Request for Information QA Responses Supplemental Pilot

DHA T-5 Procurement

RFI Questions HT9402-26-RFI-0255
#

Question

Does the Department envision this pilot as a mechanism to provide access to services, treatments, or support programs not otherwise covered by TRICARE (e.g. non-FDA approved?)

Would the Department extend pilot eligibility to Reserve Component or Coast Guard members? Does the Department have established KPIs or a scorecard for measuring pilot outcomes (e.g., clinical outcomes, utilization, cost avoidance, access to care, participant satisfaction, readiness/force retention, and financial protection for military families)?
Does the Department anticipate holding an Industry Day? Will the enrollment process for the Supplemental Cancer Pilot Program be confined to an open enrollment period, or allow for a continuous enrollment set-up? Does the Department anticipate utilizing an Other Transaction Authority (OTA), a FAR-based contract, or another acquisition vehicle?
What role, if any, will the Department and DHA play in participant education and enrollment? Does the DHA anticipate any restrictions on the carrier's ability to communicate enrollment, events/awareness, or service related activities?
Does the Department anticipate issuing a federal preemption determination to ensure uniform administration across all states and territories?

10 What cybersecurity, privacy, and HIPAA requirements will apply to participating carriers?

Government Response
No. The TRICARE program is a comprehensive health care benefit that combined with Departmental and community resources minimizes, if not eliminates, the financial burden of serious, life-altering medical conditions on members and their families – including cancer. As a statutory federal health care benefit program, TRICARE is prohibited from paying for any non-FDA approved treatments, but several exceptions to nonFDA approved services, treatments, and programs, such as clinical trials, are written into law allowing beneficiaries to receive the same access to services.
No. The NDAA defines the covered individuals to include a regular component member of the Army, Navy, Marine Corps, Air Force or Space Force and their dependents who are enrolled in TRICARE. No.
Yes. DHA is currently planning an industry event anticipated in November. All related information will be posted on SAM.gov. DHA recommends a continuous enrollment set-up but is open to industry input. To be determined.
The Department does not expect to play a role in educating or enrolling participants.