its commercial off the shelf products?

Any specific process details regarding the governance of the CPD will be explicitly detailed in the forthcoming DRAFT RFP and Final RFP.

Would the government consider allowing eligible beneficiaries in selected markets to have the option of enrolling to either the CPD contractor or to an existing regional TRICARE Managed Care Support Contractor (MCSC) as continuous enrollment as PCM Change, similar to the designated providers that support the USFHP?

Any specific process details regarding the governance of the CPD will be explicitly detailed in the forthcoming DRAFT RFP and Final RFP.

If commercial service contract is pursued, what would happen with exclusions?

Any specific process details regarding the governance of the CPD will be explicitly detailed in the forthcoming DRAFT RFP and Final RFP.

If DHA takes uses the Commercial Service Contract approach, would the government award more than one CPD Contractor in each region or market?

This will be part of acquisition strategy development and identified in the RFP.

38 Are USFHP designated providers eligible to bid on expanded CPD contracts?

Yes

Will TOM Ch 18 be published with the release of the final RFP for future CPD sites?

Yes. It will be revised and released as a draft.

Does this mean the Government intends to award only three contracts covering these geographic areas, or does the Government anticipate awarding three individual contracts per defined region (East and West)? Expanded CPD RFI attachments list DHNs across CONSUS: East and West.

The Government intends to award three separate contracts.

Will the government award a CPD contract to the same bidder across both East and West region? Will CPD contractors be able to select multiple locations or will they be restricted to one?

Potential offerors could potentially be awarded one or more CPD in any region. There will be no restrictions to the bidding process.

42 When will DHA finalize CPD sites available for bid? Site selections will be released with the RFP. The timeline will be released at a later date.

When will Government release potential enrollment (TRICARE eligibles) and demographic information (e.g., TRICARE lives by ZIP Code and beneficiary type) for future potential bids?

At the time of RFP release.

The government previously stated that CPD contractors will not be prohibited from offering value-added services or benefits that are not covered by TRICARE. However, any non-covered services/benefits must be provided at no cost to the Government, and the costs associated with such services/benefits will not be considered when rebasing the premium in future rate settings. Do any of the value-added services need to be submitted to DHA for approval prior to implementation?

Any specific process details regarding the governance of the CPD will be explicitly detailed in the forthcoming DRAFT RFP and Final RFP.

What is the governments intent with regard to additional zip codes aligned with TRICARE Prime Service Areas missing from RFI Attachments? Attachments TRICARE+PSA+MTF+Markets- West.pdf and TRICARE+PSA+MTF-East.pdf did not include Prime Service areas, utilizing the zip codes in this attachment significantly decreased the true capability.

All zip codes will be provided at release of the RFP, excluding BRAC sites.

Will TRICARE PSA without a free-standing MTF be in scope for expanded CPD? For example, TRICARE+PSA+MTF+Markets- West.pdf does not include any PSAs in Oregon, despite available TRICARE PSA zip codes.

Yes

Will the government be hosting an industry day? If so, MCE recommends in person.

All Market research options are being considered.

Will the government schedule one-on-one meetings with potential demonstration organizations which would inform the next level of participation in CPDs with specific and relevant market information. MCE would plan to encourage many of our industry colleagues across the country to participate. This request is supported by FAR 15.201 15.201 Exchanges with industry before receipt of proposals.

The Government will take this under consideration.

In support of industry research is the government willing to schedule value based care industry leader site visits? This request is supported by FAR 15.201 15.201 Exchanges with industry before receipt of proposals.

The Government will take this under consideration.

Will the government provide the cost and type of payment for EEE Support (e.g. PMPM, flat fee, cost per transaction, etc.)? Is the EEE compensated by the government or is it intended to be included in the Contractor PMPM?

Any specific process details regarding the governance of the CPD will be explicitly detailed in the forthcoming DRAFT RFP and Final RFP.

How will DHA support the CPD is promoting beneficiary enrollment in the CPD (e.g., CPD inclusion on tricare.mil Health Plan Finder (by zip code), ease of enrollment, beneficiary messaging, marketing, marketing resources, etc.)?

Any specific process details regarding the governance of the CPD will be explicitly detailed in the forthcoming DRAFT RFP and Final RFP.

Will the Government provide data regarding the population density of the eligible population, including the proportion of active-duty families and retired families for each market?

Data file will be available upon request after meeting specific requirements with release of RFP.

Upon selection of markets, will the Government provide historical claims data, including CPT codes, to allow for appropriate underwriting?

The Government will take this under consideration.

54 Will the Government perform additional market research, including reverse industry days with industry partners?

All Market research options are being considered.

The proposed expansion demo is seeking plans that will assume 100% risk in providing health care to beneficiaries, which is striking similar to the Designated Providers currently providing healthcare and administrative support at 100% risk. If the intent of the expansion is to provide beneficiaries choice, than would it not be best to provide such an option in areas in which beneficiaries currently do not have such choice?

The Government is considering all options.

Could the government clarify whether the EEE contractor will preclude any plan participating in the demo from being required to meet the pending Department of Defense's Cybersecurity Model Certification?

No. At this time, CMMC not required. DoD intends to include CMMC requirement in all solicitations issued on or after Oct 1, 2026.

What is the government's acquisition strategy (e.g., Blanket Purchase Agreement [BPA], Indefinite Delivery/Indefinite Quantity [IDIQ]) for this opportunity?

Acquisition Strategy is being developed.

58 What is the timeline for the acquisition, and how many demonstrations are intended?

Acquisition Timeline is being developed.

59 The questions seem to indicate that demos will be state-based.

Will the government please verify?

All options are being considered.

60 What does the government want industry to demonstrate (e.g., value-based care, concierge services)?

Demonstration objectives will be disclosed in release of the RFP.