J-05 GFP-GFI_DME MAC.xlsx
XLSX spreadsheet 16 KB Posted
- Attached to
- DME MAC Jurisdiction A Federal contract opportunity
- Solicitation number
- RFP-CMS-2010-0004
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J-05 GFP-GFI_DME MAC
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Gov't Furnished Materials
| Government Furnished Materials Name | Government Furnished Materials Description | # of Days After Award Materials Can Be Furnished To Contractor | Responsible Component |
| CMS Private Wide Area Network (CMSnet) | CMSnet is used to securely transport Medicare data between CMS and its contractors. | To Be Determined | Office of Information Services |
| Common Electronic Data Interchange (CEDI) | Base front end services for claims processing to be identified and defined in a Joint Operating Agreement (JOA) with the Contractor and approved by CMS. | To Be Determined | Office of Information Systems/ MCMG |
| Common Working File (CWF) System | System that uses localized databases, maintained by host contractors, to validate pre-payment Medicare claims and to coordinate Medicare Part A and B benefits. The system also provides contractors with beneficiary entitlement, utilization data, and appropriate documentation. CWF also provides the beneficiary claims history to the National Claims History. | To Be Determined | Office of Information Systems |
| Comprenensive Error Rate Testing (CERT) Database | System used to determine error rates and causes. | To Be Determined | Office of Financial Management |
| Contractor Administrative Budget and Financial Management System (CAFM) | System that manages contractor reporting activities pertaining to planning and budgeting of administrative services and operational endeavors, expenditures of administrative and benefit funds, and reconciliation of planned-to-actual expenditures. Continues to be the vehicle for tracking all benefit payments, banking issues, and CFO data, as well as historical budget data (prior to 1998). | To Be Determined | Office of Financial Management |
| Contractor Reporting of Operational and Workload Data System (CROWD) | System that collects and reports on operational and contractor workload data and types of claims processed for Part A and Part B contractors. Data includes types of claims, overall number of claims, and processing cost per claim. | To Be Determined | Office of Financial Management |
| DDISData.info Reporting System | The DDISData.info Reporting System is a secure, web based system that contains a reporting tool designed to support long term, short term, and ad hoc data gathering efforts, such as EDI interchange statistics and performance metrics. | To Be Determined | Office of Information Services |
| Debt Collection System (DCS) | Database used to refer debt to Treasury. | To Be Determined | Office of Financial Management |
| Durable Medical Equipment Coding System (DMECS) | An online coding system. Providers and suppliers can call into this system and enter information on their product to receive feedback as to which HCPCS code they should bill their product under. | To Be Determined | Project Officer or designee |
| Durable Medical Equipment Fee Schedule (DMEFS) | System that maintains, updates, and disseminates Part B pricing data for services priced under DMEPOS fee schedules. The system generates rates for Level 2 HCPCS codes. The system is legislatively mandated. | To Be Determined | Center for Medicare Management (Claims Processing) |
| Electronic Change Information Management Portal (eChimp) | The eChimp is a user-friendly, web-based, extranet application that was developed by the Centers for Medicare and Medicaid Services' (CMS') Division of Change Management (DCM) to help streamline and automate the Change Management process. eChimp provides Change Request (CR) authors with the ability to complete and validate change request forms online, and provides them with a tool to track their CR from draft to finalization. In addition, the system provides reviewers with a Point of Contact (POC) Review Forum, which consolidates the comments received from multiple reviewers for a particular CR into a single, easy to read conversation based forum. | To Be Determined | Center for Medicare Management |
| Electronic Correspondence Referral System (ECRS) | System used by contractors to transmit Coordination of Benefits information. The system supports all activities related to establishing MSP periods of coverage at CWF that result from initial MSP development activities. | To Be Determined | Office of Financial Management (Medicare Secondary Payer) |
| Enterprise Data Center (EDC) | CMS designated Enterprise Data Center (EDC) for claims processing to be identified and approved by CMS. | To Be Determined | Office of Information Systems/ MCMG |
| Error Rate Reduction Plan (ERRP) Template | Data template for development of the annual, & quarterly, contractor error rate reduction plan report | To Be Determined | Center for Medicare Management (CMM)/Office of Financial Management (OFM) |
| FISMA Assessment (FA) | The annual FA is an audit type; therefore, it is documented, tracked, and reported in the CISS in accordance with the guidance provided in the CMS POA&M and Annual FISMA Assessment using CISS Guideline. The purpose of annual FA testing (i.e., validation) is to examine and analyze implemented security safeguards in order to provide evidence of compliance with applicable laws, directives, policies, and requirements regarding information security. | To Be Determined | Center for Medicare Management (MCMG) |
| Health Care Services Information System (HCIS) | System that allows users to sift through summarized Medicare information, in predetermined views, and focus analysis on areas of suspected fraud and abuse in the Medicare program. Subject areas available for analysis include: Home Health Agency, Skilled Nursing Facility, Hospice, Inpatient, Outpatient, Clinical Lab, and Durable Medical Equipment data. | To Be Determined | Office of Financial Management |
| Incentive Reward Program (IRP) Tracking Database | The IRP tracking database contains information on IRP cases. | To Be Determined | Office of Financial Management (Benefit Integrity) |
| Medicare Appeals System (MAS) | Web-based interface accessible through the Medicare Data Center Network (MDCN) to assist Medicare Appeals processing and provide associated reporting, analysis, and imaging viewing capabilities. | To Be Determined | Center for Health Plan Choices (CPC) |
| Medicare Contractor Provider Satisfaction Survey (MCPSS) | Provider survey. | To Be Determined | Center for Medicare Management |
| Medicare Coverage Database (MCD) | Acts as a central point of dissemination for both National and Local medicare Coverage policies. On the national side, the MCD houses National Coverage Analyses (NCSs), Coding Analyses for Laboratories (CALs), and National Coverage Determinations (NCDs). On the local side, the MCD houses Local Coverage Determinations (LCDs), Local medical Review Policies (LMRPs, until December 31, 2005), and contractor articles. Besides these policies, the MCD contains downloadable indexes and reports. | To Be Determined | Office of Financial Management |
| Medicare Exclusion Database (MED) | Contains the information from the OIG's List of Excluded Individuals and Entities (LEIE) for contractors to access in order to deny claims for excluded services and prevent enrollment of excluded providers. | To Be Determined | Office of Financial Management |
| Medicare Secondary Payment (MSPPAY) module | System used to price claims where Medicare is a secondary payer. | To Be Determined | Office of Financial Management (Medicare Secondary Payer) |
| National Drug Code (NDC) to HCPCS Crosswalk | Files developed by the PDAC that provide a crosswalk from the NDC to a HCPCS code for billing purposes. | To Be Determined | Project Officer or designee |
| National Plan and Provider Enumeration System (NPPES) | The National Provider Identifier (NPI) will identify health care providers in electronic transactions for with the Secretary has adopted standards. These transactions include claims, eligibility inquiries and responses, claims status inquiries and responses, referrals, and remittance advices. Note: Whilte CMS may provide an extract data to the contractor, it will not provide system access to NPPES. | To Be Determined | Office of Financial Management |
| National Supplier Clearinghouse (NSC) | System that consolidates the identification and ownership data of all DMEPOS suppliers in the Medicare program, including historical data; System that tracks applications received, status, and time-in-process, and customer inquiries. | To Be Determined | Office of Financial Management (Program Integrity Group) |
| Next Generation Desktop (NGD) | Desktop application to allow Customer Service Representatives in contractors' contact centers to respond to beneficiary claims inquiries referred by the BCC. | To Be Determined | Center for Health Plan Choices (CPC) |
| Oral anti-cancer drug (OACD) Pricing Files | Files developed by the PDAC that contains pricing information on oral anti-cancer drugs. | To Be Determined | CMS Central Office |
| Part B Analytics Reporting (PBAR) | System that provides data used to evaluate Part B procedures, monitor contracting, allocate resources, prepare impact statements, and develop budget and legislative proposals, congressional reports, and medical reviews. | To Be Determined | Center for Medicare Management (CMM) |
| Physician and Supplier Overpayment Recovery System (PSOR) | System that prepares statistical reports that enable management of physician and supplier overpayment recoveries. The system identifies, monitors, and resolves Medicare Part B provider overpayments. | To Be Determined | Office of Financial Management (Overpayments) |
| Provider Enrollment Chain and Ownership System (PECOS) | CMS system used by contractors that captures Medicare enrollment information. The PECOS database retains enrollment information and transmits enrollment status/information to contractors. | To Be Determined | Office of Financial Management (Program Integrity Group) |
| Provider Inquiries Evaluation System (PIES) | Tool designed to facilitate contact center performance reporting. Contractors report performance on specified metrics by the tenth of each month. The PIES data provides the framework to assess contractor performance on a consistent basis relative to requirements as well as to each other on a comparative level. | To Be Determined | Centers for Medicare Management/Center for Health Plan Choices (Provider Inquiries) |
| Quality Call Monitoring (QCM) Database | On-line database where contractors enter and manage quality written correspondence monitoring data. The QCM Chart is used to reduce the subjectivity of those reviewing the quality and accuracy of provider telephone responses. The QCM Scorecard is used to review the quality and accuracy of provider telephone responses. | To Be Determined | Centers for Medicare Management (Provider Inquiries) |
| Quality Written Correspondence Monitoring (QWCM) Database | On-line database where contractors enter and manage quality written correspondence monitoring data. The QWCM Chart is used to reduce the subjectivity of those reviewing the quality and accuracy of provider written responses. The QWCM Scorecard is used to review the quality and accuracy of provider written responses. | To Be Determined | Centers for Medicare Management (Provider Inquiries) |
| Supplier/Provider Educational Materials | Supplier/Provider education materials (e.g., videos, CBTs, articles, brochures, etc.) furnished to contractors for use in educating their supplier/provider community | To Be Determined | Center for Medicare Management (Provider Communications) |
| Survey Programming Module | Website satisfaction survey programming module to be inserted into the contractor's website. | To Be Determined | Center for Medicare Management |
| Systematic MSP Automated Recovery Tracking (MCS) - (SMART) | System used to track MSP recoveries and provide an audit trail showing the history of the recovery case. Once a case has been identified for recovery, it is placed on SMART, and a demand package is created for the insurer, identified by either the DataMatch tape or retroactive recovery. | To Be Determined | Office of Financial Management (Medicare Secondary Payer) |
| Telecommunications Network | MDCN hook-up. | To Be Determined | Office of Information Systems |
| Toll-free telephone service | Toll-free network service provided through the FTS2001 Network Services Contract or its successor. | To Be Determined | Office of Operations Management |
| Training Materials | Training materials used for provider customer service staff provided on an ad hoc basis. | To Be Determined | Center for Medicare Management |
| VIPS Medicare System (VMS) | System that processes Medicare Durable Medical Equipment claims. | To Be Determined | Center for Medicare Management (Claims Processing) |
| Voucher/Financial Management System - CMS ART | System that serves as the main vehicle for planning, administering, and monitoring the administrative expenses of the Medicare contractor community. | To Be Determined | Office of Financial Management |
| Web base Intelligence (WebI) | Web based product that allows CMS and certain other entities access to data analysis, reports and research articles published by the PDAC. | To Be Determined | Project Officer or designee |
CMS-RFP-2010-0004 J-05
Durable Medical Equipment (DME) Medicare Administrative Contractor (MAC)
&"Arial,Bold"&14Attachment J-12 Government Furnished Property and Government Furnished Information
Attachment J-12 Government Furnished Property and Government Furnished Information Source Selection Information - See FAR 2.101 and 3.104 &P
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