SOLICITATION NOTICE
D -- e-IV Clearinghouse to Support EligibilityTransactions Health Care Electronic DataInterchange (EDI)
- Notice Date
- 9/4/2008
- Notice Type
- Combined Synopsis/Solicitation
- NAICS
- 518210
— Data Processing, Hosting, and Related Services
- Contracting Office
- Department of Veterans Affairs, VA Acquisition Operations Service, Department of Veterans Affairs Acquisition Operations Service, Department of Veterans Affairs;VA Central Office;Cntr. for Acquisition Innovation (049A3);810 Vermont Avenue, NW;Washington DC 20420
- ZIP Code
- 20420
- Solicitation Number
- VA-101-08-RQ-0278
- Response Due
- 9/19/2008
- Archive Date
- 11/18/2008
- Point of Contact
- SHAUNDRA J. DUGGANSCONTRACT SPECIALIST<br />
- Small Business Set-Aside
- N/A
- Description
- 1. Title: e-IV Clearinghouse to Support Eligibility Transactions Health Care Electronic Data Interchange (EDI)2. Solicitation Reference Number: VA-101-08-RQ-0278 3. Description: This is a combined synopsis/solicitation for commercial items prepared in accordance with the format in Subpart 12.6, as supplemented with additional information included in this notice. This announcement constitutes the only solicitation; quotations are being requested and a written solicitation will not be issued. Responses reflecting availability of the service as described are requested in the form of a written technical and price quotation. This solicitation is being issued as a request for quotation (RFQ). The NAICS code is 518210 (Data Processing, Hosting, and Related Services) with a small business size standard $23.0M. All responsible sources may submit a quotation that, if timely received, shall be considered by the agency. Questions in response to this solicitation are due September 10, 2008 NLT 4:00 PM EST. The due date for quotations is September 19, 2008 at 4:00 PM EST. Quotations shall be submitted electronically via email to Shaundra J. Duggans at shaundra.duggans@va.gov. The solicitation title and reference number shall be included in the subject line of ALL correspondence. 4. Statement of Work: (As a result of character limitations, only an excerpt of the Statement of Work (SOW) has been provided. Interested Offerors shall contact both Shaundra J. Duggans via email for copies of the SOW, Security Background Investigation Information, Business Associate Agreement, and Price Schedule. Telephone requests will NOT be accepted.) A. GENERAL OBJECTIVES AND REQUIREMENTS: Scope of Work: The Contractor shall support the HIPAA 270/271 transactions in both real-time and batch modes. All incoming and outgoing transactions enter and exit from VA Corporate Franchise Data Center (CFD) in Austin, Texas utilizing point-to-point Virtual Private (VPN) connection and meet all HIPAA compliance requirements and industry standards. VA health care inquiries are transmitted internally, in batch mode, from individual VA medical centers to CFD, where CFD translates into HIPAA 270 transactions for external VA transmission to the Contractor. The HCCH shall receive the 270 transactions from VA, transmit and ensure receipt of the data as required by the information source/payer or their authorized agent/clearinghouse (Payer). Additionally, the HCCH shall transmit the 271 transaction received from the Payer, or if necessary, translate the electronic data into the standard HIPAA 271 format and ensure delivery to VA. Performance Period: The period of performance (POP) shall be from date of award for a period of 12 months, hereto referred to as the base period. This task order also includes four 12-month option periods, which may be unilaterally exercised by the Government. All terms and conditions applicable to the base year shall extend to the option period unless otherwise agreed upon. Type of Contract: The pursuant award shall be a Firm Fixed Price Indefinite-Delivery Indefinite-Quantity (IDIQ). The contract minimum shall be $5,000.00 per year and the contract maximum shall be $125,000.00 per year. Place of Performance: The Contractor shall support this effort either at the Department of Veterans Affairs, 1722 I Street, NW Washington, DC 20006, or at approved Contractor facilities as directed by the COTR and mutually agreed to by the Contractor. If the work is performed at Department of Veterans Affairs' locations, the COTR will provide adequate on-site workspace and ADP equipment for Contractor personnel. B. GENERAL REQUIREMENTS 1. The HCCH must be a fully "Accredited Healthcare Network" by the Electronic Healthcare Network Accreditation Commission (EHNAC) at the time of proposal submission and maintain accreditation for the duration of the contract. 2. The HCCH must be certified by the Council for Affordable and Quality Healthcare (CAQH), as a CORE Phase I Certified Clearinghouse for both batch and real-time eligibility benefits (HIPAA 270/271) at the time of award and maintain certification for the duration of the contract. The HCCH must work towards future CORE Phase II and any other future phase certifications within a mutually specified timeframe. 3. The HCCH must adhere to VA security and data requirements as outlined in Section M. General Security Requirements. 4. The HCCH must develop and provide a detailed implementation plan to include a phase-in process for VHA entities within 30 days of award. 5. The HCCH must provide VHA technical points of contact, as well as back-ups, for the coordination of activities associated with the development and implementation phase. 6. The HCCH must provide transaction transmission service levels to be mutually agreed upon which will include at a minimum: data transmission, timeliness, accuracy and system availability metrics. C. SPECIFIC MANDATORY TASKS AND ASSOCIATED DELIVERABLES Description of Tasks and Associated Deliverables: The contractor shall perform the mandatory tasks and provide the specific deliverables described below within the performance period stated in Section A.4 of this Statement of Work (SOW). In order to assist VHA provider in increasing the value and use of e-IV, the e-IV Clearinghouse shall complete the following tasks: Task 1: Expand VA's electronic reach to new payers through the extraction, transformation and loading of data. The Contractor shall provide, in one month or less, electronic data exchange access to new payers, including at a minimum the following top payers: BCBS MD, DC & VA - CareFirst, BCBS NC, BCBS NY - Excellus, BCBS TN (Batch), Connecticare, Kitsap Physicians Service, Pacific Source, and Unicare. Deliverable 1: The contractor will deliver a report for all listed payers identifying that access is established and the date exchange access was established. This report shall be delivered to the COTR one month after contract award. Task 2: Supply and maintain a master payer list and provide access to payers. Task 2.1: The Contractor shall provide an electronic transmission vehicle to ensure the delivery of HIPAA 270 inquiries from the Contractor's site to each responsible Payer or their contracted representative, as prioritized by VA for initial implementation. The Contractor shall initiate a dialog with each responsible Payer to establish an understanding of the requirements associated with relaying VA inquiries to and from Payers. Task 2.2: The Contractor shall maintain an accurate master list of payers with their associated identification numbers available to VA through either direct connections or through other clearinghouses. The Contractor shall assist in establishment of a mechanism to keep VA's Payer list synchronized with the Contractor's list. The Contractor shall maintain the accuracy of its lists and update the Contractor's payer dictionary, website, companion guide, and any other form used for communication about requirements/specifications within 5 days of receiving a change from a payer. Deliverable 2: The contractor shall create and maintain a master payer list that includes at a minimum the payer ID, payer name, connection method and any other information relevant to the payer for VA's access. The list shall reflect all updates given to the Contractor by the payer. Task 3: Provide Real-Time data exchange services. Task 3.1: The Contractor shall respond to each HIPAA 270 real-time inquiry in less than one minute. The response to the HIPAA 270 shall be either a HIPAA 271 or an acknowledgement from the Payer. The acknowledgement shall be either a TA1 (ISA/IEA interchange rejection) or a 997 (functional group or transaction set rejection). Task 3.2: The Contractor shall develop a mutually agreed upon resubmission policy with VA. In cases where the Payer does not send a timely HIPAA 271 response or times out, the Contractor shall invoke the resubmission methodology. Deliverable 3a: The contractor shall provide a log of all real time inquiries that the contractor has responded to and list what the issue was and what the final resolution was. Deliverable 3b: The contractor, in conjunction with the COTR, shall develop a resubmission policy. The policy shall not be considered accepted until approved by the COTR. Task 4: Provide Batch Mode data exchange services. Task 4.1: The Contractor shall work with the existing eIV solution (currently operates in an asynchronous real-time mode) and provide batch functionality with minimal enhancements to the VA system. Task 4.2: The Contractor shall respond to batch transactions by the following business day when received by a predetermined cut off time. The Contractor shall return an acknowledgement/response from the Payer: a TA1 (ISA/IEA interchange rejection); a 997 (to indicate either acceptance or rejection of a Functional Group including the enclosed Transaction Set); or a HIPAA 271. Deliverable 4: The contractor shall deliver a report of all responses that have been submitted to the payer. This report shall be delivered in real time to the COTR. Task 5: The Contractor shall provide enrollment support. The Contractor shall publish enrollment requirements for all payers it has access to as well as facilitate and coordinate enrollment with payers. This shall include, at a minimum, completion of appropriate authorization forms and letters as required by Payer specific guidelines. Deliverable 5: The contractor shall create an enrollment requirements guide for all payers to assist with the payer's enrollment. Task 6: The Contractor shall participate in testing and supplying edit messages. The Contractor shall partner with VA to test capability to ensure that the HIPAA 270/271 transactions are processed in accordance with the terms and conditions of this Statement of Work. The Contractor shall have the ability to test inquiries for completeness and create a set of edit conditions with corresponding edit messages to be returned with rejected inquiries in compliance with HIPAA and VA requirements. Deliverable 6: Contractor shall develop a list of edit messages that will be returned to the payers. Task 7: The Contractor shall coordinate system changes with VHA. To achieve this end, the Contractor shall: a. Coordinate with VA for delivery of system documentation, b. Provide documentation on proposed system and/or process changes prior to implementation, c. Modify the processes for any VA-specific anomalies related to implementation for a payer, d. Add transaction sets as deemed appropriate by the VA, including at a minimum, the creation of a unique PAYERID for health care payers that shall eventually be converted to the national PAYERID. Deliverable 7a: Technical support to execute implementation (as described above). Deliverable 7b: The Contractor shall create an implementation guide which identifies the steps payers will be required to go through to be fully implemented. Task 8: The Contractor shall provide operational and customer support. Task 8.1: The Contractor shall provide, at a minimum, the following operational and customer support: a. Dedicated staff contact that shall provide technical support for day-to-day operational activities, b. Technical support during normal business hours covering Eastern, Central, Mountain and Pacific Time Zones, c. Monitoring of inbound and outbound data exchanges to identify exceptions in timing and content, d. Maintenance of ongoing Payer connections as necessary to support data exchange, e. Hardware and software maintenance as necessary to support ongoing delivery of consistent services with minimal interruption, f. Backups as necessary to support recovery for failed equipment and/or problem research; g. A secure environment that prevents access from unauthorized physical or electronic sources, h. Reformatting, routing and other data transaction management processes as may be necessary to help ensure proper application of data, i. Maintenance of production environment where all internal processes occur, j. Monitor Payer communications and industry developments to determine changes that are applicable to the scope of services, k. On line problem and transaction submission/response tracking system, and l. Published information on enhancement releases and systems changes. Task 8.2: The Contractor shall establish a schedule that allows unattended operations for the transmission and receipt of the data/transactions. The Contractor shall obtain VA approval of the operations schedule and any subsequent changes to the schedule. Additionally, the Contractor shall provide VA technical points of contact (POC) for coordination activities associated with the development and implementation phase. These contacts shall be provided to VA at no additional charge since those services shall be required to assure smooth implementation. Deliverable 8a: Operational and Customer support (as described above). Deliverable 8b: Contractor shall provide a listing of all POCs to the CBO on a monthly basis. Deliverable 8c: The contractor shall create a tracking list of customer service inquiries that the contractor has resolved. The list shall include all issues and resolutions. Task 9: Archive, Retrieve and Manage transactional documents. The Contractor shall: a. Capture and archive transactional documents as necessary to support document collation and routing, b. Submit transactions by or for VA to Payers or other transaction switch organizations via electronic means with appropriate editing and tracking controls to help assure data integrity, c. Demand retrieval of documents from archives, and d. Archive all correspondences between VA and the Contractor in a support database. Deliverable 9: Contractor shall create a listing of all archived documents. List shall be provided to COTR on a monthly basis. Task 10: As a part of the indefinite delivery, indefinite quantity (IDIQ) portion of this contract, the contractor may be asked to perform additional tasks related to healthcare EDI and its associated emerging technologies as they pertain to eligibility. The price of each task shall be negotiated on a Firm Fixed Price basis. These tasks may include the following: a. Incorporation of new mandated standards, e.g., the Contractor shall assist VA with conversion from legacy IDs NPIs; b. Assisting in the conversion of non-electronic payers to electronic payment; and c. Other issues and technologies impacting eligibility. 5. Instructions: I. SPECIAL NOTICE TO QUOTERS: (1) Failure to submit any of the information requested by this solicitation may be cause for unfavorable consideration or rejection of the proposal, and therefore not considered in the competition. (2) Proposal Disposition. Upon receipt, all proposals become Government property. In accordance with FAR Subpart 4.8 (Government Contract Files), the Government will retain one copy of all unsuccessful proposals. Unless the offeror requests otherwise, the Government will destroy extra copies of such unsuccessful proposals.(3) Discrepancies. If an offeror believes that the requirements of these instructions contain an error, omission, or are otherwise unsound, the offeror shall immediately notify the Contracting Officer in writing with supporting rationale. The offerors are reminded that the Government reserves the right to award a contract based on the initial proposal, as received without discussion. (4) Confidential Information: The Freedom of Information Act (FOIA) and its amendments have resulted in an increasing number of requests from outside the Government for copies of contract qualifications and proposals submitted to federal agencies. If an Offeror's submissions contain information that he/she believes should be withheld from such requestors under FOIA on the grounds that they contain "trade secrets and commercial or financial information" [5 USC552(b)(4)], the offeror should mark its submissions in the following manner: The following notice should be placed on the title page: "Some parts of this document, as identified on individual pages, are considered by the submitter to be privileged or confidential trade secrets or commercial or financial information not subject to mandatory disclosure under the Freedom of Information Act. Material considered privileged or confidential on such grounds is contained on page(s) _______." Each individual item considered privileged or confidential under FOIA should be marked with the following notice: "The data or information is considered confidential or privileged, and is not subject to mandatory disclosure under the Freedom of Information Act." II. INSTRUCTIONS FOR PREPARING QUOTATIONS: Quoters are cautioned to follow the detailed instructions fully and carefully. The Quotation shall consist of the following information which is divided into two parts: Technical Quotation and Price Quotation. The Quoter shall submit the Quotation electronically with the two parts clearly labeled. In addition, the Offeror shall complete and submit Section L. Key Personnel of the SOW including the names and titles of the Key Personnel proposed, and include a brief introduction of their company in a cover letter. The introduction may include a discussion of corporate background and facilities, office locations, general experience and capabilities, number of employees, etc. A. TECHNICAL QUOTATION (Volume 1) Quotations shall clearly and completely address the appropriate technical elements described below in a format that follows the SOW tasks and/or deliverables. Responses to these elements will form the basis for scoring the technical merits of each proposal. Information presented in the technical volume should clearly demonstrate that the Quoter is fully capable and prepared to perform the tasks described in the SOW as well as demonstrate the Quoter's understanding of the requirements and associated problems. A technical quotation will be considered unsatisfactory if inadequate or insufficient information is submitted, excluding it from further consideration. The Quoter must define a performance based management and technical approach that satisfies the requirements defined in this document. Technical quotations shall address the following four general areas: 1. Technical Approach: The proposal will be evaluated based on a credible, comprehensive, and adequate plan that demonstrates complete compliance with HIPAA mandated regulations and task requirements. a. Proposal meets General Requirements listed in Section B. General Requirements of the SOW; b. Proposal demonstrates appropriate methodologies, project planning and ability to complete Tasks in Section C. Specific Mandatory Tasks and Associated Deliverables of the SOW; c. Proposal indicates the Quoter's plan to continue VHAs progress in implementing EDI as noted in Task 10 of Section C. Specific Mandatory Tasks and Associated Deliverables of the SOW; d. Proposal indicates ability to meet transmission requirements listed in Section D. Transmission Requirements of the SOW; e. Proposal indicates ability to meet reports requirements identified in Section K. Reporting of the SOW. (Sub-factors are of equal importance) 2. Staffing: Qualifications of professionals and technical experts are adequate. Points will be earned for specialized experience in healthcare EDI, and health care laws and regulations. Points will also be earned for the labor categories of proposed staff (i.e., manager, subject matter expert, technical writer) and whether appropriate and sufficient categories are proposed. a. Project Manager is qualified and available during normal business hours (8:00 AM - 5:30 PM). b. Professional experience of staff proposed, indicating technically qualified staff to perform the work required. (Sub-factors are of equal importance). 3. Past Performance: Quoter shall provide proof of a satisfactory record of performance, integrity and business ethics. Quoter shall also provide 3 client references for contracts of similar size, scope, and complexity to this effort, under which work has been performed as the Prime Contractor within the last three years. The CO may contact the references for verification. If a Quoter has no experience, the experience is ambiguous, or the Government cannot reach the reference, the Quoter will be awarded 0 points. a. Contract implementation and deliverable schedules were met. b. Contract required performance levels were met. c. Promptly responds to service inquiries. d. Positively and promptly responds to technical directions, contract change orders, problem solving. (Sub-factors are of equal importance).The Government may also consider information obtained through other sources. Past performance information will be utilized to determine the quality of the contractor's past performance as it relates to the probability of success of the required effort. 4. Socio-Economic Status/Usage a. Quoter is a veteran-owned small business (VOSB) or service-disabled veteran owned small business (SDVOSB). Quoter must be registered in VetBiz.gov Vendor Information Pages. b. Quoter proposes to use a VOSB or SDVOSB as a subcontractor for portion of the contract. Offeror must state the name of the VOSB or SVOSB, describe the proposed subcontracts and include approximate dollar values. VOSB or SVOSB must be registered in VetBiz.gov Vendor Information Pages. Quoter provides subcontracting plan to include Individual Subcontracting Report (ISR) 294 and Summary Subcontracting Report (SSR) 294 or hard copy printouts from the Electronic Subcontracting Reporting System (eSRS) for the last 3 years for contracts provided as past performance references. Subcontracting plan meets requirements in FAR. Extent of small, small disadvantaged, HUBZone, women-owned, VOSB and SDVOSB in terms of total acquisition. Complexity and variety of the work small firms are to perform. Past performance in subcontracting with small business. Extent Quoter identifies likelihood of meeting VA's socioeconomic goals. Sub-factor a will receive all points allocated to this factor and sub-factor b will receive half the points allocated to this factor. Note: All Offerors that do not qualify as small businesses shall submit a subcontracting plan, as required by FAR 19.702(a)(1) and described by FAR 19.704. The plan should include overall subcontracting goals for the project. That plan, once approved, will be made a part of any contract resulting from this solicitation. The Offeror(s) shall describe the means they intend to use to enhance overall small business participation in all categories. B. PRICE QUOTATION (Volume 2) The price quotation shall be a separate volume from the technical quotation. The price quotation shall be submitted as a Firm Fixed Price quotation in accordance with the CLIN structure identified in Attachment 3. Price Schedule. III. EVALUATION: Each Quoter's submission shall be evaluated according to the following factors listed in descending order of importance: Technical Approach, Past Performance, Staffing, Socio-economic status/usage, and Price. The Contracting Officer will evaluate price. The factors other than Price, when combined, are more important than Price. IV. CONTRACT AWARD: Contract award shall be made to the responsible Quoter whose offer, in conforming to this RFQ, is most advantageous to the Government, price and other factors considered. 6. Point(s) of Contact: Primary - Shaundra J. Duggans, Contract Specialist, phone: 202-461-6808, fax: 202-273-7448, E-mail: shaundra.duggans@va.gov.
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