Issue Request for Information (RFI) for the Military Health System (MHS) Office of the Chief Financial (OCFO)

1.0 PURPOSE OF THIS RFI This Request for Information (RFI) is issued solely for information and planning purposes and does not constitute a solicitation. Neither unsolicited proposals nor any other kinds of offers will be considered in response to this RFI. Responses to this notice are not offers and will not be accepted by the Government to form a binding contract. Responders are solely responsible for all expenses associated with responding to this RFI. All information received in response to this RFI that is marked proprietary will be handled accordingly. Responses to the RFI will not be returned. Interested parties are asked to respond to this RFI and submit a capability statement that supports the focus of this RFI. No written solicitation document is available at this time. Telephone requests will not be honored, and no bidders list shall be maintained. Potential offerors are requested to direct all questions via email to the Point of Contact listed below in item 4.0. All responses should be complete; in 12-point font; and not exceed 15 pages total, including tables, graphics and appendices. A Request for Proposal (RFP) is anticipated to be released in the near Future. Based on capability statements received in response to this RFI the anticipated RFP may be solicited as a 100% small business set aside. All small business organizations (SB, SDB, WOSB, HUBZone, and VOSB and SDVOSB) are encouraged to respond to this notice. Please continue to monitor GSA and Federal Business Opportunities for any opportunities. 2.0 BACKGROUND TRICARE is the health care program serving active duty service members, National Guard and Reserve members, retirees, their families, survivors and certain former spouses worldwide. As a major component of the Military Health System (MHS), TRICARE supplements the health care resources of the uniformed services Military Treatment Facilities (MTF) with networks of civilian health care professionals, institutions, pharmacies and durable medical equipment suppliers to provide access to high-quality health care services while maintaining the capability to support military operations. The OCFO supports the OASD (HA)/TMA and the Military Health Services in applying the principles of DOD financial management by developing and implementing policies, procedures, programs, and technical standards necessary to support the delivery of high quality, cost effective health care services across the operational continuum. Approximately 28% of the 9.6 million MHS beneficiaries have self-reported they have OHI. The current process of identifying MHS beneficiaries with OHI relies on MHS staff to query beneficiaries to identify whether or not they have OHI. If yes, then the beneficiary is asked to complete an OHI Collection Form detailing the associated policy information. This information is stored in a DOD master database for use in revenue recovery actions. Beneficiaries are asked at every MTF encounter to report their availability to OHI in an effort to maintain the most recent and reliable data. MTFs provide beneficiaries with information to understand that the cost of their OHI will not increase as a result of the MHS recovering the cost of their healthcare but there may still be reluctance on the part of some beneficiaries to disclose their access to OHI. The revenue recovery actions are then processed by the MTFs based on care delivered in the MTF. The current process results in MTF claims of approximately $381M per year. MTF collections are less than $200M per year with approximately 30% of denied claims characterized as acceptable. 3.0 DESCRIPTION The Military Health System (MHS) Office of the Chief Financial Officer (OCFO) is seeking industry solutions that can enable the reporting, discovery verification and ongoing monitoring of health insurance coverage of a certain population for the purposes of revenue recovery and expense allocation. This request for information is in support of a market/industry survey to gain input from the commercial sector on: - Industry standards for rates and percentages of medical payment collections - Examples of commercially utilized enhanced recovery practices; - Recommendations on alternatives to the current MHS business process for the identification of beneficiaries with Other Health Insurance (OHI) coverage and the accuracy of our beneficiary OHI file - Recommendations on alternative methods to track and maintain real-time data integrity for payment assignment - Possible products/services employed to facilitate and improve revenue recovery - Availability of subscription services or other databases to determine existence of OHI. Responses to the RFI will be used to identify commercial capabilities capable of optimizing the MHS OHI identification and recording process to achieve industry standards in revenue recovery. Respondents' comments may be used in creating the Performance Work Statement. When replying to the RFI please provide information and understanding based on your knowledge of the marketplace and explicit company experience. If you have any specific products identified please provide a summary of product capabilities and/or a web link that already has this summary. Responses are due to this RFI by 5:00 PM on March 8, 2013. See Section 4.0 for further information. 4.0 CONTACT INFORMATION Following is the Point of Contact for this RFI: TRICARE Management Activity AM&S/ COD 7700 Arlington Boulevard, Falls Church, VA 22042 ATTN: Millie Mitchell Please submit written responses via email in Microsoft Office 2000 format by 5:00 PM EST on March 8, 2013 to the following email address: Summerlin.Walker@tma.osd.mil. No hardcopies will be accepted. No inquiries on any potential future acquisition activities or timelines will be accepted.