This is a Notice of Proposed Contract Action Synopsis. The Centers for Medicare & Medicaid Services (CMS) intends to issue a new non-competitive contract to the National Committee for Quality Assurance (NCQA) pursuant to the authority of FAR 6.302-1, Only one responsible source and no other supplies or services will satisfy agency requirements. This action is currently subject to the availability of funds. CMS intends to utilize the unique services of NCQA to transition to Electronic Clinical Data Systems (ECDS) measures for the Long-Term Services and Supports Programs (LTSS) measures (Medicaid Managed Care and Fee-for-Service) and the Home and Community-Based measures (Functional Assessment Standardized Items (FASI), The Consumer Assessment of Healthcare Providers and Systems Home and Community-Based (HCBS CAHPS®) Scorecard, Medicaid Innovation Accelerator Program (IAP) measures and new measures under development) and the HEDIS® ECDS Reporting Standard. Electronic Clinical Data Systems (ECDS) Measure Access and Technical Support The contractor shall provide and maintain an information system and IT infrastructure to collect and support submission of NCQA measures data for healthcare plans and generate a database to include health plan names, descriptive information, plan-specific HEDIS® and CAHPS® performance measurement data, health plan ratings and national, regional and state averages and percentiles. In addition to providing healthcare plans with data submission tools and instructions with detailed technical specifications for submitting NCQA measures, the contractor must facilitate and provide technical support and assistance to individual healthcare plans, as they submit data according to the plan’s requirements. The contractor will be supporting CMS in the collection and management of the annual HEDIS® transition to Electronic Clinical Data Systems (ECDS) measures for the Long-Term Services and Supports Programs (LTSS) measures (Medicaid Managed Care and Fee-for-Service) and the Home and Community-Based measures (Functional Assessment Standardized Items (FASI), The Consumer Assessment of Healthcare Providers and Systems Home and Community-Based (HCBS CAHPS®) Scorecard, Medicaid Innovation Accelerator Program (IAP) measures and new measures under development). The HEDIS® ECDS Reporting Standard provides health plans a method to collect and report structured electronic clinical data for HEDIS quality measurement and quality improvement. NCQA owns the proprietary rights to the system that collects HEDIS® data. It is the only organization authorized to add measurements and to provide technical assistance to the health plans and auditors in the use of these measurements. NCQA performs this function by convening a number of interdisciplinary multi-stakeholder panels and groups. These groups are all widely respected by the managed care industry and have stakeholder representation. Since NCQA develops the measures and makes all of the updates to HEDIS®, it is uniquely qualified to provide the needed technical assistance to health plans and auditors during data collection. As the organization that maintains and evolves HEDIS®, NCQA is the only responsible source for this activity. In 1993, NCQA released HEDIS® 2.0 that quickly became the “industry standard” performance measurement set. Originally designed for private employers' needs as purchasers of healthcare, HEDIS® has been adapted for use by public purchasers, Government compliance monitors, and managed care consumers. HEDIS data submission tools and detailed technical specifications are developed and maintained by NCQA. There will be focus on the collection and management of the annual HEDIS® transition to Electronic Clinical Data Systems (ECDS) measures for the Long-Term Services and Supports Programs (LTSS) measures (Medicaid Managed Care and Fee-for-Service) and the Home and Community-Based measures (Functional Assessment Standardized Items (FASI), The Consumer Assessment of Healthcare Providers and Systems Home and Community-Based (HCBS CAHPS®) Scorecard, Medicaid Innovation Accelerator Program (IAP) measures and new measures under development). The ECDS Reporting Standard provides health plans a method to collect and report structured electronic clinical data for HEDIS® quality measurement and quality improvement. NCQA retains sole title and ownership of the HEDIS® based measures data. The contract's period of performance will be a base year plus four (4) option years. This notice is a notice of intent to negotiate and award a contract to NCQA and should not be considered a request for proposals. This synopsis should not be construed as commitment by the Government for any purpose other than market research. All responsible sources may submit a capability statement that will be considered by the agency. Such statements must demonstrate that the firm(s) has the capability to perform the required work. All capability statements must be submitted via email to Heather Parr-Stewart Lang at
[email protected] on or before 1:00 pm est October 27, 2022. Voice communications will not be entertained. A determination by the Government not to compete this proposed action based upon responses to this notice is solely within the discretion of the Government. Information received will be considered solely for the purpose of determining whether to conduct a competitive procurement. CMS will not reimburse costs for submission of capability information. All documentation shall become the property of the Government. Please note: Any firm interested in this synopsis must be able to successfully perform the annual HEDIS® transition to Electronic Clinical Data Systems (ECDS) measures for the Long-Term Services and Supports Programs (LTSS) measures (Medicaid Managed Care and Fee-for-Service) and the Home and Community-Based measures (Functional Assessment Standardized Items (FASI), The Consumer Assessment of Healthcare Providers and Systems Home and Community-Based (HCBS CAHPS®) Scorecard, Medicaid Innovation Accelerator Program (IAP) measures and new measures under development) and the HEDIS® ECDS Reporting Standard.