RFP-CMS-2015-8A-0101_Amendment_2.doc

RFP-CMS-2015-8A-0101 Amendment Number 2 Clarification of CMS Responses to Industry Questions July 9, 2015

Does CMS anticipate eventually housing the reconciled program-collected data in the CMS Clinical Warehouse?

Data is warehoused at CMS, however, in order for the contractor to complete that analysis required, they will need to house the data.

Would CMS clarify if the PII/PHI data from the CMS data warehouses such as QIES is expected to be housed at a contractor facility?

In our experience housing of PII/PHI data requires an Authority to Operate (ATO) from CMS. Please clarify if CMS is requiring an external contractor environment for storing this data?

The contractor will be expected to obtain and store data extracts, which could contain PHI, from claims, QIES or other systems for analysis, monitoring and evaluation. Since the contractor will not be the source of the information, an ATO is not required.

1. Is the validation of the 500 records annually inclusive of all three programs, or is it 500 per program? 2. How many data elements are abstracted/validated per program type during the validation process? 3. Historically, what is the average time to abstract each data element? 4. How are the validation records selected and requested? Does the contractor need to send out the request for records? 5.

Is the contractor responsible for any reimbursement to the facility for medical record copy and mailing costs? 6. How long does the contractor need to retain and store the medical records that were validated? 7. Is the validation does through an electronic or paper tool?

1. The 500 is the total of the records for all programs reviewed. 2. Currently there are 9-11 data elements and 3-5 administrative elements, however, as measures are added, those numbers could increase. 3. Average time is not currently known. 4. The contractor is not involved in the selection or requesting the records, the records will be delivered via secure electronic media. 5. The contractor is not responsible for any reimbursement. 6.

CMS will have an electronic copy of the medical record, so the contractor need only store the records for the length of the project. 7. The validation is electronic.

Would CMS clarify if the electronic medical records contain PII/PHI and if the contractor is expected to house this data in a contractor environment external to CMS?

Yes, the records contain PHI. The contractor must make the necessary arrangements for housing the data.

What date range will the validation methodologies cover (e.g. prior 6 months or prior year)? Are we validating measures from FY2015 only in year 1 and then progressing to the other years?