NOTICE OF PROPOSED PROCUREMENT (NPP)
Solicitation # 1000194072 Closing Date: January 29, 2018 @2pm Eastern Standard Time (EST)
This requirement is for the department of Health Canada (HC).
Bid solicitation # 1000194072, issued under the framework of the Professional Audit Support Services Supply Arrangement (PASS SA), for the provision of the following professional services: Internal Audit Services.
The requirement described in this RFP is open to pre-qualified suppliers for the following stream(s) of the PASS SA: Stream 1: Internal Audit Services;
Title
Non-Insured Health Benefits (NIHB) Error Rate Measurement report for the pharmacy, medical supplies and equipment (MS&E) and dental benefits payments.
Objective
The objective is to award a contract for two (2) resources (Project Manager/Leader x 1, Senior Auditor x1) to carry out the procedures described in the error rate measurement frameworks and to report on the results of the procedures without any expression of opinion to help HC to determine the error rates of Health Benefits payments by Express Scripts Canada (ESC).
Background, Assumptions and Specific Scope of the Requirement
HC has awarded a contract to a private sector corporation, ESC, to process and adjudicate claims by providers of pharmaceuticals, dental services and medical supplies and equipment to eligible clients. The processing and adjudication of claims were previously being done by First Canadian Health (FCH). After expiry of the FCH contract, the new contractor, ESC Canada, began operations and claims processing activities in December 2009.
The department seeks assurance that the contractor is undertaking the payment of these claims in adherence to departmental and governmental standards and that the payment errors do not exceed the defined maxima. In response to recommendations from the Office of the Auditor General, HC commissioned a study by Sussex Circle to develop a cost-effective strategy to measure the errors in the payments by the contractors. The recommendations from this study include determining the error rates by conducting an independent assessment of a sample of transactions periodically, which will be based on the controls at ESC and HC.
The project was initiated to determine the error rate for these payments, establish the error rate and establish an action plan, should the error rate be above the tolerable level according to HC.
Period of Contract: The initial period of the Contract will be from contract award date to May 31, 2018.
The Contractor hereby grants to Canada the irrevocable option to extend the period of the Contract by up to two (2) additional one (1) year period(s) under the same terms and conditions. The Contractor agrees that, during the extended period of the Contract, it will be paid in accordance with the applicable terms set out in the Basis of Payment.
Enquiries regarding this Request for Proposals are to be submitted in writing to:
Chantal Laferrière
c••••••••@••••••.ca
