Amendment05ResponsestoQuestions.pdf

BOP RESPONSES TO QUESTIONS RECEIVED

IN RESPONSE TO RFQ100-0006-07 FOR

MEDICAL CLAIMS ADJUDICATION SERVICES

1. Can the BOP provide an estimate of customer service (physician, prison administrator, etc.) call volume per year?

RESPONSE: The information provided by the BOP (e.g., number of payments, number of institutions, number of inmates) as well as the contractor’s experience in providing this service to other customers should serve as a guide in determining the projected customer service call volume. The contractor should anticipate questions from institution health services administrators and/or their staff regarding information contained in the Explanation of Benefits generated by the contractor as well as questions regarding technical/IT issues for any systems and/or software deployed by the contractor.

2. Can the BOP provide a projection of the volume of “good faith estimates” that would be requested from the Contractor per year?

RESPONSE: The number of payments made by the BOP as well as the contractor’s experience in providing this service to other customers should serve as a guide in determining the projected volume of “good faith estimates”. The contractor should recognize that each claim for payment must be supported by a preauthorization submitted by a BOP institution and it is the submission of the preauthorization which necessitates the need for a good faith estimate.

3. Can the BOP provide clarification of the composition of the 40-45,000 claims per year (Inpatient, Outpatient, Specialty, Ambulance, etc.)?

RESPONSE: Contractors must recognize that the BOP processed 45,215 PAYMENTS in fiscal year 2006 and that a single payment MAY consist of multiple claims. However, each payment will be supported by at least one claim. The BOP does not have a system or means to provide the composition of the payments processed. However, the BOP can broadly state that such payments are primarily for outpatient services, but also include payments for a full array of medical services such as inpatient, outpatient, and specialty services.

4. Can the BOP verify the following ratio? Based upon the RFQ volume of 45,000 claims for 190,000 inmates = 0.24 claim/inmate (in other words 1 claim per year for every 4 inmates).

RESPONSE: While the ratio is mathematically correct, contractors must recognize that the BOP processed 45,215 PAYMENTS in fiscal year 2006 and that a single payment MAY consist of multiple claims.

5. Can the BOP further define all the activities it considers part of a “claim”? For instance, if an estimate is completed, but no claim is ever sent to the contractor, does that estimate work constitute a “claim” for which the contract would be paid the cost per claim amount?

RESPONSE: Payment will be made by the BOP for each claim which completes the adjudication process (i.e., claim is supported by an approved preauthorization submitted by a BOP institution and a contract with the health care provider which is to provide the services); claim submitted by a bona fide health care provider (i.e. provider is under contract with the BOP); adjudicated by the adjudication contractor; and EOB issued by the adjudicator to BOP which results in payment of the claim.

Please address the following sub-questions:

A. Is the Good faith estimate part of the initial claim or a separate claim?

RESPONSE: The generation of a good faith estimate by the contractor is necessary to properly support the obligation an institution will set up in the Financial Management system for medical services anticipated. The contractor will generate a good faith estimate for each preauthorization submitted by a BOP institution and will be part of the initial claim.

B. Does the BOP expect the Explanation of Benefit (EOB) produced to be part of the cost per claims?

RESPONSE: The contractor shall include the cost of generating an EOB as part of the cost per claim.

C. Can the BOP define Final Paid claim?

RESPONSE: Not sure what this is in reference to or in what context it is asked as this phrase is not mentioned in any of the solicitation documents. The BOP views “final paid claim” to mean no further payments are anticipated for the claim and any unexpended obligations associated with the claim will be liquidated with the last (and final) payment.

D. Can the BOP describe how Adjustments to a claim would be paid? Are adjustments to be treated like a new claim or part of the original claim?

RESPONSE: Adjustments should be supported (authorized) by the initial preauthorization submitted by a BOP institution. In some cases, a BOP institution will not know the full extent of an inmate’s medical condition until that inmate has been seen by a health care provider. Once a full diagnosis has been made, the BOP institution would amend the previously submitted initial preauthorization accordingly.

E. How many Adjustments does the BOP expect per year?

RESPONSE: The BOP can only state that there will be cases where adjustments will be needed, but the BOP cannot quantify this as it does not have the means to do so.

Accordingly, the number of payments made by the BOP and the contractor’s experience in providing this service to other customers should serve as a guide in determining the expected number of adjustments.

F. What is the definition of “Payments Completed”?

RESPONSE: Not sure what this is in reference to or in what context it is asked as this phrase is not mentioned in any of the solicitation documents. “Payment completed” is viewed as the payment for the subject claim being processed., or it could also be viewed as the same as “final paid claim”.

6. How many healthcare providers (hospital, physician, institutions, etc.) currently serve this population? And the counts of each provider type?

RESPONSE: The BOP has no way to track this information. However, please refer to the response to Question 7.

7. Can the BOP provide an estimate on the number of provider contracts the BOP currently has, and the breakdown of CMS verses Non-CMS schedules?

RESPONSE: The number of contracts will continually change as old contracts expire and new contracts are awarded. However, to date, the BOP estimates it has about 96 contracts and/or Blanket Purchase Agreements (BPA) for which bill adjudication will be necessary. Of this 96, approximately 78 percent are wholly Medicare-based, 13 percent are a blend of Medicare-based and commercial fee schedules, and 9 percent are commercial fee schedules. These percentages may change over time as contracts are re-competed. These numbers do not include any contracts awarded by institutions under which bills may be sent for adjudication.

8. Can the BOP provide an estimate, on a monthly basis, of the number of modification/changes to provider contracts (including new and terminated contracts)?

RESPONSE: The BOP has no way to track this information. However, the BOP does not think there are a vast number of modifications being done. Routine rate adjustments typically are not effected by modifications, so the vendors should be aware that rate changes will occur automatically as CMS updates it schedules. Commercial fee schedule contracts will be updated when the BOP submits new fee schedules to the bill adjudicator contractor.

9. Can the BOP clarify the level of effort expected for Utilization Review and Case Management process? What does the contractor do with flagged cases to manage?

RESPONSE: Some DRGs are known to be common for payment error (i.e., one-day stays and DRG 143 - chest pain). The contractor would request medical records for a specified percentage of those cases and would review the documentation to ensure DRG admission criteria was met. Another possible “pend” would be “present on admission” when implemented by CMS. The contractor would review a percentage of those records to ensure the record demonstrates the complication resulting in a higher DRG was not present on admission. The contractor would request records from the provider and review the records to ensure correct coding and billing. Records would be destroyed per the contractor’s business rules after claims have been adjudicated. Medical records for purposes of continuity of care will be handled by the BOP institutions and will not be part of the claims adjudication process. Regarding case management opportunities, studies would include those similar to those conducted by private insurance companies and CMS.

Examples of studies might include case mix index analysis for various groups of provider cases to the BOP, review of the top 5 DRGs in the BOP for males in comparison to the national average. The contractor would need the ability to query the data gathered for these types of studies and would also need personnel knowledgeable in current reimbursement issues and ability to analyze data.

10. Can the BOP provide an estimate of the percentage of claims that will be submitted electronically to the contractor vs on paper?

RESPONSE: Although the industry will eventually migrate to 100% electronic invoicing, the BOP cannot provide an estimate of the percentage of claims which will be submitted electronically as each contract it has with a service provider will have to be modified to include this requirement. Accordingly, the BOP anticipates the contractor will receive both electronic and paper claims for the foreseeable future.

11. Does the FAR Part 2 and FAR Part 12 - Commercial procedures > $100,000 apply?

RESPONSE: Yes.

12. Can the BOP supply clarification on Price Schedule. Will the cost associated with the “estimated maximum” quantities be used to evaluate the total contract award amount? If not, what is the purpose of including this information in our proposal? How is the BOP evaluating this line item? It appears the bidder could bid low on the minimum guaranteed amount and higher on the maximum estimated amount and receive the award.

RESPONSE: The Pricing Schedule is being revised and will be posted via a future Amendment to RFQ100-0006-07.

13. In the Solicitation, section A.15 there was no Business Management Questionnaire included in the documentation. What is the purpose of this document? Will this be corrected by amendment to the solicitation? Please advise as to what action should be taken.

RESPONSE: The Business Management Questionnaire is included as an attachment to this Amendment. The purpose of the Business Management Questionnaire is to assist in determining contractor responsibility.

14. The SOW did not include a complete list of deliverables, a schedule or time frame for the deliverables. If deliverables are required, will an amendment be issued to address the required deliverables and schedule?

RESPONSE: The Statement of Work is being revised with regard to this question. The revised Statement of Work will be posted via a future Amendment to RFQ100-0006-07.

15. Can the BOP supply additional clarification on Paragraph 12 on the SOW? Does the BOP expect the data file formats included in the proposal, or is this to be defined after contract award during the operational phase of the contract?

RESPONSE: The contractor should indicate whether or not they can comply with the data file and format requirements specified in the SOW and include in their quote any cost associated with complying with that requirement. The BOP expects some level of collaboration in assisting the contractor in developing/modifying the contractor’s system/software to meet the BOP’s needs.

16. Does the Service Contract Act apply, and if so, can the BOP supply a wage determination schedules? If not, please provide your reference of FAR guidance.

RESPONSE: Amendment 01 to RFQ100-0006-07 issued on July 13, 2007 incorporated the Service Contract Act in the solicitation. It is recommended to assist in determining the wage schedules which would be applicable to the location or area your adjudication services are conducted the prospective quoter go to www.dol.gov to obtain the wage determination.

http://www.dol.gov

17. Can the BOP give additional detail on the type of each customer service call the contractor is expected to handle? Will BOP staff call for Technical assistance? Will Providers offices call to inquire on a payment?

RESPONSE: The contractor should anticipate questions from institution health services administrators and/or their staff regarding information contained in the Explanation of Benefits generated by the contractor as well as questions regarding technical/IT issues for any systems and/or software deployed by the contractor. Service providers should not contact the contractor regarding payment status and the contractor should refer any such calls to the BOP institution which was provided the service.

18. As written in the RFQ, all payments will be made from the Prison accounting system. The contractor will not make any payments. Based on this, what should the contractor do when a provider calls requesting information on a payment of a claim?

RESPONSE: Refer the call to the BOP institution which was provided the service.

19. Can the BOP elaborate on the types and breadth of the auditing procedures?

RESPONSE: We anticipate occasional visits by BOP staff to ensure compliance with the contract. This is customary. However, the contractor should recognize that visits by officials from other governmental entities, e.g., GAO, OIG, etc., may occur at any time without notice and without the knowledge of the BOP.

20. How many BOP staff currently perform this work today? And how many BOP staff would need access to the new computer systems to perform the work in the future?

RESPONSE: Staff in the Health Services Unit and Business Office in each BOP institution (at least four (4) per site) perform claims adjudication and related accounting and payment services, and it is anticipated the same number will need access to the contractor’s system.

21. How many characters and in what format is the Prisoner number described in the RFP (should be RFQ) that will be used for Prisoner identification in the contractor’s system?

RESPONSE: The inmate number is numeric and consists of 8 numeric characters and one symbol (i.e., xxxxx-xxx, where x is a numeric character and the hyphen is the symbol).

22. What liability, if any, would the contract hold on the estimates of the claims? Estimates can vary greatly depending on the services rendered, patients pre-existing conditions and many other factors.

RESPONSE: Contractually, the contractor is bound to the requirements of the contract and, at the discretion of the contracting officer, a variety of sanctions could be imposed as provided for under the Federal Acquisition Regulation (FAR) and the Bureau of Prisons Acquisition Policy (BPAP). Operationally, the key phrase is “good faith”.

As long as the process through which the estimate is generated is based on objective criteria which can be reasonably substantiated (e.g, previously payments for the same service, fee schedules), then the contractor would be deemed as performing in accordance with the contract. However, the contractor must explain, to the BOP’s satisfaction, the methodology for which the “good faith” estimate will be generated.

23. Will a centralized BOP office be performing the systems work, with the EOB’s being sent to the individual prison? Or would each prison need access to the new system? If this is the case, who would be billed in the condition that less than the guaranteed 40,000 claims are processed?

RESPONSE: It depends on the IT solution proposed by the contractor but it is our experience that an enterprise (centralized) server with institution access works best.

Regardless of the solution, EOBs must be sent or otherwise accessed by the individual institutions. As far as billings go, each institution is to be billed for the claims submitted for the services provided to them. The Pricing Schedule is being revised and will be posted via a future Amendment to RFQ100-0006-07.

24. RE: The Solicitation/Contract/Order form Page 15, Section A.15 titled, “Business Management Questionnaire” states that there is a questionnaire included in “Section J” that is to be completed and submitted with the offeror’s business proposal. I am unable to locate the questionnaire or even a “Section J”. Can you tell me if this question applies to this R.Q. and if so, where may I locate it or locate this section?

RESPONSE: The Business Management Questionnaire is included as an attachment to this Amendment. The purpose of the Business Management Questionnaire is to assist in determining contractor responsibility.

25. RE: Statement of Work. The “Background” section of the statement of work describes how current claims submitted to the BOP are 100% paper. You further state that “for the purpose of contract award, a claim for contracted healthcare services reimbursed using the Medicare model is defined as either: a current paper version of the UB92 or CMS15000;

or alternatively, electronic claims that conform to Medicare and HIAA electronic billing standards”. In section 5 “Invoicing Medical Service (Claims)”, you state that Electronic Data Interchange invoicing of claims between the healthcare provider and the contractor will be required.

My question for clarification. Do you require 100% submission of claims to be electronic or is some volume of paper claim submission permitted? Are non-contracted providers permitted to submit claims via paper as the above reference described only “contracted” healthcare services?

RESPONSE: Although the industry will eventually migrate to 100% electronic invoicing, we cannot provide an estimate of the percentage of claims which will be submitted electronically as each contract the BOP has with a service provider will have to be amended to include this requirement. Accordingly, we anticipate the contractor will receive both electronic and paper claims for the foreseeable future.

26. RE: Statement of Work, Section 7, Prompt Payment Considerations - This is the only reference that I can find that described any standard of performance. Your requirement is to “notify” providers of improper claim submissions within 7 days of receipt. Is the contractor required to return incorrect claims with notification to the providers and include instructions for correct submission?

This section is also the only place where adjudication timeliness is described. Your requirement is to adjudicate and transfer to the paying institution record of adjudication, EOB and any other information with 3 workdays of receipt. Can you clarify that for the purposes of this contract that the adjudication standard for processing properly submitted claims is 100% within 3 workdays of receipt?

Are there any other performance metrics that need to be considered, whether related to claims adjudication, customer service, quality or any other performance indicator?

RESPONSE: The contractor is required to return incorrect claims with notification to the providers and include instructions for correct submissions within seven (7) days of receipt of improper claims. This is a requirement of the Prompt Payment Act.

Yes, the requirement for processing a properly submitted claim is within 3 working days of receipt of the claim which is supported by a preauthorization submitted by a BOP institution for the service(s) billed and a contract with the service provider submitting the claim.

27. RE: Statement of Work, Section 8, Billing of Adjudication Services - The contractor is required to submit bills direction to the institutions for payment of adjudication services based on the number of claims paid for that institution. What are the payment timeliness requirements for the institutions to pay the contractors? Are the payment standards the same as for the contractors, I. E., the institutions must submit reimbursement to the contractors within three work days of receiving the contractors billing statement?

RESPONSE: The Prompt Payment Act applies to any and all payments made by the Federal Government. The contractor will be paid within 30 days of receipt of the bill which is the date the bill is received in the Accounts Payable Office. The only exception is if the contractor offers a discount on payment (e.g., 2% / 10 days, net 30), then payment would be made within 10 days to receive the 2% discount.

28. Request to extend the opening date of RFQ100-0006-07 for Medical Adjudication Services.

RESPONSE: With the posting of Amendment 4, the quote due date is extended to August 31, 2007, at 2:00 p.m.

29. Please check on the bidder auto-notification function for updates relating to the solicitation. Prospective quoter has registered, but did not receive notification that the solicitation documents had been posted.

RESPONSE: It is recommended the prospective quoter try again to register for automatic notification through the Federal Business Opportunities (FBO) website. In addition, it is recommended that any prospective quoter check the FBO website each day for any additional postings regarding this solicitation.

30. Provider Network: Is the network currently in place?

RESPONSE: The BOP has entered into individual comprehensive medical contracts and agreements with service providers and this is what we refer to as our “network of providers”.

31. Will an electronic provider file be provided or is this a manual entry of provider data and fee schedule into the processing system?

RESPONSE: CMS schedules will be identified for each contract, as applicable; the contractor should be responsible for loading those applicable CMS schedules into their database. The BOP will have to negotiate any non-CMS schedules with those applicable contractors; if the BOP can get an electronic provider file it will, but there may be instances when an electronic provider file cannot be obtained.

32. Current number of providers in the network.

RESPONSE: The BOP has no way to track this information. However, please refer to the response to Question 7.

33. Is the contractor expected to solicit providers to join the network?

RESPONSE: No. Only the BOP can solicit and award contracts to service providers.

34. Who holds and creates the contracts with the providers?

RESPONSE: The BOP establishes all prime contracts for inmate healthcare. The prime contractor may establish subcontracts as necessary directly with health care providers.

35. Can you define “identify large case management”?

RESPONSE: Case management opportunities are studies similar to those conducted by private insurance companies and CMS. Examples of studies might include case mix index analysis for various groups of provider cases to the BOP, review of the top 5 DRGs in the BOP for males in comparison to the national average. The contractor would need the ability to query the data gathered for these types of studies and would also need personnel knowledgeable in current reimbursement issues and ability to analyze data.

36. Please define inside consultants and outside hospitalization.

RESPONSE: “Inside” consultants are health care specialists which come into the institutions to provide their services. “Outside” hospitalizations are services provided outside an institution in a community-based clinic or hospital.

37. Preauthorization: “The contractor shall provide, in advance of medical services, a good faith estimate of the expected costs of services.” Does this mean that when the contractor sends the request for authorization to each institution an estimated payment should accompany the authorization request per service?

RESPONSE: Each institution will generate a preauthorization for health care service upon which the contractor is to generate a good faith estimate for the cost of that service.

38. Payment files: Please verify if the contractor is just pricing the medical services and the BOP is paying the providers or is the BOP approving payment and the contractor sending payments (checks or direct deposits) to the provider of services?

RESPONSE: The BOP will pay the providers directly. The contractor will not send any payments to the providers of the services.

39. Is anyone currently performing this work? If so, who?

RESPONSE: Adjudication of medical services claims is currently being performed manually by BOP institution health services staff. Furthermore, each BOP institution has a Business Office that performs the payment functions.

40. Can you provide proposal instructions such as page limits, etc.?

RESPONSE: There are no restrictions or instructions for how the quote should be formatted.

The prospective quoter should ensure that all technical, past performance, and pricing is addressed in its quote.

41. What is the award date?

RESPONSE: There is not specific date established for award.

42. Can you extend the quote due date?

RESPONSE: With the posting of Amendment 4, the quote due date is extended to August 31, 2007, at 2:00 p.m.

43. Must all data be on a single back-end server stored in a relational database or can the mainframe use a non-relational database?

RESPONSE: A non-relational database is acceptable as long as the contractor is solely responsible for the non-relational database’s support and maintenance.

44. Do databases housed in a industry standard data center, with controlled access, 24 hour monitoring, and tightly controlled processes require the databases to be encrypted?

RESPONSE: The BOP preference is that the active database be encrypted. However, as long as the data center in which the database is maintained is secured to the standards outlined in the Department of Justice (DOJ) Information Technology Security Stand Physical and Environmental Protection Control Family program statement (included as an attachment to this Amendment), then there is no objection.

45. Within what timeframe does the BOP anticipate the implementation period to occur, (e.g.

three months, six months)?

RESPONSE: The Statement of Work is being revised with regard to this question. The revised Statement of Work will be posted via a future Amendment to RFQ100-0006-07.

46. Is it a requirement that the application must run on hardware physically residing within a federal facility and supported by federal IT staff?

RESPONSE: It is not a requirement that the application must run on hardware physically residing within a Federal facility and supported by Federal IT staff. However, the facility and staff that support the hardware must meet the requirements of the standards outlined in the Department of Justice (DOJ) Information Technology Security Stand Physical and Environmental Protection Control Family program statement (included as an attachment to this Amendment).

47. Do you have the data on how many different Providers currently submit claims for payment to the various Federal Prisons. In the RFP it states 45,215 payments were made for outside hospitalizations, …………… but it does not give an estimation on how many various providers have contracts with the Bureau to provide medical care.

RESPONSE: The BOP has no way to track this information.

48. For the 45,215 payments made in FY2006, how many claims were UB (Facility) vs.

HCFA (Physician)?

RESPONSE: The BOP does not have the means to provide this information.

49. How many contracts does the BOP have with "network of healthcare provider'? How many are contracted using Medicare rates vs. an alternate fee structure?

RESPONSE: The number of contracts will continually change as old contracts expire and new contracts are awarded. However, to date, the BOP estimates it has about 96 contracts and/or BPAs for which bill adjudication will be necessary. Of this 96, approximately 78 percent are wholly Medicare-based, 13 percent are a blend of Medicare-based and commercial fee schedules, and 9 percent are commercial fee schedules. These percentages may change over time as contracts are re-competed.

These numbers do not include any contracts awarded by institutions under which bills may be sent for adjudication.

50. Please confirm pre-authorization is being performed by the BOP institutions. If not the BOP, please provide name of current vendor.

RESPONSE: BOP staff are currently performing the preauthorizations.

51. What is the purpose of estimating expected reimbursements upon receipt of a pre-authorization? What is the turnaround time expected for issuance of an estimated reimbursement? What is the anticipated notification process?

RESPONSE: The purpose of the good faith estimate is to allow the BOP to establish a properly supported obligation in the BOP’s Financial Management Information System.

This estimate should be reasonably accurate based on the health care services expected to be provided. The turn around time would need to be within 24 hours.

Notification should be accomplished electronically.

52. Can the BOP provide examples of the paper and database formats utilized in transmitting schedules for "network of healthcare provider" rates? How often do the rates and/or formats change?

RESPONSE: The BOP will provide the adjudication contractor with fee schedules in support of contracts that are not based on Medicare rates. Fee schedules will be provided to the adjudication contractor in the format received from the provider and may vary in format. For Medicare-based contracts, the applicable CMS fee schedules will be identified for the adjudication contractor. The adjudication contractor will be responsible for acquiring the applicable CMS fee schedules and any/all rate adjustments under those fee schedules. Fee schedules under non-Medicare based contracts will be updated as the providers submit new fee schedules to the BOP.

Rate changes under Medicare-based contracts will automatically occur as CMS updates its rate schedules. In addition, as medical contracts renew, any identified discounts or premiums which apply to the underlying fee schedules may change with the yearly extension of the contract and/or as modified by the BOP.

53. What is the BOP's expectation in reference to allowing Bureau Central Office staff to manage and maintain the systems from D.C.? Is this for audit or detailed account management purposes? The reason for the question is that we provide web-based applications and reporting systems and are trying to determine if on-line access will be sufficient in meeting this requirement.

RESPONSE: If the quoter is actually managing the system’s operating system, database and application software, the BOP staff (field and Central Office) only need on-line access to manage staff access to the system.

54. Provide example of the function (s) BOP staff would perform relative to this system requirement.

RESPONSE: BOP staff need on-line access to the system to manage user accounts. If the quoter is going to perform this function for the BOP’s 110 plus sites, then access may only be needed for audit and reporting purposes.

55. In reference to the requirement of having the ability to interoperate with other Bureau systems such as "Pharmacy systems from Advanced Technologies Group", will the Contractor be reviewing/adjudicating pharmacy claims? If yes, provide an explanation of what is expected in reference to work performed.

RESPONSE: BOP staff need to be able to work with the Adjudication System in conjunction with the Pharmacy and Electronic Medical Records (EMR) systems. If the quoter’s system is web-based application then it should be no problem for our staff to have multiple browser windows open and be able to reference the Pharmacy and EMR systems to determine what care was given to an inmate. There is no intention to track third-party health care costs within either the Pharmacy or EMR systems.

56. What is the BOP's expectation in reference to "using" the Contractor's system? The reason for the question is that we provide web-based applications and reporting systems and are trying to determine if on-line access will be sufficient in meeting this requirement.

RESPONSE: If the quoter is actually managing the system’s operating system, database and application software, the BOP staff (field and Central Office) only need on-line access to manage staff access to the system.

57. Provide copy of policy "P1237.13" for computer room requirements.

RESPONSE: A copy of Program Statement P1237.13 is included as an attachment to this Amendment.

58. What is the BOP's expectation in reference to "using" the Contractor's system? The reason for the question is that we provide web-based applications and reporting systems and are trying to determine if on-line access will be sufficient in meeting this requirement.

RESPONSE: If the quoter is actually managing the system’s operating system, database and application software, the BOP staff (field and Central Office) only need on-line access to manage staff access to the system.

59. How many BOP employees are expected to be involved with the implementation? What are their roles? What percentage of their time will they be expected to devote to the project?

RESPONSE: The extent of BOP’s involvement will be predicated on the contractor’s implementation plan.

60. How many automated interfaces are expected to be implemented? Is there any documentation related to these interfaces? How is the information currently being interfaced?

RESPONSE: The BOP anticipates only one automated interface and documentation would be provided to facilitate the integration with the contractor’s system. This information is not interfaced with any other system at this time.

61. Can you give us any information about the types of edits that will be required, including CCI edits required?

RESPONSE: Correct Coding Initiative edits (published by CMS) would be the main edit. When the “present on admission” coding becomes mandatory for Medicare, we would also want to use that as an edit. This would be in line with CCI. In addition to CCI edits, there will need to be edits for BOP inmates’ register numbers, names, location, and any other necessary demographic information. The BOP will provide an extract (sequential file format) as frequently as is required of our current inmate population to enable these edits to be correctly implemented.

62. Even though the fee schedules will be different for each provider, can we expect that the information will be provided to us in the same format?

RESPONSE: For Medicare-based contracts, the applicable CMS schedules will be identified and the contractor will be responsible for incorporating those applicable CMS schedules into their database. Fee schedules for non-Medicare based contracts will be provided in the format received from the provider. As such, non-Medicare based fee schedules may vary in format.

63. Can the BOP provide copies of the following policies: DOJ Order 2640.2E, BOP PS 1237.11; BOP PS 1237.12; BOP IS, P1237.13; BOP Human Resource Management Manual 3000.02D?

RESPONSE: A copy of DOJ Order 2640.2E and Program Statement P1237.13 are attached to this Amendment. BOP PS 1237.11 was superceded by BOP PS 1237.12. To obtain a copy or view BOP PS 1237.12 and BOP Human Resource Management

Manual 3000.02D, go to www.bop.gov, click on Policy/Form at top of page, then click on Find a Policy and browse the 1000 and 3000 series to find the appropriate program statement or manual.

64. Please provide two years of historical data - by facility - on the average monthly number of provider claims related to care for inmates in the Bureau of Prisons (BOP) facilities.

RESPONSE: The BOP has no way to track this information. The Statement of Work and Pricing Schedule are being revised and will be posted via a future Amendment to

RFQ100-0006-07.

65. Section A.15 Business Management Questionnaire of the Solicitation requires bidders to complete and submit the Federal Bureau of Prisons Service Contract Business Management Questionnaire, which is supposed to be included in Section J of the Solicitation. However the Solicitation contains no Section J. Do bidders for RFQ 100- 0006-07 need to complete this form? If so, please provide a copy of the Federal Bureau of Prisons Service Contract Business Management Questionnaire.

RESPONSE: The Business Management Questionnaire is included as an attachment to this Amendment. The purpose of the Business Management Questionnaire is to assist in determining contractor responsibility.

66. The Background section of the RFQ states that most providers have electronic billing capability. Will health care providers submit EDI claims, or will the submitted claims be received both in paper and electronic form?

RESPONSE: Although the industry will eventually migrate to 100% electronic invoicing, the BOP cannot provide an estimate of the percentage of claims which will be submitted electronically as each contract it has with a service provider will have to be modified to include this requirement. Accordingly, the BOP anticipates the contractor will receive both electronic and paper claims for the foreseeable future.

67. Please provide the following information regarding the technical and interoperability requirements

a. The RFQ is silent on the financial responsibility of the purchase/lease of server hardware and software and maintenance agreements. Please confirm that the BOP is financially responsible for the purchase/lease of server hardware and software and maintenance agreements.

RESPONSE: If the Contractor’s solution requires the BOP to purchase server hardware, http://www.bop.gov software and maintenance agreements, then it will do so. The BOP will factor the costs to the agency of acquiring these products and services into the overall cost of the Contractor’s solution.

b. Does the BOP plan to host the server hardware within the BOP’s data center?

RESPONSE: If the Contractor’s solution requires the BOP to purchase server hardware and software, then the BOP will house it in our data center in Washington, DC.

c. If the servers are hosted by the Contractor (or subcontractor), please confirm that the BOP is responsible for providing the network connectivity and hardware between the data center and the BOP network (e.g., JUTNET)?

RESPONSE: If the servers are hosted by the Contractor, then the BOP will provide network connectivity to its site. The Contractor will be responsible for maintaining the servers supporting the BOP in a data center that meets the requirements of the Department of Justice Information Technology Security Standard Physical and Environmental Protection Control Family and the Bureau Information Security Program Statement 1237.013 (copy attached).

d. The RFQ is silent on the ongoing monitoring/support/maintenance of the server hardware. Please confirm that the BOP is responsible for the ongoing monitoring/support/maintenance of the server hardware and software?

RESPONSE: If the Contractor’s solution requires the BOP to purchase and maintain server hardware and software at its own site, then the BOP will be responsible for the ongoing monitoring, support and maintenance of that equipment and software.

The BOP will factor the costs to the agency of maintaining these products and services into the overall cost of the Contractor’s solution.

68. As stated in Section 11.J. of the Statement of Work, “The Contractor must be able to support any and all hardware and software installation that is necessary for the Bureau to connect to and use the new system.”

a. Does this refer to any potential new hardware and software that is required at the individual BOP facilities, or only at the server hosting facility?

RESPONSE: This refers only to hardware and software at the server hosting facility.

b. Please confirm that the contractor will only be responsible for supporting the installation of the new hardware and software, while the ongoing maintenance and support of the hardware and software is the BOP’s responsibility.

RESPONSE: The BOP can and will support the hardware and software on an ongoing basis.

The cost to do so will be factored into the Contractor’s proposal cost.

69. In relation to Section 8, Billing of Adjudication Services, the RFQ requires the contractor to bill each BOP institution separately for adjudication services rendered, based on the actual number of claims processed by the contractor for each institution. This adds significant processing costs to the BOP’s contract. Is the BOP willing to consider the much more cost- and time-effective alternative of a single unified bill - with detail provided down to the facility level - sent to the Bureau’s central office?

RESPONSE: The BOP has a de-centralized accounting system, therefore the contractor must bill each institution separately.