The purpose of this notice is to obtain program management and business requirement services to support the Healthcare Quality Information Systems Value Based Purchasing (VBP) and Standard Data Processing System (SDPS) application groups.

The HealthCare Quality Information System (HCQIS) is a major application environment that uses application groups, shared servers, and WAN to monitor and improve utilization and quality of care for Medicare and Medicaid beneficiaries. HCQIS is composed of 4 application groups. This solicitation will deal only with the following application groups: - Standard Data Processing System (SDPS) for Quality Improvement Organizations (QIOs), including the Clinical Data Abstraction Center (CDAC); - Value Based Purchasing (VBP) IT Infrastructure for Physician Quality Reporting Initiative (PQRI) and Hospital Outpatient; This statement of work is related to the SDPS and VBP application groups and is phase 1, of a 4-phase process. The other phases will be issue as separate solicitations with their specific SOW, requirements, evaluation criteria, etc. The Government estimates that it will issue these separate solicitations during 2008-2009. This information is being provided as informational only and it does not obligate the Government to issue a solicitation or award a contract. The four Phases that currently being developed are: Phase 1 - Program Management and Business Requirement Contract (Current Solicitation) Phase 2 - Infrastructure Contract Phase 3 - Reports and Analytics Contract Phase 4 - Development Contract CMS will utilize several contracts to develop and support the SDPS and VBP application groups. The Healthcare Quality Improvement Systems Program Management and Business Requirements contractor will not be eligible to bid on any follow up development work associated with this effort (Phase 4 - Development Contract). Background The Standard Data Processing System (SDPS), implemented in 1997, supports the Quality Improvement Organization (QIO) program and Centers for Medicare & Medicaid Services (CMS) community. Prior to SDPS, each QIO was responsible for developing solutions to meet the management and reporting requirements of the Statement of Work (SOW). Besides the obvious inefficiencies of redundant systems and costs, each QIO had different competencies during that period. Since the inception of SDPS, the functions of SDPS have encompassed support, standardization and development of data, software and standards for the QIO community. SDPS continues to rapidly evolve with innovative technology to meet the challenges of supporting and interfacing directly with the QIO community and surrounding healthcare industry. Quality Improvement Organizations (QIO) are under contract by Centers for Medicare and Medicaid Services (CMS) to - Improve quality of care for beneficiaries; - Protect the integrity of the Medicare Trust Fund by ensuring that Medicare pays only for services and goods that are reasonable and medically necessary and that are provided in the most appropriate setting; and - Protect beneficiaries by expeditiously addressing individual complaints, notices, and appeals, such as beneficiary complaints; provider-issued notices of non-coverage (Hospital-Issued Notice of Non-Coverage [HINN], Notice of Discharge and Medicare Appeal Rights [NODMAR], and Medicare Advantage appeal); Emergency Medical Treatment and Labor Act (EMTALA) violations; and other related statutory QIO responsibilities. The statutory authority for the QIO Statement of Work is found in Part B of Title XI of the Social Security Act (hereinafter referred to as the Act), as amended by the Peer Review Improvement Act of 1982. The Act established the Utilization and Quality Control Peer Review Organization Program, now known as the Quality Improvement Organization (QIO) Program. The statutory mission of the Program, as set forth in Section 1862(g) of the Act, is to improve the effectiveness, efficiency, economy, and quality of services delivered to Medicare beneficiaries. In support of the QIO program, CMS authorized the design and implementation of a SDPS for the User Community. SDPS is an information system solution that provides a common platform for users to share applications and data to promote efficiency and increase productivity. SDPS is the QIO Information Technology and data support infrastructure. The SDPS User Community, for purposes of this contract, refers to the QIOs, the State Agencies, CMS Central and Regional Offices, the Clinical Data Abstraction Center (CDAC), and other organizations/partners that may be incorporated in support of CMS initiatives. This system services the daily, ongoing support that the SDPS User Community needs to fulfill their contractual requirements in a manner supportive of an ongoing quality improvement program. The VBP application group utilizes SDPS applications and warehouses in addition to other VBP specific products. These applications and warehouse support two provisions of the Tax Relief and Health Care Act of 2006 (TRHCA) Division B, Title 1: 1. Section 101, Physician Payment and Quality Improvement, includes The Physician Quality Reporting Initiative (PQRI). This law authorizes a financial incentive for eligible professionals to participate in a voluntary quality reporting program. Eligible professionals, who chose to participate and successfully report on a designated set of quality measures for services paid under the Medicare Physician Fee Schedule and provided between July 1 and December 31, 2007 to Medicare beneficiaries under the traditional fee-for-service program, may earn a bonus payment of 1.5% of their charges during that period, subject to a cap. On December 29, 2007, the President signed Public Law 110-173, the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA), which authorized the continuation of the Physician Quality Reporting Initiative (PQRI) for 2008. The 2008 PQRI reporting period is January 1-December 31, 2008. The Extension Act also provides new authorities for enhancing PQRI that CMS will be implementing during 2008. MMSEA requires CMS to establish alternative reporting periods and alternative criteria for satisfactorily reporting groups of measures via claims for 2008. It also requires CMS to establish alternative reporting periods and alternative criteria for satisfactorily reporting measures via registries to enable professionals to earn the 1.5% incentive for participation in PQRI based on data submitted via these mechanisms. 2. Section 109, requires the development of measures for the evaluation of the quality of care of services provided by hospitals in outpatient settings. An Outpatient Prospective Payment System (OPPS) Reporting Hospital Quality Data for Annual Payment Update (RHQDAPU) program modeled after the current Inpatient Prospective Payment System (IPPS) RHQDAPU program will be established. Section 109, which applies to hospitals as defined under section 1886(d)(1(B) of the Act, also requires that hospital outpatient departments (HOPD) that fail to report data required for the quality measures selected by the Secretary will incur a reduction in their annual OPD fee schedule increase factor by 2.0 percentage points. OPPS payments beginning in CY 2009 will be based on hospital reporting of OPD data beginning in CY 2008. The contractor shall provide a program management team that assists CMS in managing the SDPS and VBP development efforts; identifies and reports to CMS of any potential risk factors that may inhibit or impede the performance of any task; facilitate the completion of program business requirements; assists CMS with the management of each product; manages timelines and ensure project plans are developed in MS Project or other SDLC approved packages for all programs and products ;ensures the full development of business requirements in the format and with the specific tools approved by CMS; assists in the preparation of white papers, presentations, position papers, etc. to enable CMS to make appropriate, efficient, effective decisions/options; develops and maintains program management plans. The contractor shall facilitate and participate in business requirements definition meetings with program staff from CMS. The work during this phase will culminate in the completion of the Business Requirements and Issues Documents. The business requirements defined during the Business Requirements Definition phase shall translate to specific application requirements through the inventory and catalogue of functional requirements. These definition phases shall follow standard SDLC processes, procedures, and documentation guidelines. The Contractor shall ensure that requirements capture the business and technical capabilities of the VBP and SDPS applications, data warehouses, and web tools. The Contractor shall develop a Requirements Document (RD), which shall include business, user, and system requirements. The requirements management tool at CMS/OCSQ is Dimensions and CMS requires its use for storing and managing requirements. Specialized documents and reports may be required to be produced from Dimensions to support requirements reviews. The contract will include the following scope of services: 1. The contractor shall develop and maintain program management plans. A program management plan will at a minimum describe the components of a program and the interrelationship between applications, warehouses/database, reports, and websites. 2. The Contractor shall gather and write requirements such that they are correct, complete, clear, consistent, testable, traceable, feasible, modular, and design-independent. 3. The contractor shall coordinate Joint application Development (JAD) meetings and manage all administrative tasks for these meetings. This includes facilitation, agendas, minutes, etc. 4. The contractor shall assist CMS with project management of all products through the System Development Life Cycle. The contractor should have experience managing multiple large multi million dollar complex programs and developing or facilitating the development of business requirements for applications, warehouses, web portals, and reports. The minimum contractor requirements are written proof of a CMMI Level II Certification (SCAMPI Report), at time of contract award. All efforts shall be performed in accordance with Centers for Medicare & Medicaid Services (CMS) requirements and shall meet the objectives of increasing efficiency and effectiveness of operations and timely implementation of statutory and regulatory requirements. This is a Set Aside for 8(a) business. The estimated level of effort for the contract is approximately 75,000 hours per year (Base + 6). CMS anticipates awarding this contract in January 2009, the Period of Performance will be Base + 6 12-month option years. Teaming arrangements are encouraged.