Description
The Centers for Medicare and Medicaid Services (CMS) intends to award a 5-year cost plus award fee contract, with a performance period of one base year and four one-year options, to a small business to assist CMS in the assignment of National Provider Identifiers/National Plan IDS (NPIs/NplanIDs) to health care providers and plans by utilization of the National Plan and Provider Enumeration System (NPPES). This is a total small business set-aside. Potential offerors are hereby advised that their accounting system must be adequate for determining costs applicable to the contract and that FAR Clause 52.219-14 Limitations of Subcontracting will be incorporated into the solicitation and resultant contract. BACKGROUND: The administrative simplification provisions of the Health Insurance Portability and Accountability Act (HIPAA) of 1996 (P.L. 104-191) require the Secretary of Health and Human Services to adopt a national standard identifier for health care providers for use in the health care industry. HHS adopted the National Provider Identifier (NPI) as the standard identifier in a Final Rule issued January 23, 2004. The NPI is a 10-position number, with a check-digit in the last position, and no intelligence about the provider in the number. The preamble of the Final Rule includes discussions on how providers will get NPIs, what system will generate the NPIs, what information is needed to assign NPIs, what information will be disseminated from the system and to whom. It also discussed requirements that will be imposed on health plans, health care providers, and health care clearinghouses regarding the NPI, what impact the NPI will have on those entities, what uses will be made of the NPI, and the cost associated with building and maintaining the enumeration system, enumerating providers and keeping their data current. The effective date of the NPI Final Rule is May 23, 2005, which marks the beginning of the enumeration phase for the NPI. Beginning on the effective date, health care providers may apply for NPIs. The compliance date of the NPI is May 23, 2007, the date by which covered entities (except small health plans) must obtain and use the NPI in standard transactions. Small health plans must comply beginning May 23, 2008. Small health plans are health plans with annual revenues of $5 million or less. The Final Rule states that NPIs will be issued by one organization known as “Enumerator”. The National Plan and Provider Enumeration System (NPPES) is the computer system that will be used to uniquely identify health care providers, assign them NPIs, update their information, and disseminate data to the industry The administrative simplification provisions of the Health Insurance Portability and Accountability Act (HIPAA) of 1996 (P.L. 104-191) also require the Secretary of Health and Human Services to adopt a standard unique national identifier for health plans for use in the health care industry. CMS has not yet adopted the standard unique identifier for health plans. Once CMS adopts that standard, and upon the effective date of that Final Rule, the NPPES will assign that identifier to health plans. DESCRIPTION OF REQUIREMENTS: The contractor, generally, will carry out a number of functions, including, but not limited to, entering identifying information about a health care provider into the NPPES for those providers applying by paper application; provide NPI application forms to providers upon request; notifying such a provider of its NPI. The contractor will process provider information updates received from providers via paper applications. The contractor will be responsible for assisting providers with questions or problems, including assisting those providers applying for NPIs by the Internet. The contractor will handle all requests for deactivations and replacement NPIs for providers. The contractor will handle potential error resolutions including investigating and resolving pending applications (applications with errors that prevent the NPPES from assigning an NPI). The contractor will work with provider organizations that wish to submit files through Electronic File Interchange (EFI). The contractor will validate the organization’s identity and establish accounts. The contractor will be responsible for working with organizations to determine if their providers have NPIs. The contractor will be responsible for resetting the web users passwords and user IDs. The contractor will be responsible for maintaining a call center for providers. This announcement is not a request for proposal (RFP). CMS anticipates release of the Request for Proposal in early November 2004 and it will be made available electronically at http://www.fedbizopps.gov.