Loren Data's SAM Daily™

FBO DAILY ISSUE OF FEBRUARY 01, 2004 FBO #0796
SOLICITATION NOTICE

B -- HOSPITAL OUTPATIENT PROSPECTIVE PAYMENT SYSTEM

Notice Date

1/30/2004
 

Notice Type

Solicitation Notice
 

Contracting Office

Department of Health and Human Services, Centers for Medicare & Medicaid Services, formerly known as the Health Care Financing Administration, Acquisition and Grants Group, 7500 Security Blvd. C2-21-15, Central Building, Baltimore, MD, 21244-1850
 

ZIP Code

21244-1850
 

Solicitation Number

Reference-Number-767-4-141502
 

Response Due

2/17/2004
 

Archive Date

3/3/2004
 

Point of Contact

Lucille Lee, Contract Specialist, Phone 410-786-5447, Fax 410-786-9643, - Lucille Lee, Contract Specialist, Phone 410-786-5447, Fax 410-786-9643,
 

E-Mail Address

LLee4@cms.hhs.gov, LLee4@cms.hhs.gov
 

Description

The Centers for Medicare and Medicaid Services (CMS) intends to award on a sole source basis, under the Simplified Acquisition Procedures, a firm fixed price award to Newton Associates, 21 Old Granary Court, Catonsville, Maryland 21228. The purpose of this contract is two-fold: (1) to procure expert services to assist CMS staff in planning, prioritizing, and conducting all data analyses relevant to developing proposed and final rules for the OPPS for 2005; and, (2) to procure expert services to prepare CMS staff to assume full responsibility beginning with the 2006 OPPS update for every aspect of planning, prioritizing, and conducting the data analyses necessary for the annual OPPS updates, and to transition management of the OPPS data programs and standard analytic data files to permanent CMS staff. The contractor would perform the following tasks for the 2005 OPPS update and provide advice and guidance in transitioning these tasks to CMS staff for future updates: 1. Assist in coordinating all activities related to incorporating new policy decisions into rate calculations and impact analyses. 2. Provide quality assurance and oversight of all activities related to analyses needed for publication of the OPPS proposed and final rules for 2005, including construction of addenda and public use files. 3. Provide advice and assistance in coordinating individual and group tasks needed to generate work products. 4. Develop specifications and data requirements to construct a standard analytical file for annual update of OPPS and policy analysis. 5. Develop the approach and processes needed to evaluate data obtained from secondary sources to evaluate the clinical integrity of specific payment groups and relative payment weights. 6. Provide advice related to methods for renovating current programming to maximize efficient and accurate data processing. 7. Evaluate and assess reasonableness of final results within the context of discretionary and statutory policies and requirements. 8. Assist in developing processes to ensure thorough documentation of analytical files and related policy decisions that underlie the proposed and final OPPS rules. The hospital outpatient prospective payment system (OPPS) is new and complex. It has been made even more complex by legislative changes enacted in 2003 that will affect the 2005 update. Updating the OPPS for 2005 in accordance with statutory mandates and policy refinements implemented in the 2004 update requires the assistance of a contractor with extensive knowledge and experience in performing Medicare systems analyses combined with a thorough familiarity with the data and rate setting models that were the basis of prior OPPS updates. To ensure that accurate data are captured for the OPPS update requires expert knowledge of the claims processing format and system as well policy determinations made for the 2004 update related to the use of external data and special provisions implemented in 2003 related to payments for drugs, biologicals, and devices that will affect construction of the data set for the 2005 update. Marilyn Newton (registered as ?Newton Associates?) possesses the experience, knowledge, and expertise that are required for this project. She has over 30 years of experience with Medicare payment systems that she acquired as a CMS employee. For 26 of these years, she performed research, systems analyses, and data development for various payment systems including the Medicare inpatient prospective payment system and the physician fee schedule. During a substantial number of those years, she planned, prioritized, and directed the work of a large staff responsible for completing such tasks. As a result of this work, Ms. Newton has acquired in-depth knowledge of Medicare data reporting requirements and claims processing. She has vast knowledge and experience with the various systems through which Medicare bills are processed and the types of edits applied to each system. She has expert knowledge of the Claims Expansion/Line Items Processing (CELIP), which hospitals are required to use to bill for outpatient services paid under the OPPS, and the software that is used to edit and pay these claims. She has considerable experience with and knowledge of the Healthcare Common Procedure Coding System (HCPCS) that is required for OPPS billing and used to construct the OPPS analytical data files. In 1999, Ms. Newton assisted in completing the system analyses and data modeling that resulted in the successful implementation of the new OPPS on August 1, 2000. Ms. Newton has provided invaluable support in modifying the OPPS analytical files to incorporate new policy decisions and requirements for the 2001, 2002, 2003, and 2004 OPPS updates. Ms. Newton?s extensive experience in working with the OPPS analytical files and programs coupled with her extensive past experience as a leader in resolving policy issues, constructing appropriate data files, and coordinating the programming needed for the OPPS updates for 2001 through 2004, amplify her importance in successfully updating the OPPS for 2005. Her expert services are essential to assist a team of policy analysts in identifying the data elements, files, and programming that require modification; to analyze and resolve policy issues related to such modifications; to coordinate the programming that incorporates policy changes; to calculate payment rates and relative weights; to develop impact analyses; to construct all addenda and related public use files for the 2005 proposed and final rules; to renovate programs for maximum efficiency in data processing; and to implement appropriate data file documentation. In addition, CMS is assuming fuller responsibility beginning with the 2005 OPPS update for every aspect of planning and conducting the data analyses necessary for the annual OPPS updates. Because Ms. Newton was primarily responsible for these tasks for the 2001-2004 OPPS updates, her services are essential to continue the transition of coordination of the OPPS data programs and standard analytic data files to permanent CMS staff. All responsible sources may submit capability statements in consideration to the Agency at the above address.
 

Place of Performance

Address: 7500 Security Blvd., Baltimore, MD

Zip Code: 21244

Country: USA
 

Record

SN00512986-W 20040201/040130212041 (fbodaily.com)
 

Source

FedBizOpps.gov Link to This Notice
(may not be valid after Archive Date)

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