70--Utilization Management Criteria
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The Department of Veterans Affairs Strategic Acquisition Center plans to enter into a sole source contract with McKesson Technologies, LLC to provide validated and reliable utilization review criteria for assessing the appropriateness of medical services within the Veterans Health Administration (VHA). This effort supports VHA’s commitment to delivering efficient, effective, and appropriate healthcare to veterans by ensuring consistent, high-quality care through utilization management (UM). The contract will encompass licensing for unlimited use, updates, clinical and technical support of evidence-based UM criteria and tools in electronic formats, including InterQual® Level of Care Criteria, CareEnhance® Review Manager Enterprise, InterQual® View, Mobile, and the InterRater® Reliability Suite. These tools will assist in reviewing inpatient care initially, with plans to extend to outpatient and community-based services, aligning UM with VHA’s Quality Management System. The licensing agreement covers ongoing software updates, patches, upgrades, report generation, and help desk support, with a requirement that any changes remain compatible with the VA’s National Utilization Management Integration system, coordinated at least 60 business days prior to implementation. The procurement is conducted under the NAICS code 519190 and is not open for competitive bidding, though interested parties can submit capability statements by a specified deadline. The contract emphasizes the Government's intent to proceed with the sole source arrangement unless compelling interest and capabilities from other vendors are presented within the specified timeframe.
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