Sources Sought Notice - Medical-Technical Experts 6.24.docx

U.S. Department of Labor Office of the Senior Procurement Executive Office of the Assistant Secretary for Administration and Management

U. S. Department of Labor Employee Benefits Security Administration (EBSA) Request for Information (RFI)

Project title: Provide Medical/Technical Experts

SPECIAL NOTICE:

In accordance with Federal Acquisition Regulation (FAR) 10.002(b) (2) (i), this notice is issued for the purpose of conducting market research. Market research is being conducted to determine if there are potential businesses with the capacity and experience to perform the required work. This notice is not to be misconstrued as a Request for Proposal or Quotation. This notice does not represent a commitment by the Government to issue a solicitation or award a contract.

There is no solicitation currently. Information provided in response to this RFI is submitted voluntarily and is not being requested as part of a solicitation for actual pricing. This request for capability information does not constitute a request for proposals; submission of any information in response to this market survey is purely voluntary; the government assumes no financial responsibility for any costs incurred. The Government is not obligated to and will not pay for information received because of this announcement. No reimbursement will be made for any costs associated with providing information in response to this announcement and any follow-up information requests to include an invite to further explain/demonstrate aspects of their proposed approach.

Acknowledgment of responses will not be made, nor will respondents be notified regarding the results of the Government’s evaluation of the information received. The determination to proceed with the acquisition is within the discretion of the Government. Telephone inquiries will not be accepted.

Please be reminded that a respondent interested in obtaining a contract award with the Government must be registered in the Federal Government's System for Award Management (SAM) database. Additional information regarding contractor registration can be obtained through www.SAM.gov. All qualified small businesses, including 8(a) firms, are encouraged to participate.

1.0 PURPOSE OF RFI

The purpose of this RFI is to gather information about potential solutions and determine sources of supply for medical/technical experts.

2.0 BACKGROUND

The Employee Benefits Security Administration's (EBSA) Office of Enforcement (OE) promotes the protection of pension and welfare benefits under the Employee Retirement Income Security Act of 1974 (ERISA) by ensuring a strong and effective national and field office enforcement program through: (1) Policy formulation; (2) Project identification and program planning; (3) Guidance development and implementation; (4) Field liaison; (5) Field and project evaluation; and (6) Coordination of investigations to detect and correct violations of Title I of ERISA and related criminal laws.

OE, with the assistance of the Office of the Solicitor's Plan Benefits Security Division (PBSD), determined the Department of Labor (DOL or the Department) needs a Medical Expert Consultant to assist EBSA with identifying, screening, and securing a variety of Medical and Technical Experts who can consult and assist EBSA with (a) the analysis and review of Coverage Policies and technical medical coding for alignment with generally accepted medical and coding standards and comprehensiveness and (b) analyzing the application of the Coverage Policies, technical medical coding, and benefit contractual provisions to claims determinations, including medical necessity and administrative denials for Employee Welfare Benefit Plans.

To do this, EBSA envisions contracting with a Medical Expert Consultant that can identify, screen, and secure both Medical and Technical Experts that have demonstrated experience with the creation and/or operation of Coverage Policies; determining the medical necessity of claims based upon Coverage Policies, benefit contractual provisions, and technical medical coding; and analyzing Coverage Policies to review alignment with generally accepted medical standards.

3.0 SCOPE

The Contractor shall identify, screen, and secure Medical and Technical Experts necessary to perform the scope of services listed herein. The Medical and Technical Experts provided by the Contractor must be able to analyze, evaluate, and opine on the medical basis for and application of approximately 100 Coverage Policies, including associated technical medical coding (procedure and diagnosis codes). These 100 Coverage Policies include a wide range of topic areas including, but not limited, to:

· Testing (e.g., Covid-19, allergy, nucleic acid pathogen, genetic, Vitamin D, etc.)

· Radiology and Ultrasound Services

· Therapies (e.g., Physical, occupational, acupuncture, chiropractic)

· Rehabilitation

· Cardiology, Endocrinology, Gastroenterology, Oncology

· Devices (e.g., compression, orthotic devices, home traction, etc.) (collectively Coverage Topics)

The Contractor must provide EBSA with Medical and Technical Experts that can review the Coverage Policies and technical medical coding to opine on the degree of alignment with generally accepted medical standards and coding conventions and guidelines. The Medical and Technical Experts’ review of the Coverage Policies and technical medical coding will also include an analysis of whether the Coverage Policies are comprehensive for the Coverage Topic.

In addition, the Medical and Technical Experts will assist EBSA in reviewing application of the Coverage Policies and technical medical coding to benefit determinations, including medical necessity and administrative denials, within the Coverage Topics.

The Medical and Technical Experts may also review claims and appeals data associated with the Coverage Policies and technical medical coding to identify any patterns in coverage determinations and opine on the outcomes of these claims and appeals based on generally accepted medical standards.

The Medical and Technical Experts may also be asked to assist EBSA in preparing for or participating in interviews, depositions, reviewing documents, or other investigative activities.

4.0 QUESTIONNAIRE

1. Provide a company description, discussion of company capabilities, and general summary of the approach to accomplishing the requirements listed in the attached Draft Performance Work Statement (PWS).

2. Historical information (description and length of time providing this service and under what North American Industry Classification System (NAICS) to the public and other federal agencies.

3. Describe your type of business (i.e., small, small disadvantaged, woman-owned, H.U.B. Zone, serviced-disabled veteran-owned small business, large business, etc.) under your proposed NAICS.

4. Does your company possess the capabilities to provide the entire range and scope of these requirements? If not, please list which requirements your company can provide?

*Note: Respondents are encouraged to include additional comments/information considered appropriate and useful in assisting the program office in refining the Draft Specific Tasks (Section III) and assessing potential costs and potential risks. These include the following:

5. Based on a review of the referenced services in the RFI, are there suggestions that your firm would propose in terms of providing this service?

6. Identify any questions or clarifications that the industry would likely request regarding the RFI as drafted.

5.0 RESPONSES TO RFI

RFI responses should address the service category or categories the vendor would respond to if this were a request for proposal. Responses shall conform to the format below and provide the following information:

1. Cover Letter – The cover letter must include the following information:

· Company name

· DUNS, Business Size, GSA Schedule (if applicable)

· Company points of contact, telephone number, and email address

· Date submitted

2. Respondents shall respond to each of the general questions.

3. If the respondent chooses not to respond to a question, indicate "no response."

4. Submit a capabilities package that includes the above considerations that demonstrate capabilities and expertise related to the services they are qualified to contract. As part of the market research associated withthis RFI, we are also seeking pricing information. Any pricing information received must be a Rough Order of Magnitude and is solely for information-gathering and planning purposes.

5. Marketing and reference materials, if included, shall be placed at the end of the response in anappendix.

6. Responses shall not exceed ten (10) pages and should be submitted in Microsoft Word .doc or .docx formats, Times New Roman 11-point or 12-point font, with 1-inch margins minimum all around.

6.0 RFI SCHEDULE

Responses to the RFI shall be submitted via email to worrells.deborah@dol.gov with a copy to britton.maria.m@dol.gov by June 28 at 3:00pm.

7.0 DISCLAIMER

This RFI is only issued for information and planning purposes and does not constitute a solicitation. The Government does not intend to award a contract based on this RFI or to otherwise pay for information received in response to this RFI. All information received in response to this RFI marked Proprietary will be handled accordingly. Responses to the RFI will not be returned. Information provided in response to this RFI will be used to assess tradeoffs and alternatives available for determining how to proceed in the acquisition process for an agency- wide asset management system and may lead to developing a Performance Work Statement for the system. Per FAR 15.201(e), responses to this RFI are not offers and cannot be accepted by the Government to form a binding contract. Responders are solely responsible for all expenses associated with responding to this RFI.

BASED ON THE RESPONSES TO THESE SOURCES SOUGHT NOTICE/MARKET RESEARCH,THIS REQUIREMENT MAY BE SET-ASIDE FOR SMALL BUSINESSES OR PROCURED THROUGH FULL AND OPEN COMPETITION.

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