SPECIAL NOTICE
R -- Selection of Hospital Outpatient Measures and Development of Specifications
- Notice Date
- 9/15/2009
- Notice Type
- Special Notice
- NAICS
- 541690
— Other Scientific and Technical Consulting Services
- Contracting Office
- Department of Health and Human Services, Centers for Medicare & Medicaid Services, Office of Acquisition and Grants Management, 7500 Security Blvd., C2-21-15, Baltimore, Maryland, 21244-1850
- ZIP Code
- 21244-1850
- Solicitation Number
- SN-CMS-2009-POK359-91536
- Point of Contact
- Christina F Heller, Phone: 410-786-1896
- E-Mail Address
-
christina.heller@cms.hhs.gov
(christina.heller@cms.hhs.gov)
- Small Business Set-Aside
- N/A
- Description
- SPECIAL NOTICE Date: September 15, 2009 Synopsis: The Centers for Medicare and Medicaid Services intends to modify and existing sole source contract entitled "Selection of Hospital Outpatient Measures and Development of Specifications" with the Oklahoma Foundation for Medical Quality (OFMQ) to "Support, Reevaluate and Restructure the Hospital Outpatient Quality Care Measures to accommodate version 5010 and the use of the ICD-10 code sets" by adding Task 4 and to extend the period of performance to September 30, 2010. This contract modification will be awarded to OFMQ as a follow-on effort lasting 12 additional months. The estimated value of this effort is $133,340. The Tax Relief and Health Care Act of 2006 (PL 109-432), enacted December 20, 2006, included Division B, Title I, Section 109, establishes an incentive arrangement to encourage hospital outpatient departments and ambulatory surgical centers to voluntarily report quality information. Effective for services provided in CY 2009, providers that do not provide quality data as established by the Secretary will have their annual payment update under their respective payment systems reduced by 2 percentage points. The statute requires the Secretary to develop the quality measures that hospitals will be required to submit in order to receive their updated payments for outpatient services they provide beginning in CY 2009. Prior to this initial contract, there were no set of measures that reflected care provided by hospital outpatient departments. The contractor was charged to develop 10 new outpatient measures by the end of July 2007. Since the statute created a very aggressive timeframe for development and implementation of hospital outpatient measures, it is in the best interest of the government to award a sole source contract modification to OFMQ to continue the work to maintain, support, and reevaluate the newly developed hospital outpatient measures for a minimum of 12 months. According to the initial contract regarding the selection of hospital outpatient measures and development of specifications, in order to meet the deadline established by the statute, hospitals need to report their data in early 2008 for purposes of determining payment eligibility for 2009. The development of measure specifications is the first step in implementing this provision of TRHCA. Other components within CMS were dependent on receiving the measure specifications in order to construct the Information Technology (IT) System needed to allow hospitals to submit their data to CMS. If the measure specifications were not delivered to CMS' Information Systems Group (ISG) in a timely matter (by July 31, 2007), ISG would not have been able to build the IT infrastructure in time to begin receiving data from hospitals' outpatient departments in January 2008. Based on a long standing agreement with the Joint Commission (TJC) with whom CMS works collaboratively on the collection and reporting of hospital quality data, 120 days after the delivery of measure specifications is needed to develop and produce the software and data warehouse to collect and report data from hospitals. The length of time needed to complete the IT infrastructure once the measure specifications are provided by OFMQ is 6 months; 4 months for programming and testing the CART or CART-like data collection tool (or TJC vendor tools) and building the data warehouse to store the data and 2 months to educate or train the hospitals on the new CART or TJC vendor tools. Data collection on these measures began January 2008 and data submitted for the 1st quarter of 2008 was used to determine whether hospitals will receive their payment update on outpatient services they provided beginning January 2009. In addition, the U.S. Department of Health and Human Services (HHS) recently released two final rules that will facilitate the US ongoing transition to an electronic health care environment through adoption of a new generation of diagnosis and procedure codes and updated standards for electronic health care and pharmacy transactions. The first rule adopts two medical data code sets as Health Insurance Portability and Accountability Act of 1996 (HIPAA) standards for use in reporting diagnoses and inpatient hospital procedures in health care transactions (ICD-10 final rule). The standards adopted under this final rule will replace the ICD-9-CM code sets, developed nearly 30 years ago, with greatly expanded ICD-10 code sets. The second final rule adopts updated versions of the standards for certain electronic health care transactions, under the authority of HIPAA (5010/D.0 final rule). The updated versions replace the current versions of the standards and will promote greater use of electronic transactions. The final rule also adopts a standard for Medicaid pharmacy subrogation transactions, a process through which State Medicaid agencies recoup payments for pharmacy services in cases where a third party payer has primary financial responsibility. HHS' proposed rules, published on Aug. 22, 2008, proposed earlier compliance dates for the transition to the ICD-10 code set and the updated versions of the transactions standards, but a large majority of public comments stated that more time would be needed for effective industry implementation. The final rules accommodate these concerns. Under the transaction standards final rule, covered entities must comply with Version 5010 (for some health care transactions) and Version D.0 (pharmacy transactions) on January 1, 2012. Covered entities must comply with the standard for the Medicaid pharmacy subrogation transaction (Version 3.0) on Jan. 1, 2012. However, for Version 3.0, small health plans have an additional year and must comply on Jan. 1, 2013. The ICD-10 code sets rule sets the compliance date at Oct. 1, 2013. Re-structuring the current system to accommodate the ICD-10 data structure will be conducted in five phases in terms of System Design Life Cycle defined by CMS Office of Information System (OIS). The five phases are listed in the following with targeted completion dates set by the OIS - Business Requirements by September 30, 2009, Design by March 31, 2010, Coding by September 30, 2010, Testing by November 30, 2010, and Implementation on January 1, 2011. This is not a request for competitive proposals and no solicitation is available. All interest sources must respond in writing with clear and convincing evidence to support their ability to perform this work within 15 days after posting. A determination by the Government not to compete this action based on the response received is solely within the discretion of the Government. Interest sources are defined as those companies owned by US citizens and incorporated and located within the fifty (50) United States. The Contracting Officer for this action is Jaime Galvez. He may be contacted via email at Jaime.galvez@cms.hhs.gov or by phone at (410) 786-5701. The Contract Specialists is Christina Heller. She may be contacted via email at Christina.heller@cms.hhs.gov or by phone at (410) 786-1896.
- Web Link
-
FBO.gov Permalink
(https://www.fbo.gov/spg/HHS/HCFA/AGG/SN-CMS-2009-POK359-91536/listing.html)
- Place of Performance
- Address: Oklahoma Foundation for Medical Quality (OFMQ), 1400 Quail Springs Parkway, Suite 400, Oklahoma City, Oklahoma, 73134, United States
- Zip Code: 73134
- Zip Code: 73134
- Record
- SN01955724-W 20090917/090916002112-3782746255edae2688398ba3038f8f77 (fbodaily.com)
- Source
-
FedBizOpps Link to This Notice
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