Skip to main content

Military Health System

Utility Navigation Links

WEEKEND MAINTENANCE: The maintenance outage is scheduled for June 22nd at 6:00am EST ending NLT Sunday, June 23rd at 11:59pm Eastern EST. The TRICARE Manuals web site may be available intermittently during this period but it's usage is not recommended.

TRICARE Operations Manual 6010.62-M, April 2021
Transitions
Chapter 2
Section 1
Management and Administration
Revision:  
1.0  CONTRACT TRANSITION MEETINGS
1.1  Transition Specifications (TRANSPEC) Meeting
1.1.1  The incoming and outgoing contractor shall attend a five business day meeting with the Defense Health Agency (DHA) within 15 calendar days following contract award.
1.1.2  The Government will notify the incoming and outgoing contractor(s) as to the exact date, length, and location of the meeting, and will provide the meeting agenda prior to the TRANSPEC Meeting.
1.1.3  The incoming contractor shall provide to the Government, at the TRANSPEC Meeting, a technical Point Of Contact (POC) for each of the Systems Interface Meetings listed in Chapter 2, Section 2.
1.2  Interface Meetings
1.2.1  The incoming contractor shall meet with DHA Communications within 30 calendar days following contract award to review requirements in Chapter 11, and other DHA Communications associated activities.
1.2.2  The incoming contractor shall meet with DHA Records Management (RM) and Contracting Officer (CO) within 30 calendar days following contract award to establish concurrence of the DHA records transfer requirements and the Incoming Records Transfer Plan. For reporting requirements, see DD Form 1423, Contract Data Requirements List (CDRL), located in Section J of the applicable contract.
1.2.3  The incoming contractor shall adhere to the System Interface Meeting requirements identified in Chapter 2, Section 2.
1.2.4  The Government will notify the incoming contractor as to the exact date, length, and location of all interface meeting(s), and will provide the meeting agenda prior to the meeting(s).
1.3  Transition Status Meetings
1.3.1  The incoming contractor shall participate in transition-in meetings to provide the Government a status or progress of all transition activities.
1.3.2  The outgoing contractor shall participate in transition-out meetings to provide the Government a status or progress of all transition out activities.
1.3.3  The Government will notify the incoming and outgoing contractors as to the frequency, location, and provide the agenda of the meeting(s).
2.0  INTEGRATION WITH MARKETS AND MILITARY MEDICAL TREATMENT FACILITIES (MTFs)
2.1  The incoming contractor shall conduct site visits to Coast Guard leadership sites, Markets, and other sites designated by DHA at the TRANSPEC Meeting.
2.2  These meetings shall be conducted no later than 60 calendar days after the TRANSPEC Meeting. The purpose of these visits, at a minimum, shall be to address local optimization opportunities and challenges to implement the requirements in Chapter 15 and to begin the development of the Memorandum of Understanding (MOU).
2.3  The incoming contractor shall conduct site visits to MTFs, Coast Guard Clinics, and sites designated by DHA at the TRANSPEC Meeting. These meetings shall be conducted no later than 100 calendar days after the TRANSPEC Meeting.
2.4  The purpose of these visits, at a minimum, shall be to address local optimization opportunities and challenges to implement the requirements in Chapter 15 and to begin the development of the MOU.
2.5  The Government will provide the meeting agenda for the Integration Meetings at the TRANSPEC Meeting.
2.6  The outgoing contractor shall communicate, collaborate, and coordinate with the incoming contractor to allow an orderly transition, without interruption, of all functions relating to the Markets and MTFs.
3.0  External Resource Sharing Agreements (ERSAs), Internal Resource Sharing Agreements (IRSAs), and Clinical Sharing Agreements (CSAs)
3.1  The incoming contractor shall include in its Integrated Master Plan (IMP) and Integrated Master Schedule (IMS) its ERSA, IRSA, and CSA implementation plan for execution at the start of health care delivery (SHCD) to prevent any break in service.
3.2  The incoming contractor shall deliver its MTF Market Optimization Support plan 60 calendar days prior the SHCD as identified by DD Form 1423, CDRL, located in Section J of the applicable contract.
3.3  The Government will review and either accept or reject the contract deliverables. If the deliverable is rejected, the incoming contractor shall resubmit the revised plan within 15 calendar days for the Government’s review and acceptance.
3.4  The incoming contractor shall receive from the outgoing contract a list of all existing ERSAs, IRSAs, and CSAs no later than 30 calendar days after the TRANSPEC Meeting.
3.5  The incoming contractor shall contact all Markets and MTFs with existing ERSAs, IRSAs, and CSAs within 10 calendar days of the receipt of outgoing contractors file to begin the process of transitioning the agreements for implementation at the SHCD.
3.6  The incoming contractor shall provide the Markets and MTFs its instructions (how to begin proposals and Business Case Analysis (BCAs) template) to initiate new ERSAs, IRSAs, and CSAs at the interface meetings for implementation at the SHCD.
3.7  The Market and MTF will submit to the incoming contractor any new proposals and BCAs including all Provider Types, Support Staff, and Current Procedural Terminology (CPT) codes back to the incoming contractor to complete their analysis 30 calendar days after the interface meeting.
3.8  The incoming contract shall complete new BCAs within 30 calendar days of receiving request for ERSAs, IRSAs, and CSAs proposals and return to DHA/Market/MTF for review.
3.9  The incoming contractor shall prioritize and establish network agreements with Civilian Network Facilities with ERSAs, or alternatively find a facility that meets the needs of the ERSA. The incoming contractor shall also prioritize contracting with CSA and IRSA providers and non-provider support staff to prevent a break in service to the Markets/MTFs.
3.10  The incoming contract shall have 90% of ERSAs, IRSAs, and CSAs fully executed 30 calendar days prior to the SHCD, to begin at SHCD.
4.0  TRANSITION-IN DELIVERABLES
4.1  The incoming contractor shall deliver an IMP, as identified by DD Form 1423, CDRL, located in Section J of the applicable contract.
4.2  The incoming contractor shall deliver an IMS, as identified by DD Form 1423, CDRL, located in Section J of the applicable contract.
4.3  The Government will review and either accept or reject the IMS and IMP. If the deliverable is rejected, the incoming contractor shall resubmit the IMS or the IMP within 15 calendar days for the Government’s review and acceptance.
4.4  The incoming contractor shall deliver a weekly IMP, as identified by DD Form 1423, CDRL, located in Section J of the applicable contract.
4.5  The incoming contractor shall deliver a weekly IMS, as identified by DD Form 1423, CDRL, located in Section J of the applicable contract.
4.6  The incoming contractor shall deliver a weekly risk and mitigation report, as identified by DD Form 1423, CDRL, located in Section J of the applicable contract.
5.0  TRANSITION-OUT ACTIVITIES
5.1  The outgoing contractor shall provide the Government the name of its project manager at the TRANSPEC Meeting who will be responsible for transition-out activities who will serve as the single point of contact for the Government.
5.2  The outgoing contractor shall provide a proposed Phase-Out Plan at the TRANSPEC Meeting as identified by DD Form 1423, Contract Data Requirements List (CDRL), located in Section J of the applicable contract.
5.3  The Government will review and either accept or reject the phase-out plan. If the phase-out plan is rejected, the outgoing contractor shall resubmit the revised phase-out plan within 15 calendar for the Government’s review and acceptance.
5.4  The outgoing contractor shall meet with DHA Records Management within 30 calendar days following contract award to establish concurrence of the DHA Records transfer requirements and for the Outgoing Records Transfer Plan. For reporting requirements, see DD Form 1423, CDRL, located in Section J of the applicable contract.
5.5  The outgoing contractor shall submit a weekly status report of inventories and phase-out activities to DHA beginning the 20th calendar day following the TRANSPEC Meeting as identified by DD Form 1423, CDRL, located in Section J of the applicable contract.
5.6  The outgoing contractor shall provide the incoming contractor the most recent version of all Market and MTF MOUs in place at that time for the purpose of ensuring continuity of services and continuity of care for TRICARE beneficiaries. The transfer of the MOUs shall take place no later than 30 calendar days following contract award.The outgoing contractor shall provide the incoming contractor a list of all existing ERSAs, IRSAs and CSAs with the Markets and MTFs no later than 30 calendar days after the TRANSPEC Meeting.
6.0  MOU WITH THE DHA
The incoming contractor shall prepare an MOU with the Healthcare Operations Directorate (HCO), and Statements of Responsibility (SOR) with each standalone MTF and Market in accordance with Chapter 15, Section 1.
7.0  PERFORMANCE READINESS VALIDATION (PRV) - GENERAL
7.1  The incoming contractor shall conduct PRV to assess their performance readiness in following areas in accordance with this chapter:
•  Management
•  Enrollments
•  Provider Networks
•  Customer Service
•  Records Management
•  Referral Management
•  Claims Processing
•  Medical Management (MM)
7.2  The incoming contractor shall provide the Government a comprehensive briefing on the processes, results, and course of actions of each PRV assessments no later than five calendar days after the assessment.
8.0  PERFORMANCE READINESS ASSESSMENT AND VERIFICATION (PRAV) - GENERAL
8.1  The Government will conduct PRAV activities to assess and verify the incoming contractor’s performance readiness identified in paragraph 5.0.
8.2  The Government will provide the incoming contractor with projected PRAV dates, location(s), team structure, and specific assessment and verification methods prior to PRAV activities.
8.3   Following the completion of a PRAV activity, the Government will provide a brief to the incoming contractor(s) on findings. If, after review, the Government finds the incoming contractor’s performance readiness to be deficient, the incoming contractor shall submit a detailed mitigation plan no later than 10 calendar days following the Government’s findings.
9.0  PRV/PRAV - MANAGEMENT
During transition, the incoming contractor’s performance readiness status regarding management will be subject to PRV and PRAV reviews as described below.
9.1  Management PRV
9.1.1  The incoming contractor shall validate its ability to provide training and ongoing customer support for Government personnel who access the contractor’s data information system(s) and data repository as required by the contract. The validation results shall be briefed to the Government no later than 75 calendar days prior to the SHCD.
9.1.2  The incoming contractor shall validate its ability to provide Government users with access to the data information system(s) and data repository required by the contract via a data access interface mutually agreed upon by the Government and available prior to the SHCD. The validation results shall be briefed to the Government no later than 60 calendar days prior to the SHCD.
9.2  Management PRAV
9.2.1  The incoming contractor shall comply with the Government’s approach for assessment and verification of the contractor’s performance readiness regarding management as described above. If, after review, the Government finds the incoming contractor’s performance readiness for management to be deficient, the incoming contractor must submit a detailed mitigation plan no later than 10 calendar days following the Government’s findings.
9.2.2  Specific PRAV activities, assessment techniques, and performance readiness thresholds will be identified by the Government during the TRANSPEC Meeting.
- END -
Follow us on Instagram Follow us on LinkedIn Follow us on Facebook Follow us on Twitter Follow us on YouTube Sign up on GovDelivery