Questions and Answers WTCHP NPN RFI.docx

Q#

Will the prime contractor for comprehensive Nationwide Provider Network (NPN) solutions for the World Trade Center (WTC) Health Program be prohibited from serving as a prime contractor for any other World Trade Center (WTC) contract opportunities administered by the National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC) (or vice-versa; i.e., are there any current WTC contractors prohibited from serving as the prime contractor for this opportunity)?

Anyone can respond to this RFI.

If the answer to question 1 is “yes”, can you please identify those current contracts or future planned contract opportunities for which there is a conflict?

“Describe how the WTC Health Program benefits will be delivered in a geographically spread member population including providing at least one dedicated clinic site for a community with 1,000 - 2,000 members within a 75-100 mile radius.”

Does the term “dedicated clinic site” mean a brick and mortar clinic that monitors, evaluates, and treats only WTC Health Program members and no other patients?

Could the NPN contractor partner with and augment an existing medical practice to act as the designated WTC Health Program clinic and serve the WTC Health Program members in that area in addition to their existing (non-WTC Health Program) patients?

“Describe a comprehensive approach to conduct COB for all survivor members' claims prior to submission for payment with explanation of benefit and validation of benefits with or without primary insurance in accordance with the Affordable Care Act as the WTC Health Program is the payer of last resource”

NPN8

“Describe a comprehensive approach to assess, collect and manage health insurance coverage information for medical and pharmacy benefits, and transmission of data to the WTC Health Program”

Do these requirements create duplication of effort with the Comprehensive Cost Avoidance-Coordination of Benefits contract that is pending award?

If the answer to question 3 is “no”, please clarify how this requirement is different.

“Describe how the pharmacy benefits will be managed and delivered for approved formularies and prescriptions including Durable Medical Equipment (DME) and required supplies”

Is the expectation that the solution should include a Pharmacy Benefits Management Solution exclusively for the members of the NPN?

https://www.cdc.gov/wtc/materials.html https://www.cdc.gov/wtc/laws.html https://www.cdc.gov/wtc/ataglance.html

If the answer to question 4 is “no”, is NIOSH asking that the NPN coordinate and facilitate pharmacy coverages with the existing WTC Health Program PBM contractor?

“Describe how a call center service, including WTC Health Program Member Phone Bank/Resource Line, will be provided and managed including center workflow, triaging and priorities process and how the nature of the calls are addressed and monitored for timeliness and appropriateness, and calls should be referred to the WTC Health Program Call Center or next level of services-such as case managers”

NPN26

“Describe call center workflow, triaging and priorities process and how the nature of the calls are addressed and monitored for timeliness and appropriateness.”

Are NPN15 and NPN 26 separate requirements, or is NPN26 duplicative to the highlighted portion of NPN15?

“Describe member enrollment and disenrollment processes.”

By “member enrollment” do you mean the process to have a member become part of the NPN after they are approved WTC Health Program members or should the solution include a way to enroll non-members into the WTC Health Program?

https://www.cdc.gov/wtc/materials.html https://www.cdc.gov/wtc/laws.html https://www.cdc.gov/wtc/ataglance.html