R--TRICARE Claims Review Services (TCRS)

The Defense Health Agency (DHA) is contemplating a follow-on indefinite delivery/indefinite quantity (IDIQ) contract with fixed unit prices for the TRICARE Claims Review Services (TCRS). The TCRS assists the Improper Payment Evaluation and Transition Branch (IPE&TB) which oversees the Defense Health Agency's (DHA's) implementation, enforcement, and compliance with key provisions of the Improper Payment Information Act of 2002 (IPIA) and the Improper Payment Elimination and Recovery Act of 2010 (IPERA). The purpose of the TCRS contract is to assist the IPE&TB in identifying and reporting improper payments. This contract provides independent impartial review of claims processing procedures, reimbursement determinations, and purchased-care contractor compliance with TRICARE policy and directives. The purpose of this Notice is to provide potential offerors with the DRAFT solicitation. This Notice is a follow on to earlier Requests for Information (RFIs) (DHA-RFI-14-TCRS and DHA-RFI-15-TCRS) and is part of ongoing market research. It is intended solely for information and planning purposes and is NOT a solicitation. Offerors are invited to review the attached DRAFT solicitation documents and submit questions or comments via email to Ms. Cynthia Turk, Contract Specialist, cynthia.d.turk.civ@mail.mil, not later than September 2, 2015. Please include the following in the subject line: DRAFT TCRS HT9402-15-R-0003. DHA seeks industry questions and feedback on the adequacy of the description of the TCRS requirements and DHA's approach in the draft solicitation. DHA requests industry input concerning healthcare best practices, industry standards, and incentives to promote the delivery of high quality claims review services. DHA requests industry comments and suggestions concerning contract transition-in and start up. 1. What is the minimum amount of time necessary for a contractor to complete start up and commence claims review operations on a DOD/DHA contract? 2. What is the optimum amount of time a contractor would prefer to have for transition in/start-up in terms of schedule, costs and performance for a DOD/DHA contract? 3. How does a shorter transition in timeline impact the contractor's costs, schedule and performance? 4. What are industry norms for transition in? What are the industry benchmarks? DHA requests responders submit any questions or comments about the DRAFT solicitation via email to Ms Turk. DHA requests that responders identify the specific solicitation document and cite specific paragraphs where appropriate, using the Word file attached to this DRAFT solicitation. DHA will treat all questions/comments as source selection information (FAR 2.101 & 3.104). Interested firms shall not send proposals in response to this Notice, nor shall they contact any other individuals about this Notice or the TCRS requirement. Any information provided to DHA is strictly voluntary and given with no expectation of compensation and is clearly provided at no cost to the Government. DHA is not issuing a solicitation at this time, and this Notice shall not be construed as DHA's commitment to issue a solicitation nor does it restrict DHA to a particular acquisition approach. DHA estimates a formal solicitation may be issued on the Federal Business Opportunities (fbo.gov) website in the near future. If DHA issues a solicitation, DHA will conduct the source selection in accordance with FAR 15, as supplemented, at the Contract Operations Division-Aurora (COD-A), in Aurora, Colorado. Any future information on this acquisition will be posted on www.fbo.gov. It is the responsibility of the prospective offeror to review this site regularly for updates and/or changes. BACKGROUND: The DHA's mission is to achieve greater integration of the direct and purchased health care delivery systems to accomplish the Military Health System's (MHS) Quadruple Aim: Readiness, Population Health, Experience of Care and Per Capita Cost. The DHA supports the delivery of integrated, affordable, and high quality health services for more than 9.5 million beneficiaries of the Military Health System (MHS) and is responsible for shared services, functions, and activities of the MHS and other common clinical and business processes in support of the Military Services.