SPECIAL NOTICE
70 -- Network Adequacy Measurement Multi-State Plan Program - OPMOSDBU0023
- Notice Date
- 5/28/2015
- Notice Type
- Special Notice
- NAICS
- 334111
— Electronic Computer Manufacturing
- Contracting Office
- Office of Personnel Management, Facilities, Security and Contracting, Contracting, 1900 E Street, N.W., Room 1342, Washington, District of Columbia, 20415-7710, United States
- ZIP Code
- 20415-7710
- Solicitation Number
- OPMOSDBU0023
- Archive Date
- 7/14/2015
- Point of Contact
- Terri J. Miller, Phone: 2026062518
- E-Mail Address
-
Terri.miller@opm.gov
(Terri.miller@opm.gov)
- Small Business Set-Aside
- N/A
- Description
- OPMOSDBU0023 Request for Information Network Adequacy Measurement (NAM) Multi-State Plan Program Developed by U.S. OFFICE OF PERSONNEL MANAGEMENT HEALTHCARE AND INSURANCE NATIONAL HEALTHCARE OPERATIONS Point of Contact Information Terri Miller   Table of Contents Responses 3 Response Submission 4 Instructions 4 Questions 5 Proposed Timetable 5 RFI Contact 5 Key Information 5 Background 5 Request for Information Objectives 6 Objective 6 Requirements and Requested Information 7 Requirements 7 Appendix A: Applicable IT Policies and Standards 8 Security and Privacy 8 Enterprise Architecture and Capital Planning and Investment Control 8 Records Management and Acceptable Use 8 Accessibility and Assistive Technology 9 HEALTHCARE AND INSURANCE NATIONAL HEALTHCARE OPERATIONS The U.S. Office of Personnel Management (OPM) is releasing this Request for Information (RFI) with the intent of soliciting information from well-qualified vendors who are capable of providing high-quality systems and services in the areas of network adequacy. The RFI is seeking information on available options to integrate and manage business and technology solutions for Network Adequacy Measurement (NAM). Responses Responses should include detailed information about your experience in providing the services discussed in this RFI. Specific examples from your current and past client base are especially helpful. As this is not a Request for Proposals (RFP), partial responses will be accepted. In addition to the requested information within this document, please include the following information with your response: 1. Name and address of your firm. 2. Two points of contact, including: name, title, phone, fax and email address. 3. Ownership of the firm, indicating whether it is a: large, small, small disadvantaged, 8(a), women-owned, HUBZone, and/or Veteran-owned business. 4. Number of years in business. 5. Up to three current or past (within 5 years) performance references of similar programs or projects. Include the size and type of the contract, if your company was the prime contractor, and a description of services provided. 6. Experience in Network Adequacy and discuss if you have a commercial (including commercially available off-the-shelf with modifications) or non-developmental system that could meet the needs as described in this RFI. 7. Specify what types of additional information you would need in order to provide a thorough response to an RFP. 8. Estimation of how much time you would need to prepare a response to an RFP. 9. Estimation of how much time you would need from the date of award to be ready to start. Interested small businesses are encouraged to respond to this notice and vendors are encouraged to provide evidence that they can comply with FAR 52.219.14 ("Limitations of Subcontracting"). This is not an RFP. Proposals are not requested at this time and will not be considered or accepted. Do not include any pricing information with your response. A determination on how, or if, to proceed with this requirement will be based in part upon responses to this RFI and will be solely within the discretion of the government and based on its needs and requirements. You do not have to respond to this RFI in order to respond to any future RFP. The government may request to meet one-on-one with selected respondents to this RFI for a more in-depth capabilities presentation. OPM anticipates scheduling one-on-one capabilities presentations with firms responding to this RFI within 30 days after the RFI's due date. Your response to this RFI is voluntary. The information gathered from this RFI will be used to improve and enhance our understanding of the industry's current capabilities and practices and will potentially help us craft an RFP. Please note that OPM often receives requests under the Freedom of Information Act to publicly disclose information it receives from industry. If you consider anything you provide us to be confidential, proprietary or otherwise protected from public disclosure, you must clearly identify and mark it as such. We recommend that firms planning to respond to this RFI register their email addresses on the Federal Business Opportunities (FedBizOpps or FBO) website at http://www.fbo.gov to receive notices of any changes as they are uploaded to the website, or information on a future RFP. Response Submission Instructions Your response should be direct and concise. Please adhere to the format guidelines outlined below. Submissions shall be no more than 25 pages in length, excluding the cover page, table of contents and past performance. •Formatting should include printing on 8.5" x 11" paper, 1" margins, and 12 pt. font. •All responses must be included in the table of contents with the appropriate page number referenced. •Responses must include a restatement of the request (number and text) with the response immediately following. •Appendices and other supplemental information provided with your response must be clearly identified. •Prospective respondents should mail or deliver five (5) hard copies of the RFI to the point of contact listed in this RFI. Please also send your submission electronically in Microsoft Word file format to Terri Miller at Terri.Miller@opm.gov. Reference the RFI number in the subject line. Please note that excessively large documents and/or numerous attachments may not be deliverable through the OPM email system.   Questions Prospective respondents may submit questions in writing via email to the RFI contact by the date and time indicated in the timeline. We will provide all questions and answers to all prospective respondents by the date and time indicated in the timeline. We will not accept telephone inquiries. Proposed Timetable The timeline is provided below for informational purposes. OPM reserves the right to change the dates. Every effort will be made to notify prospective respondents of changes to the proposed timeline. Activity Date/Time (All Times in Eastern Time) OPM releases RFI Wednesday May 27, 2015 Prospective Respondents' questions (in writing) due Tuesday June 16, 2015 - 3:00 p.m. EST OPM distributes answers to prospective respondents' questions Tuesday June 23, 2015 RFI Responses due Monday June 29, 2015 - 3:00 p.m. EST RFI Contact Terri Miller Small Business Specialist, FSC/OSDBU U.S. Office of Personnel Management 1900 E Street, NW Washington, DC 20415 Terri.Miller@opm.gov Prospective respondents may contact only the RFI contact. All correspondence and questions must be submitted in writing via email to the RFI contact in accordance with the timeline set forth in this RFI; other OPM personnel are not authorized to discuss this RFI with prospective respondents. Key Information Background As part of implementing the Affordable Care Act (ACA), OPM performs network adequacy analysis for health insurance issuers that participate in the MSP Program. Health insurance issuers that participate in the Multi-State Plan Program must eventually offer plan options ("MSP options") in all 50 states and the District of Columbia. Each year, OPM certifies that MSP options are in compliance with applicable state and federal laws before an issuer is authorized to offer them on the State or Federal Health Insurance Marketplaces. One aspect of this certification is a comprehensive review of an issuer's contracted provider, facility, and pharmacy networks for reasonable access. While state and federal regulators use various methods to assess network adequacy, network adequacy standards typically are based on either travel time, distance, or a combination of both, and these standards may vary by the type of provider and geographic location. OPM has adopted its own network adequacy standards based in part on Medicare Advantage time and distance standards for Providers and Facilities, and retail pharmacy access standards based on Medicare Part D requirements. Some additional provider types not found in Medicare Advantage have been added to the OPM network adequacy review to account for the differences between the two enrollee populations. Request for Information Objectives Objective The U.S. Office of Personnel Management (OPM) is charged with implementing the Multi-State Plan Program (MSP), as authorized by Section 1334 of the Affordable Care Act (ACA). Through contracts with OPM, health insurance issuers offer Multi-State Plan options (MSPs) on the Health Insurance Marketplaces (Marketplaces). OPM's evaluation of a health insurance issuer's proposed MSP options includes an analysis of provider networks. OPM verifies that the issuer has sufficient numbers of facilities, providers, and pharmacies participating in its network to make care readily accessible to prospective and current enrollees. OPM assesses the adequacy of MSP Program Applicant networks in each county within each service area in which the issuer proposes to offer MSP options in accordance with the MSP Program regulation, found at 45 CFR 800.109. Currently, OPM measures an issuer's provider and facility network adequacy using the time and distance standards established by the Centers for Medicare and Medicaid Services (CMS) for Medicare Advantage plans. The CMS standards do not include pediatricians as a specialty type. To address this OPM augments these standards to include pediatricians in the network adequacy assessment. For pharmacy network adequacy, OPM uses the CMS Medicare Part D standards. Assessing network adequacy is both more critical and more challenging as new technologies, delivery systems, and network configurations emerge. OPM is interested in obtaining information on available tools and criteria for measuring network adequacy using traditional approaches and receiving suggestions and solutions for different approaches to assessing the adequacy of networks.   Requirements and Requested Information In each of the below sections, we describe our anticipated requirements and the requested information for a response to this RFI. The requested information will help us better clarify requirements in the future. Requirements We are interested in receiving information about your network adequacy measurement processes. 1.What is your experience with providing network adequacy analysis? 2.Discuss the number and size of the clients you provide these services for. 3.Discuss the methodologies, criteria, and technology you employ to perform network adequacy analysis. 4.Discuss the amount of time it typically takes you to analyze an issuer's network. 5.Do you typically require standard file formats or customize per clients' formats? 6.Discuss your ability to generate standard reports and ad hoc reports using any of the collected data elements for deeper data analysis. Discuss how your system accomplishes these reporting needs. 7.Discuss your ability to generate standard or customized maps of provider networks and service areas. 8.Discuss your ability to analyze the breadth of a provider network compared to the universe of available providers in a given geographic area. 9.Discuss your ability to vary/customize the criteria you use to analyze networks. 10.Discuss any efforts you have undertaken to develop new or alternative methods for analyzing networks. 11.Discuss your ability to analyze whether a network includes adequate essential community providers (ECPs). 12.Discuss your ability to analyze the quality of a provider network, including the availability of Centers of Excellence 13.Discuss your ability to examine claims data in order to identify gaps in provider networks and/or determine which provider types are most commonly used by enrollees.   Appendix A: Applicable IT Policies and Standards Security and Privacy •Federal Privacy Rule for Personal Health Information - Health Insurance Portability and Accountability Act of 1996 (HIPAA) •The Federal Information Security Management Act (FISMA) of 2002 •Section 208 of the E-Government Act of 2002 (Public Law 107-347) •The Privacy Act of 1974, Public Law 93-579, December 31, 1974, (5 U.S.C. 552a) •Office of Management and Budget (OMB) Memorandum "Protection of Sensitive Agency Information" (OMB M-06-16) •The Federal Enterprise Architecture Security and Privacy Profile •National Institute of Standards and Technology (NIST) Special Publication 800-18, "Guide for Developing Security Plans for Information Technology Systems" •Federal Information Processing Standards (FIPS) Publication 197 regarding encryption standards •OPM - Information Security and Privacy Policy (OPM Policy 2011) •OPM - Information Security and Privacy Policy addendum (OPM Policy 2013) •OPM IT Security Policy and Procedures (OPM Policy 2011) •OPM Incident Response and Reporting Guide (OPM Policy 2009) •OPM Policy for Responding to Breaches of Personally Identifiable Information (PII) Enterprise Architecture and Capital Planning and Investment Control •IT Enterprise Architecture •IT Baseline Management Policy (OPM Policy 2011) •OPM Policy on Information Technology (IT) Procurement, 2009 •System Development Life Cycle (SDLC) •OPM Financial Management Manual, 2013 Records Management and Acceptable Use •The Paperwork Reduction Act of 1995, as amended (44 U.S.C. 3501) •Office of Management and Budget Circular No. A-130 "Management of Federal Information Resources" •Web Publishing Policy, 2006 •OPM Policy for Computer User Responsibilities (OPM Policy 2009) •OPM Policy - Email Management Annual Notice, 2014 •OPM Records Management Handbook, 2003 •OPM Rules of Behavior   Accessibility and Assistive Technology •Section 508 of the Rehabilitation Act (29 U.S.C. 794d), as amended by the Workforce Investment Act of 1998 (P.L. 105-220) •Section 255 of the Telecommunications Act of 1996 •Section 508 Standards for Electronic and Information Technology •OPM Information Technology Accessibility - Section 508
- Web Link
-
FBO.gov Permalink
(https://www.fbo.gov/spg/OPM/OCAS/CD/OPMOSDBU0023/listing.html)
- Place of Performance
- Address: Contractors location, United States
- Record
- SN03745729-W 20150530/150529040156-4f12e4ae28ff75805807ce85e69882ab (fbodaily.com)
- Source
-
FedBizOpps Link to This Notice
(may not be valid after Archive Date)
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