Common Electronic Data Interchange (CEDI)

Department of Health and Human Services (DHHS) Centers for Medicare & Medicaid Services (CMS) Office of Acquisition and Grant Management (OAGM) Center for Medicare (CM) Agency: Contracting Office: Document Type: DHHS/CMS/OAGM/CM 7500 Security Blvd. Baltimore, MD 21244 Small Business Sources Sought Notice SSN Number: Title: HHS-CMS-SBSS-2022-000001S-CEDI Common Electronic Data Interchange (CEDI) Posted Date: March 1, 2022 Response Date: March 15, 2022 Classification Code: D - Information technology services, including telecommunication services NAICS Code: Incumbent: 541512 - Computer Systems Design Services National Government Services, Inc. This is a SOURCES SOUGHT NOTICE posted for INFORMATIONAL PURPOSES ONLY and will be used to assist CMS in determining the availability of businesses that have the capability to provide the services noted in this Notice. This is a Sources Sought Notice to determine the availability of potential small businesses (e.g., 8(a), service-disabled veteran owned small business, HUBZone small business, small disadvantaged business, veteran-owned small business, and women-owned small business) to develop and maintain a Common Electronic Data Interchange (CEDI) front-end application for all four Durable Medical Equipment (DME) Medicare Administrative Contractor (MAC) claims processing jurisdictions. DESCRIPTION The purpose of the CEDI front-end system is to provide a single front-end solution for the submission and retrieval of electronic transactions, and promote both standardization and greater efficiencies in inbound and outbound EDI exchange for the CMS Medicare Durable Medical Equipment (DME) fee-for-service (FFS) claims processing environment. The CEDI System processes an estimated volume of 77-80 million FFS DME claims per year. The CEDI front-end system supports external Trading Partner (TP) submitted X12 837 claims and 276 Claim Status Inquiry transactions. The CEDI system performs all front-end edits on these transactions, assigns the Claim Control Number (CCN) to claims accepted by the CEDI, and creates the flat files for delivery to the appropriate DME MAC. All X12 837 claims accepted by the CEDI are delivered to the appropriate DME MAC based on the beneficiary state code - 276 files are delivered based on the contractor code in the header record of the file. CEDI authenticates and validates that the TP electronic submitter is eligible to submit electronic transactions to the CEDI system. The CEDI system then performs edits on incoming Medicare FFS DME electronic transactions, translates the transaction into a flat file and forwards the output data from transactions that pass edits to the core of the ViPs Medicare System (VMS) claims processing environment. CEDI also receives the X12N 835 Electronic Remittance Advice (ERA) and 277 Claims Status Response transactions from the DME MACs, translates that data into the X12 format and delivers them to the appropriate Trading Partner's CEDI mailbox. The National Council for Prescription Drug Programs (NCPDP) transactions currently passes through an exchange with VMS for both inbound and outbound transactions. The CEDI System contractor provides all of the necessary hardware, software, labor, and supplies necessary to be responsible for receiving, sending, translating, routing, editing and retaining all DME MAC electronic transactions, as well as trading partner management. REQUIREMENTS Please describe your capabilities and detailed experience for the work or similar work as noted in the - Description above. Specifically, please submit responses to the items below: Demonstrate your experience with Medicare FFS shared system claims or similar system processing. Demonstrate your experience with processed Medicare FFS claims or similar system for adjudication and payment in an active production EDI environment. Demonstrate your experience with implementing front-end EDI operations. Demonstrate your ability to provide EDI staff familiar with Medicare front-end systems, or show the ability to recruit and train new staff within a reasonable period of time, in order to perform the functions described in this Notice. BUSINESS INFORMATION - Please provide the following in your response: a. DUNS # b. Company Name /Company Address c. Current GSA Schedules d. Current GWACs e. NAICS code under which the company conducts business as a small business and socio-economic status of the small business as validated via the System for Award Management (SAM). All potential offerors must be registered in SAM. f. Type of Company (i.e., small business, 8(a), woman owned, veteran owned, etc.) as validated in SAM. g. Company Point of Contact, Phone and Email address; also individuals who can verify the demonstrated capabilities identified in the responses. h. Capability Maturity Model Integration - CMMI Level RESPONSES Responses should reflect the respondent's ability to meet the requirements included in this Notice. Capability statements will not be returned and will not be accepted after the due date. Respondents will not be notified of the results of the review of their submissions. Information received will be considered solely to make informed decisions regarding a potential small business set-aside. The format is as follows: Microsoft Word (or PDF) document with page size 8.5 by 11 inches, with a minimum of 1 margins. Calibri Font Size 11 with no less than single spacing between lines. Submissions shall not exceed 10 pages. PERIOD OF PERFORMANCE The Department of Health and Human Services (HHS), Centers for Medicare & Medicaid Services (CMS) intends to issue a competitive solicitation for the CEDI DME MAC. It is anticipated that a contract will be awarded with a 1-year base period and 4 option years. TEAMING ARRANGEMENTS All teaming arrangements should also include the above-cited information for each entity on the proposed team. 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). DISCLAIMER AND IMPORTANT NOTES This notice does not obligate the Government to award a contract or otherwise pay for the information provided in response. 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. POINTS OF CONTACT Herman Harris, Contract Specialist, Herman.Harris@cms.hhs.gov and Evelyn Dixon, Contracting Officer, evelyn.dixon1@cms.hhs.gov.