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TRICARE Operations Manual 6010.62-M, April 2021
Transitions
Chapter 2
Section 3
Critical Processes (CPs) - Provider Networks
Revision:  
1.0  TRANSITION-IN ACTIVITIES
1.1  The incoming contractor shall establish an adequate network of providers for all TRICARE beneficiaries in its geographical area of responsibility in accordance with the contract and access standards outlined in Chapter 5, Section 1 and 45 Code of Federal Regulations (CFR) 156.230.
1.2  The incoming contractor shall not rely on the provider data base from the outgoing contractor to create the network of providers.
1.3  The incoming contractor shall have completed 100% of provider network development (to include completion of provider agreements and credentialing) no later than 60 calendar days prior to the start of health care delivery (SHCD).
1.4  The incoming contractor shall ensure the network of providers have the capability and capacity to enroll all beneficiaries eligible in accordance with Chapter 5, Section 1, no later than 60 calendar days prior to the SHCD.
1.5  The incoming contractor shall submit a Network Implementation Plan (NIP), as identified in DD Form 1423, Contract Data Requirements List (CDRL), located in Section J of the applicable contract. Submission of the NIP shall be no later than 240 calendar days prior to the SHCD.
1.5.1  The incoming contractor shall include in the NIP a Network Sizing Model establishing contracting targets sufficient to support the program’s access standards for all TRICARE beneficiaries.
1.5.2  The Government will review and either accept or reject the initial NIP. If the NIP is rejected, the incoming contractor shall resubmit the revised NIP within 15 calendar for the Government’s review and acceptance.
1.6  The incoming contractor shall begin reporting on network status (Network Status Report), as identified in DD Form 1423, CDRL, located in Section J of the applicable contract. Reporting shall start 150 calendar days prior to the start of the SHCD.
1.7  The incoming contractor shall ensure written agreements established with institutional providers comply with Chapter 5, Section 1. Actions shall be completed no later than 60 calendar days prior to the SHCD.
1.8  The incoming contractor shall provide a Behavioral Health (BH) network status report that includes subspecialties of individual providers. For reporting requirements, see DD Form 1423, CDRL, located in the Section J of the applicable contract.
1.9  The incoming contractor shall provide a report detailing freestanding psychiatric and/or Substance Use Disorder (SUD) facilities. For reporting requirements, see DD Form 1423, CDRL, located in the Section J of the applicable contract.
2.0  PROVIDER CERTIFICATION
2.1  The outgoing contractor shall transfer to the incoming contractor all provider certification files to the incoming contractor no later than 30 calendar days after contract award in accordance with Chapter 9, Section 2. Updates will be provided to the incoming contractor monthly until the incoming contractor’s SHCD.
2.2  The incoming contractor shall limit certification actions to new providers and shall verify a provider’s credential upon application to become a certified provider.
3.0  WRITTEN AGREEMENTS WITH INSTITUTIONAL PROVIDERS
3.1  The incoming contractor shall establish written agreements with each institutional provider over which the contractor has review authority. These agreements shall be maintained throughout health care delivery. Agreements shall specify that:
•  Institutional providers shall cooperate with the incoming contractor in the assumption and conduct of review activities.
•  Institutional providers shall allocate adequate space for the conduct of on-site review.
•  Institutional providers shall deliver to the incoming contractor a paper or electronic copy of all required information within 30 calendar days of a request for off-site review.
•  Institutional providers shall provide all beneficiaries, in writing, their rights and responsibilities (e.g., “An Important Message from TRICARE” (Chapter 7, Addendum A), “Hospital Issued Notice of Noncoverage” (Chapter 7, Addendum B)).
•  Institutional providers shall inform the incoming contractor within one business day if they issue a notice that the beneficiary no longer requires inpatient care.
•  The contractor shall notify the Primary Care Manager (PCM) (if TRICARE Prime) within one business day of the inpatient discharge.
•  Institutional providers shall assure that each case subject to preadmission or pre-procedure review has been reviewed and approved by the incoming contractor.
•  Institutional providers shall agree, when they fail to obtain certification as required, that they shall accept full financial liability for any admission subject to preadmission review that was not reviewed and is subsequently found to be medically unnecessary or provided at an inappropriate level (32 CFR 199.15(g)).
3.2  The incoming contractor shall reimburse the provider for the costs of providing documents using the same reimbursement as Medicare.
3.3  The incoming contractor shall provide detailed information on the review process and criteria used, including financial liability incurred by failing to obtain preauthorization.
4.0  PERFORMANCE READINESS VALIDATION (PRV)/PERFORMANCE READINESS ASSESSMENT AND VERIFICATION (PRAV)
During transition, the incoming contractor’s performance readiness status regarding provider networks will be subject to PRV/PRAV reviews as described below.
4.1  Provider Credentialing PRV
4.1.1  The incoming contractor shall conduct an audit, which must include either 5% (but not less than 50) or 100 (50% initial files as is available, 50% re-credential files), whichever is less, of all contractors’ and subcontractors’ network provider credentialing and privileging files and facility credentialing files, including: individual providers, facilities, BH facilities, to ensure that information is appropriately verified and timeliness standards are met.
4.1.1.1  Not less than 95% of the audited files shall be in full compliance with all provider file requirements.
4.1.1.2  The audit shall be completed no later than 90 calendar days prior to the SHCD.
4.1.2  The incoming contractor shall notify and invite the Government to observe the contractor’s audit no later than 30 calendar days prior to the scheduled audit. At the time of the audit, the Government will identify the provider and facility type of files to be audited.
4.1.3  The incoming contractor shall submit a written Corrective Action Plan (CAP) to the Government no later than five business days after the audit, which addresses all credentialing and privileging files not in full compliance.
4.1.4   The incoming contractor shall have corrected all deficient files to full compliance and inform the Government no later than 30 calendar days after completion of the audit. Documentation shall be completed in accordance with DD Form 1423, CDRL, located in Section J of the applicable contract.
4.2  Provider Network PRV
4.2.1  The incoming contractor shall validate they have established an adequate network in its geographical area of responsibility for PCMs, BH providers, specialty care providers, and inpatient health care facilities (institutional providers) no later than 60 calendar days prior to the SHCD.
Note:  For the purposes of assessing adequacy, the validation shall assess all Prime Service Areas (PSAs) in the geographical area of responsibility individually and not the geographical area of responsibility as whole.
4.2.2  The incoming contractor shall ensure accurate and complete provider information is entered into contractor and Government automated provider files that interface directly with the Defense Enrollment and Eligibility Reporting System (DEERS), contractor Medical Management (MM) systems, and supporting MM systems identified by the Government not later than 60 calendar days prior to the SHCD.
•  Loading PCMs into DEERS shall begin no later than 150 calendar days prior to the SHCD.
•  Fifty percent (50%) of the PCMs shall be loaded into DEERS no later than 120 calendar days prior to the SHCD.
•  Seventy-five percent (75%) of the PCMs shall be loaded into DEERS no later than 100 calendar days prior to the SHCD.
•  One hundred percent (100%) of the PCMs shall be loaded into DEERS no later than 60 calendar days prior to the SHCD.
Note:  At a minimum, the contractor shall load the required number of PCMs for every PSA.
4.2.3  The incoming contractor shall validate accurate and complete provider system loads for all network providers.
4.2.3.1  The incoming contractor shall submit load file completion report, in accordance with DD Form 1423, CDRL, located in Section J of the applicable contract to the Government which compare the percentage of providers loaded into the requisite systems with the number of providers required by the contractor’s NIP.
4.2.3.2  The reports shall include the incoming contractor’s accuracy attestation to the Government regarding the total number of provider system loads by category (PCMs, BH, specialty care providers, and inpatient health care facilities) and the percentage of records loaded that meet the scheduled accuracy threshold listed below in all data fields.
4.2.3.3  The incoming contractor validation standards are as follows:
•  Fifty percent (50%) of all providers loaded no later than 120 calendar days prior to the SHCD at a 90% accuracy rate.
•  Seventy-five percent (75%) of all providers loaded no later than 90 calendar days prior to the SHCD at a 90% accuracy rate.
•  One hundred percent (100%) of all providers loaded no later than 60 calendar days prior to the SHCD at a 95% accuracy rate.
Note:  At a minimum, the contractor shall load the required number of providers for every PSA.
4.2.4  The incoming contractor shall validate the completeness and accuracy of the online directory of network providers.
4.2.4.1  The incoming contractor shall submit validation reports to the Government as identified below. The reports shall compare the number of network providers and facilities who have been entered in the online directory to the total number of network providers and facilities required by the contractor’s NIP.
4.2.4.2  The incoming contractor validation standards are as follows:
•  Fifty percent (50%) of network providers and health care facilities entered no later than 120 calendar days prior to the SHCD at a 90% accuracy rate.
•  Seventy-five percent (75%) of network providers and health care facilities entered no later than 90 calendar days prior to the SHCD at a 90% accuracy rate.
•  One hundred percent (100%) of network providers and health care facilities entered no later than 60 calendar days prior SHCD at a 95% accuracy rate.
4.2.4.3  The incoming contractor shall validate that its provider directory is online and operational 60 calendar days prior to the SHCD at a 95% accuracy rate.
4.2.5  The incoming contractor shall validate accurate and complete provider system loads for all specialty providers.
4.2.5.1  The incoming contractor shall submit load file completion report, in accordance with DD Form 1423, CDRL, located in Section J of the applicable contract to the Government which compare the percentage of providers loaded into the requisite systems with the number of providers required by the contractor’s NIP.
4.2.5.2  The reports shall include the incoming contractor’s accuracy attestation to the Government regarding the total number of provider system loads by category (PCMs, BH, specialty care providers, and inpatient health care facilities) and the percentage of records loaded that meet the scheduled accuracy threshold listed below in all data fields.
4.2.5.3  The incoming contractor validation standards are as follows:
•  Fifty percent (50%) of specialty providers loaded no later than 120 calendar days prior to the SHCD at a 90% accuracy rate.
•  Seventy-five percent (75%) of specialty providers loaded no later than 90 calendar days prior to the SHCD at a 90% accuracy rate.
•  One hundred percent (100%) of specialty providers loaded no later than 60 calendar days prior to the SHCD at a 95% accuracy rate.
Note:  At a minimum, the contractor shall load the required number of specialty providers for every PSA.
4.2.6  The incoming contractor shall validate accurate and complete provider system loads for all BH providers.
4.2.6.1  The incoming contractor shall submit load file completion report, in accordance with DD Form 1423, CDRL, located in Section J of the applicable contract to the Government which compare the percentage of providers loaded into the requisite systems with the number of providers required by the contractor’s NIP.
4.2.6.2  The reports shall include the incoming contractor’s accuracy attestation to the Government regarding the total number of provider system loads by category (PCMs, BH, specialty care providers, and inpatient health care facilities) and the percentage of records loaded that meet the scheduled accuracy threshold listed below in all data fields.
4.2.6.3  The incoming contractor validation standards are as follows:
•  Seventy-five percent (75%) of BH providers loaded no later than 120 calendar days prior to the SHCD at a 90% accuracy rate.
•  One hundred percent (100%) of BH providers loaded no later than 90 calendar days prior to the SHCD at a 95% accuracy rate.
Note:  At a minimum, the contractor shall load the required number of BH providers for every PSA.
4.2.7  The incoming contractor shall validate accurate and complete provider system loads for all inpatient healthcare facilities.
4.2.7.1  The incoming contractor shall submit load file completion report, in accordance with DD Form 1423, CDRL, located in Section J of the applicable contract to the Government which compare the percentage of providers loaded into the requisite systems with the number of providers required by the contractor’s NIP.
4.2.7.2  The reports shall include the incoming contractor’s accuracy attestation to the Government regarding the total number of provider system loads by category (PCMs, BH, specialty care providers, and inpatient health care facilities) and the percentage of records loaded that meet the scheduled accuracy threshold listed below in all data fields.
4.2.7.3  The incoming contractor validation standards are as follows:
•  Fifty percent (50%) of inpatient healthcare facilities loaded no later than 120 calendar days prior to the SHCD at a 90% accuracy rate.
•  Seventy-five percent (75%) of inpatient healthcare facilities loaded no later than 90 calendar days prior to the SHCD at a 90% accuracy rate.
•  One hundred percent (100%) of inpatient healthcare facilities loaded no later than 60 calendar days prior to the SHCD at a 95% accuracy rate.
Note:  At a minimum, the contractor shall load the required number of inpatient healthcare facilities for every PSA.
4.2.8  The incoming contractor shall provide the Government with a comprehensive briefing on the processes, results, and course of actions no later than five calendar days after completion of each PRV activity.
4.3  Provider Network PRAV
4.3.1  The incoming contractor shall comply with the Government’s approach for assessment and verification of the contractor’s performance readiness regarding provider networks as described above. If, after review, the Government finds the contractor’s performance readiness to be deficient, the contractor shall submit a detailed mitigation plan no later than 10 business days following the Government’s findings.
4.3.2  Specific PRAV activities, assessment techniques, and performance readiness thresholds will be identified by the Government during the Transition Specifications (TRANSPEC) Meeting.
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