SOURCES SOUGHT
R -- Medicare Provider/Supplier Screening
- Notice Date
- 4/8/2011
- Notice Type
- Sources Sought
- NAICS
- 518210
— Data Processing, Hosting, and Related 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
- CMS-APP-111134
- Archive Date
- 5/10/2011
- Point of Contact
- Cameron A. Williams, Phone: 4107865794
- E-Mail Address
-
cameron.williams@cms.hhs.gov
(cameron.williams@cms.hhs.gov)
- Small Business Set-Aside
- N/A
- Description
- Description. This is a Small Business Sources Sought notice. This is NOT a solicitation for proposals, proposal abstracts, or quotations. The purpose of this notice is to obtain information regarding: (1) the availability and capability of qualified small business sources; (2) whether they are small businesses; HUBZone small businesses; service-disabled, veteran-owned small businesses; 8(a) small businesses; veteran-owned small businesses; woman-owned small businesses; or small disadvantaged businesses; and (3) their size classification relative to the North American Industry Classification System (NAICS) code for the proposed acquisition. Your responses to the information requested will assist the Government in determining the appropriate acquisition method, including whether a set-aside is possible. An organization that is not considered a small business under the applicable NAICS code should not submit a response to this notice. Background. The Centers for Medicare & Medicaid Services’ (CMS’) Center for Program Integrity (CPI) is accountable for the prevention and detection of fraud, waste, abuse, and errors in the Medicare and Medicaid programs. CPI is implementing a National Fraud Prevention Program (NFPP) focused on prevention and detection that is integrated, risk-based, and measurable. CMS is planning improvements to its provider screening process with several goals: · To compile provider-related data needed to support the NFPP · To comply with provisions of CMS Rule 6028-FC · To automate provider/supplier screening procedures which currently happen manually · To automate assessment of risk pre-enrollment CMS Rule 6028’s provisions affect all new applications and revalidations occurring after March 25, 2011 and require complete revalidation of all enrolled providers and suppliers in the Medicare fee-for-service (FFS) program by March 23, 2013. Under current business processes, CMS is managing approximately 700,000 Medicare FFS providers and suppliers, and processing more than 20,000 new Medicare FFS enrollments each month. C urrently ensuring the completeness and accuracy of the enrollment form is a manual process. This announcement briefly summarizes the technical requirements for Provider Screening, initially for the Medicare FFS program, and the required capabilities sought by CMS. Purpose and Objectives. The purpose of this requirement is to obtain the following capabilities: 1) to perform automated screening on new and existing enrollments of participating providers/suppliers and 2) to conduct automated risk assessments for potential fraud, waste, and abuse on a pre- and post-enrollment basis, and provide needed alerts and reporting to designated CMS business partners. Project requirements. The Contractor shall deliver automated method(s) (system, process, or service) to validate provider/supplier data and score vulnerabilities to screen and detect risk of fraud. Ninety (90) days after contract award, the Contractor must be operationally ready to provide comprehensive validation screening, and risk assessment methods, covering all provider/supplier categories and types, to include physicians and non-physician practitioners, and encompassing providers in all states and territories. Specific requirements include: 1. Fully hosted and integrated managed offerings that include operating products with referenceable customers providing: a. risk scoring methodologies adaptable to the healthcare industry and CMS specific algorithms b. identity validation, screening and linking of providers/suppliers currently enrolled and seeking to enroll into Medicare FFS using various external data sources c. management of an auditable master provider file 2. Ability to validate data across the disciplines such as: a. Identity b. Licensing (State Licensing Boards for all 50 states and territories) c. Professional accreditation sources [CMS will provide or facilitate access to other government and legislatively mandated provider screening datasets.] 3. Ability to supplement data across disciplines such as: a. Geo Spatial b. Financial c. Criminal d. Tax and Business 4. Capability to concurrently process monthly revalidation/risk scoring workload for a minimum of one million existing records, and monthly validations/risk scoring workloads of 50,000 new records 5. Experience and capabilities with Extraction, Transformation and Loading ( ETL) for data analysis 6. Available facilities and an information security environment capable of handling CMS data and a proposed solution for electronically exchanging information with CMS. The provider screening product must identify and prioritize providers that are high risk of being potentially fraudulent based on screening criteria, and return corrected data fields, supplementary data relevant to the risk assessment, a risk score, and appropriate feedback reports to designated CMS business partners. Fifteen (15) months from the date of award, the provider screening process is expected to be integrated with the current Medicare FFS provider enrollment system of record such that automated record checks are performed in real time. Anticipated period of performance. The provider screening requirement will have a minimum base year period of performance, with four optional years. Data Use and Contractors’ Facility and Information Security - CMS will not provide equipment or office facilities at the CMS site for contractor personnel. CMS collects records on Medicare FFS providers and suppliers on CMS-Form 855 that includes personally identifiable information for individual representatives and business entities seeking enrollment in Medicare FFS programs. Contractors are granted access to CMS provider/supplier enrollment data under specific data use agreements and are required to protect all Personally Identifiable Information (PII) and Protected Health Information (PHI) at its facility and during transport of information. To help ensure that good information security practices are in place and maintained by the Contractor, it is important that CMS contractors have well-articulated and documented information security practices and plans that are current with OMB and NIST requirements, and have a well-articulated and documented information security training and awareness programs for their personnel. The CMS minimum security requirements are outlined on the CMS Information Security (IS) Acceptable Risk Safeguards (ARS). The Contractor shall adhere to the IS ARS in the development/modification of any system that shall support this work. The applicable IT security p olicies, standards and procedures which are available on the CMS web site ( http://www.cms.hhs.gov/InformationSecurity/). Information Requested Vendors interested in this opportunity are requested to respond to the points above under Project Requirements. The information is for CMS internal use and consideration in preparing is acquisition plan. Each of the points above must be addressed in your response. Please detail your experience, knowledge and your ability to provide these requirements. Business Information Your response must also address the following business information: a) Vendor’s DUNS number, organization name, address, size and type of business (e.g., 8(a), WOSB, VOSB, SDVOB, or HUBZone small business) pursuant to the applicable NAICS code; respondents’ technical and administrative points of contact, including names, titles, addresses, telephone and fax numbers, and e-mail addresses. b) Identify proposed teaming partners (if any) and include for each their DUNS number, organization name, address, size and type of business (e.g., 8(a), WOSB, VOSB, SDVOB, or HUBZone small business) pursuant to the applicable NAICS code; respondents’ technical and administrative points of contact, including names, titles, addresses, telephone and fax numbers, and e-mail addresses, and describe the teaming partner’s role/capability to be provided to meet the project requirements. c) Provide currect CMMI Certification Level. d) Provide information about GWAC and GSA Schedule Contracts (if any) or other contractual vehicles used by your company for selling similar services to the Federal Government, for instance: o GSA IT Schedule 70 (Please indicate appropriate item numbers) o GSA FABS Schedule 520 (Please indicate appropriate item numbers) o GSA LOGWorld Schedule 874-V (Please indicate appropriate item numbers) o GSA Government-wide Acquisition Contracts o Identify other contracting vehicles in place with the Federal Government and provide the Contract Number and contact information for the Contracting Officer Instructions for Submittal. Written responses shall be provided electronically, by 10:00 a.m. local time on April 25, 2011. The subject line of the e-mail message shall read: “Provider Screening” and shall be addressed to the attention of: CPI Info@cms.hhs.gov CMS will not accept telephone, facsimile, courier, mail, or hand delivery methods of response. The page limitation is 15 pages. Corporate capability information used as marketing material are included in the 15 page limit, however, may be submitted as separate files. The file size limitation for e-mail attachments is 3 megabytes. Further, access by CMS to information in any files attached to a response is the responsibility of the submitting party. CMS is not responsible for any failure to access information. Therefore, please ensure that files are easily accessible by CMS - Word files are preferable, but CMS will accept.pdf files as long as they meet the 3 megabyte size limitation. Disclaimer and Important Notes. This notice does not obligate the Government to award a contract or otherwise pay for the information provided in response. The Government reserves the right to use information provided by respondents for any purpose deemed necessary and legally appropriate. Any organization responding to this notice should ensure that its response is complete and sufficiently detailed to allow the Government to determine the organization’s qualifications to perform the work. Respondents are advised that the Government is under no obligation to acknowledge receipt of the information received or provide feedback to respondents with respect to any information submitted. After a review of the responses received, a pre-solicitation synopsis and solicitation may be published in Federal Business Opportunities. However, responses to this notice will not be considered adequate responses to a solicitation. Confidentiality. No proprietary, classified, confidential, or sensitive information should be included in your response. The Government reserves the right to use any non-proprietary technical information in any resultant solicitation(s).
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- SN02421068-W 20110410/110408235137-bbe0dba8c0df92126353571008d163e1 (fbodaily.com)
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