Notice ID: 36C10B21R0021
The Department of Veterans Affairs (VA) has a requirement for a secure data transport service between the VA and Medicare Administrative Contractor (MAC) using Centers for Medicare and Medicaid Services (CMS)-approved, commercially available Internet-based connection services that enable VA to obtain the MAC-initiated Unsolicited Response (UR) transactions and provide fail-over connectivity between the MAC and VA should the connectivity be disrupted. The MAC processes the Medicare claim transactions from VA Medical Centers and renders a Medicare-equivalent Remittance Advice (e-MRA).
The purpose of the e-MRA initiative is to obtain the adjudication information that would be generated if VA were permitted to bill and receive reimbursement from Medicare. VA acquires this adjudication information through a MAC under contract with CMS. CMS has agreed to provide the data using the MAC-initiated data transfers, also referred to as UR.
The Contractor shall provide the license for a service that will enable transfer of MAC-initiated unsolicited responses between the VA and CMS. The Contractor shall be approved to be CMS as administrators of this data. These services include provision of a secure data transport service between VA and the MAC that is recognized by CMS as an authorized VPN Internet-based commercially available connection. The service shall comply with the following additional constraints:
- The service shall not require VA to install vendor software or hardware within the VA environment
- The service shall provide Medicare patient deductible and co-insurance amounts related to non-VA health care from the MAC under contract with the CMS without any changes to the current file structure used by the VA. (See Appendix A)
- The service shall enable VA/MAC data exchanges utilizing a VA/vendor VPN and Secure File Transfer Protocol (SFTP) as approved by the VA Office of Information and Technology Configuration Management Division and the Enterprise Security Configuration Control Board;
- The service shall provide one-way data transfers from the MAC without a VA-initiated request for data passing through this service;
- The service shall support unlimited transactions…
