Med Referral Industry Day QA.pdf

GOVERNMENTIS RESPONSEiOEEEROR*SailBTIOMS'AGEAISID PARAGI^RH

The government's intent is to pay Medicare rates plus an administrative services percentage for all successfully completed network services, as described in Section 5.20 and Exhibit H

Is the intent for the government to limit pricing not to exceed Medicare rates, or is the government using

Medicare as an index and allowing the vendor to add a percentage above the Medicare RVUs?Page 60, Sections.20.1

The values are estimated quantities of that type of service required at that location in a year. These values are based on historical MEPCOM requirements

What do the values within the spreadsheet denote?

If these are estimated service volumes, what is the timeframe used to make the estimates?Exhibit G, Table 1

Yes, if a cell is green with no value, the contractor is still expected to have network providers available and will be measured accordingly in the related PRS.

As currently drafted, the only services that are required at ail locations regardless of projected volume (green with no projected quantity) are

Ancillary, Opthal/Opto, and Psychiatry/Psychology

When the cel! within the spreadsheet is green but no value is present, does this mean there is no estimated volume but an in-network consultant is

Exhibit G, Table 1 still required?

Within the spreadsheet there are instances where the columns in row 5 appear to be duplicative (i.e.

cells H5 and 15; J5 and K5; M5 and N5; U5, V5 and

W5). What is the difference between these when those headers are the same or similar?

This was an administrative error, the duplicative columns will be removed in the final solicitationExhibit G, Table 1

Performance Objective 1 will be applied to all completed network appointments; in-line with

Exhibit G, Table 1

Will Performance Objective 1 be measured according to the specialty consultant requirements by MEPS as shown in Exhibit G, Table 1?Page 80, Exhibit L

The government states that 'The DoD only recognizes certifications issued by boards that are members of the American Board of Medical Specialties (ABMS) or the AOA Bureau of Osteopathic Specialists'. Is board certification a requirement for physicians?

The government is considering alternate language for this requirement that may reduce the requirement in some instances. See the final solicitation for any potential changes.Exhibit B

Can the Government provide clarification for the statement '[Qualification for APN requirement under

Ancillary Market Segment]' as listed under the Nurse

Practitioner (Advanced Practice Nurse) header?

This was an administrative error, this statement will be removed in the final solicitationExhibit B

How does the Government plan to update Exhibit G, Table 1 overtime? See 5.4.7.1; with 120 days noticeExhibit G, Table 1

At this time, the government's experience is that behavioral health appointments are most suitable for telehealth, but the government will consider proposed telehealth solutions for any order where the contractor can justify that telehealth is appropriate to satisfy the requirements of the order

Please provide guidance on specialties allowed to conduct appointments via teieheaith.PWS Section 5.1.2

Yes. Non-Network Services Order Results (5.23.3.5) incorporates 5.18, which incorporates 5.22.1 and the requirement for typed reports

Wil l Section 5.22.1 (The Contractor's SCNs shall provide typed reports rendering medical diagnosis..)

apply to Non-Network Referral Services/Providers?PWS Section 5.23

Will the Government allow for exceptions to be granted in meeting scheduling and appointment execution timelines given industry data that shows many specialties are unable to satisfy these requirements?

PRS Objectives #5-7 will apply to ail orders, as appropriate. No specific exceptions are granted, but the Objectives are not 100%PWS Section 5.5.3

The government requires all Nurse Practitioners to be certified. The government requires the Nurse

Practitioner to have an active RN or Nurse

Practitioner license as required by the state where services are performed.

Does the Government require only a Registered

Nurse (RN) license for Nurse Practitioners and not the Nurse Practitioner license in states where services are performed, except in states that do not license Nurse Practitioner?Exhibit B

What are the expectations for the Government to provide accurate applicant availability at the time of request?

The government will provide any known applicant availability limitations at the time the order is placedPage 57, 5.7

In order to decrease turnaround time for approvals to take place from the Government to the vendor for non-network provider costs will the Government provide a threshold cost for non-network provider consultation costs?

The government is considering limits for non-network provider consultation costs. See the final solicitation for any potential changes^PWS 5.23.3.1

This was an administrative error. The "Exhibit I" mention in Exhibit J reference should have been updated to Exhibit J to match the PWS 5.23.4 reference. This will be corrected in the final solicitation. There is no Exhibit I.

In Exhibit J it references a non-network services administrative fee in Exhibit I. Will the Government be able to supply Exhibit I or provide a threshold for non-network administrative cost?PWS 5.23.4

This procedure will be refined with the contractor post-award. The government intends to timely approve exceptions and/or provide the contractor advance notice when the order is placed if the applicant can accept an appointment within 30 miles of the applicant's current address lAW 5.6.3.1.

What is the estimated response time of the

Government for approval of exceptions?Page 57,5.6.3.1

As currently drafted for Industry Day, all reschedules as a result of government cancellation would be subject to the Secondary Scheduling timelines, as stated in Para 5.9.2.1.

Does the Government anticipate that any rescheduling will be needed after the appointment has been accepted/confirmed by the MEPS? If Yes, If the request to reschedule is made beyond 48 hours of the initial confirmation? For example, if a request to reschedule was made on day 12 of 15, how will the appointment timeline be measured?

Para 5.9.2.1 is under consideration for rewording to state that rescheduled appointments due to government cancellations wil l restart back to the primary scheduling timeline requirements, which would address this concern. Review the final solicitation for any potential changes.Page 58, 5.7.1.2

Projected no-show quantities will be added to Exhibit

G of the final solicitation.

How frequently should the contractor expect no-shows?Page 59,5.10.1

The context of this question isn't fully understood.

MEPS do not get to choose "preferred providers" and there is no mention of that in the PWS. As stated in

5.6.1, the government will provide preferences for scheduling dates/times to maximize the likelihood the applicant can attend an offered appointment. It is the contractor's responsibility to provide network services within the distance parameters identified in

Para 5.6.3 and 5.6.3.1 to satsify the requirements of the order.

What is the role of the MEPS in selecting preferred providers that may be outside of radius?Page 57,5.6

If the contractor is meeting Performance Objectives

#5, #6, and #8 then this option likely wil l not need to be pursued often. The health of military recruiting may also dictate how often the government must exercise this option to expedite applicant processing when network services aren't provided in the timelines required^

How frequently does the Government expect to exercise the option to simultaneously pursue non network appointments?Page 63,5.23.1.1

The government has provided some relief from all of the requirements of network providers, as stated in

Para 5.23. It is the intent of the government to incentivize the contractor to have network services that meet the Performance Objectives to reduce the need for non-network services to the maximum

Can the Government explain the rationale for the non-network provider request? If the Government does not relieve the contractor of the practitioner, credentialing, training, appointing and documentation requirements, is it the intent of the government to create a financial disincentive for the contractor when non-network providers are utilized? extent practicable.Page 63, 5.23

The values are estimated quantities of that type of service required at that location in a year. These values are based on historical MEPCOM

Please confirm that the totals listed in Exhibit G, Table 1 - Required Specialty Consultant Types, Ancillary Services, and Laboratory Services by MEPS, are projected annual quantities? requirementsExhibit G Table 1

Is our understanding that we will provide a list of our network providers that will accept the

Medicare rates within the radius of each MEPS with

Review the final solicitation for proposal submission requirements. It is not the intent of the government to receive a detailed list of every individual provider the contractor intends to network with. The contractor's network may change throughout the life of the contract.

our proposal submission. Please confirm that this will establish our "network" and that all other providers utilized will be considered "non network."

Draft Exhibits H and J were provided in the Industry

Day postingCan you please provide the documents?Draft PWS references Exhibits H and J