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TRICARE Operations Manual 6010.62-M, April 2021
Transitions
Chapter 2
Section 6
Critical Processes - Records Management
Revision:  
1.0  RECORDS TRANSITION - GENERAL
The incoming contractor’s Records Management Liaison shall attend the Defense Health Agency (DHA)-provided records management training prior to the start of health care delivery (SHCD) in accordance with Chapter 9, Section 1.
2.0  OUTGOING CONTRACTOR RESPONSIBILITES
2.1  The outgoing contractor shall develop an Outgoing Records Transfer Report that details the process and timeliness of the transfer of all DHA records. For report submission requirements, see DD Form 1423, Contract Data Requirement List (CDRL), located in Section J of the applicable contract.
2.2  The Government will review and set up a meeting if necessary to discuss the initial Outgoing Records Transfer Report.
2.3  The outgoing contractor shall transfer all DHA records not eligible for destruction, along with its associated metadata, to the incoming contractor or DHA Records Management in accordance with Chapter 9.
2.4  The outgoing contractor shall transfer DHA records to the appropriate receiving party (i.e., incoming contractor or DHA Records Management) no later than the following timeline and this timeline is applicable only for records management tracking purposes:
•  Thirty (30) calendar days after the Transition Specification (TRANSPEC) meeting, a cross-section representation of DHA records shall be transferred to include the record layouts with specifications, formats, definitions of fields and data elements, access keys, and sort orders, for the following, but not limited to:
•  Beneficiary History Files
•  Claims History Files
•  TRICARE Encounter Provider Files (TEPRVs)
•  Enrolled Beneficiary and Primary Care Manager (PCM) Assignment Files
•  Automated Data Processing (ADP) files, such as the Provider and Pricing Files
•  Case Management (CM)/Care Coordination Files
•  Two hundred and ten (210) calendar days prior to the end of Health Care Delivery (HCD), one year of history (the one year period begins with the date of the transfer minus one year).
•  One hundred and fifty (150) calendar days prior to end of HCD additional on year of history (year 2).
•  Ninety (90) calendar days prior to the end of HCD additional one year of history (year 3).
•  Thirty (30) calendar days prior to the end of HCD, the outgoing contractor shall transfer records from 180 days to 30 days from the end of HCD.
•  For the last 30 days of HCD, the outgoing contractor shall transfer records to the incoming contractor weekly. The records shall be transferred no later than the second business day of the week.
•  Thirty (30) calendar days after the end of HCD, additional two years of history (years 4 and 5).
•  Sixty (60) calendar days after the end of HCD, additional two years of history (years 6 and 7).
•  Ninety (90) calendar days after the end of HCD, additional two years of history (years 8 and 9).
•  One hundred and twenty (120) calendar days after the end of HCD, all remaining records shall be delivered.
2.5  The outgoing contractor shall transfer all electronic records to DHA Records Management that are responsive to records freeze or that are considered contractor’s proprietary records.
2.5.1  The outgoing contractor shall transfer all records to DHA Records Management if there is no incoming contractor.
2.5.2  The outgoing contractor shall request approval from the DHA Records Management Officer (RMO) prior to transferring records to the DHA Records Management Office.
2.5.3  The outgoing contractor shall follow electronic records transfer procedures as described in Chapter 9, Section 4 and Chapter 9, Addendum B to transfer electronic records to DHA.
2.5.4  The outgoing contractor shall provide records in the native electronic format in which the record was created or received. Mainframe screen shots or any other system screenshots are not acceptable record formats. The acceptable formats of records are detailed in Chapter 9, Section 3.
2.5.5  The outgoing contractor shall include required metadata files that support the accessibility, usability, searchability, and retrievability of the images. This includes any unique identifiers used to accurately retrieve electronic records or record objects.
2.6  The outgoing contractor shall communicate, collaborate, and coordinate with the incoming contractor and DHA Records Management to report and resolve issues related to records transfer activities.
2.6.1   The outgoing contractor shall inform the Contracting Officer (CO) and DHA Records Management Office of any records it considers proprietary.
2.6.2  The outgoing contractor shall identify proprietary data in records within 30 calendar days of contract award.
2.7  The outgoing contractor shall communicate, collaborate, and coordinate with the incoming contractor and DHA Records Management to conduct Proof of Concept testing to ensure the file format is acceptable and records are accessible, usable, searchable and retrievable no later than 30 calendar days prior to the start of records transfer.
2.8  The outgoing contractor shall communicate, collaborate, and coordinate with the Government Designated Authority (GDA) and the incoming contractor to provide a monthly update of transfer records activity in accordance with the Outgoing Records Transfer Report, Integrated Master Plan (IMP) and Integrated Master Schedule (IMS).
2.9  Records Disposition
2.9.1  The outgoing contractor shall comply with the provisions of Chapter 9, Section 1 for final disposition of all files and documentation.
2.9.2  The outgoing contractor shall destroy all copies to include backup data in accordance with 36 Code of Federal Regulation (CFR) Part 1226, “Implementing Disposition”, once the transition of records and materials has been accomplished as outlined in above paragraphs.
2.9.3  The outgoing contractor shall not dispose or destroy any copies or backup data prior to formal written notification from the DHA Contracting Office and DHA RMO.
2.9.4  The outgoing contractor shall follow the provisions of Chapter 9, Section 5, Destruction of Records.
2.9.5  The outgoing contractor shall document the removal of extra copies of records after a successful transfer of electronic records to the incoming contractor, as identified by DD Form 1423, CDRL, located in Section J of the applicable contract, Declaration of Transfer and Destruction of Records, and in accordance with 36 CFR Chapter XII, Subchapter B, Department of Defense Manual (DoDM) 5200.01, and DoD Instruction (DoDI) 8510.01.
2.9.6  The incoming contractor shall document permanent removal of electronic records that have met their legal disposition, as identified by DD Form 1423, CDRL, located in Section J of the applicable contract, Declaration of Transfer and Destruction of Records, in accordance with 36 CFR Chapter XII, Subchapter B, DoDM 5200.01, and DoDI 8510.01.
3.0  INCOMING CONTRACTOR RESPONSIBILITES
3.1  The incoming contractor shall develop an Incoming Records Transfer Report that details the process and timeliness of the receipt of all DHA records transferred from the outgoing contractor. For plan submission requirements, see DD Form 1423, CDRL, located in Section J of the applicable contract.
3.1.1  The Government will review and either accept or reject the initial Incoming Records Transfer Report.
3.1.2  The incoming contractor shall resubmit the revised Incoming Records Transfer Report within 15 calendar days to the Government’s, if the Incoming Records Transfer Report is rejected.
3.2  The incoming contractor shall receive all DHA records not eligible for destruction, along with their associated metadata, from the outgoing contractor in accordance with Chapter 9, Section 2.
3.3  The incoming contractor shall contact the DHA Records Management Office to recall records from the Federal Records Center (FRC).
3.4  The incoming contractor will receive DHA Records from the outgoing contractor in accordance with the following timeline no later than the following timeline and this timeline is applicable only for records management tracking purposes:
•  Thirty (30) calendar days after the TRANSPEC meeting, a cross-section representation of DHA records shall be transferred to include the record layouts with specifications, formats, definitions of fields and data elements, access keys, and sort orders, for the following, but not limited to:
•  Beneficiary History Files
•  Claims History Files
•  TEPRVs
•  Enrolled Beneficiary and PCM Assignment Files
•  ADP files, such as the Provider and Pricing Files
•  Two hundred and ten (210) calendar days prior to the end of HCD, one year of history (the one year period begins with the date of the transfer minus one year).
•  One hundred and fifty (150) calendar days prior to end of HCD additional on year of history (year 2).
•  Ninety (90) calendar days prior to the end of HCD additional one year of history (year 3).
•  Thirty (30) calendar days prior to the end of HCD, the outgoing contractor shall transfer records from 180 days to 30 days from the end of HCD.
•  For the last 30 days of HCD, the outgoing contractor shall transfer records to the incoming contractor weekly. The records shall be transferred no later than the second business day of the week.
•  Thirty (30) calendar days after the end of HCD, additional two years of history (years 4 and 5).
•  Sixty (60) calendar days after the end of HCD, additional two years of history (years 6 and 7).
•  Ninety (90) calendar days after the end of HCD, additional two years of history (years 8 and 9).
•  One hundred and twenty (120) calendar days after the end of HCD, all remaining records shall be delivered.
3.5  The incoming contractor shall communicate, collaborate, and coordinate with the outgoing contractor and DHA Records Management to conduct Proof of Concept testing to ensure the file format is acceptable and records are accessible, usable, searchable and retrievable no later than 30 calendar days prior to the start of records transfer.
3.6  The incoming contractor shall communicate, collaborate, and coordinate with the outgoing contractor and DHA Records Management to report and resolve issues related to records transfer activities.
3.7  The incoming contractor shall communicate, collaborate, and coordinate with the GDA and the outgoing contractor to provide a biweekly update of transfer records activity in accordance with the Incoming Records Transfer Report, IMP and IMS.
3.8  The incoming contractor shall validate that all transferred records are accessible, usable, searchable, and retrievable no later than 30 calendar days after receipt from the outgoing contractor.
3.9  The incoming contractor shall continue the validation process until the full set of records transferred has been completed and all transferred records have been validated.
3.10  The incoming contractor shall sign off the custodial ownership document confirming the acceptance of transferred records following their validation of the accessibility, usability, searchability, and retrievability of the transitioned records.
3.11  The incoming contractor shall complete and submit the custodial ownership document as identified by DD Form 1423, CDRL, located in Section J of the applicable contract.
4.0  PROGRAM INTEGRITY CASES
4.1  The outgoing contractor shall deliver to the incoming contractor all case files and documentation regarding all open program integrity cases, all open leads under development, and proactive action items to the incoming contractor no later than 30 calendar days prior to the SHCD for the incoming contractor.
4.2  The incoming contractor shall contact the DHA Program Integrity Office the next business day of the receipt of the files to ensure seamless continuity of oversight of these cases, leads, and action items.
4.3  The outgoing contractor shall provide weekly updates, following the initial transfer of case files and documentation, to include new cases under development, active leads, and proactive action items to DHA PI and the incoming contractor as identified by DD Form 1423, CDRL, located in Section J of the applicable contract.
5.0  PERFORMANCE READINESS VALIDATION (PRV)/PERFORMANCE READINESS ASSESSMENT AND VERIFICATION (PRAV)
During transition, the incoming contractor’s performance readiness status regarding records management will be subject to PRV/PRAV reviews as described below.
5.1  Records Management PRV
5.1.1  The incoming contractor shall continually monitor and validate its progress towards receiving records from the outgoing contractor and ensuring that the file format is acceptable and records are accessible, usable, searchable and retrievable during the transition-in period. Progress shall be monitored based on the time lines and goals established in the IMP and IMS.
5.1.2  The incoming contractor shall brief the validation results monthly to the Government for the duration of the transition period.
5.1.3  The incoming contractor shall conduct a re-validation of a percentage of records transferred no later than 30 calendar days following submission of the custodial ownership document.
5.1.4  The incoming contractor shall identify a random sample equal to 5% of each record set (e.g., claims, referrals and authorizations) and re-validate that the file format is acceptable and the records are accessible, usable, searchable, and retrievable.
5.2  Records Management PRAV
5.2.1  The incoming contractor shall comply with the Government’s approach for assessment and verification of the contractor’s performance readiness regarding records management as described above.
5.2.2  The incoming contractor must submit a detailed mitigation plan no later than 10 business days if, after review, the Government finds the contractor’s performance readiness for records management to be deficient.
5.2.3  Specific PRAV activities, assessment techniques, and performance readiness thresholds will be identified by the Government during the TRANSPEC meeting.
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