Ad_QIC_190948-JA_Exemption_to_Fair_Opportunity-FBO_Post.pdf

JUSTIFICATION FOR AN EXCEPTION TO FAIR OPPORTUNITY

Acquisition Title: Administrative Qualified Independent Contractor (Ad QIC) Agency: Health and Human Services (HHS)/Centers for Medicare & Medicaid

Services (CMS) Acquisition Year: 2019 Authors: Matthew Waskiewicz

1. Description of Action:

A. Nature

a. ☐ New Requirement

b. ☒ Follow-On Order

c. ☐ Modification of Existing Purchase Order / Contract Number

B. Order Against

a. Multiple Award Indefinite Delivery Indefinite Quantity (IDIQ) Contract Number

HHSM-500-2004-00010I

C. Contract Type

a. ☐ Firm-Fixed Price

b. ☐ Time and Materials

c. ☒ Cost Plus Fixed Fee (CPFF)

i. ☐ Term

ii. ☒ Completion

d. ☐ Cost Plus Award Fee (CPAF)

e. ☐ Other:

CMS seeks consideration to award a two-year logical-follow-on (LFO) task order to Q2 Administrators (Q2A) from September 14, 2019 through September 13, 2020 with one (1) 12-month Renewal Period for the Ad QIC Program.

Award of a LFO task order is requested after consideration of the following:

FAR 16.505(b)(2)(i)(C) allows for a task order to be issued on a sole-source basis under an IDIQ contract in the interest of economy and efficiency because it is a logical follow-on to an order already issued under the contract, provided that all awardees were given a fair opportunity to be considered for the original order.

• The existing Ad QIC task order (HHSM-500-2004-00010I/HHSM-500-T0003) was competed amongst all of the active QIC IDIQ contract holders.

• There are four (4) active QIC IDIQ holders: C2C Innovative Solutions, Maximus Federal Services, Q2 Administrators, and IPRO.

Current Ad QIC Task Order (HHSM-500-2004-00010I/HHSM-500-T0003):

The current task order was awarded in August 2013 to Q2A. To date, a total of approximately $37.36 million has been obligated across 6 total periods of performance.

The period of performance of HHSM-500-T0003 is as follows:

Base Period: September 14, 2013 – September 13, 2014 Renewal Period 1: September 14, 2014 – September 13, 2015 Renewal Period 2: September 14, 2015 – September 13, 2016 Renewal Period 3: September 14, 2016 – September 13, 2017 Renewal Period 4: September 14, 2017 – September 13, 2018 Renewal Period 5: September 14, 2018 – September 13, 2019

2. Description of Supplies or Services:

The purpose of the proposed LFO AdQIC task order is to perform all of the tasks associated with providing administrative services in support of the Qualified Independent Contractors (QICs) that perform adjudication services in accordance with §1869 of the Social Security Act, as amended by both the Medicare, Medicaid, and State Children’s Health Insurance Program (SCHIP) Benefits Improvement and Protection Act (BIPA) of 2000 and the Medicare Prescription Drug, Improvement and Modernization Act (MMA) of 2003. The AdQIC includes providing appeals training and coordination, long term case file storage, referrals to the Medicare Appeals Council within the Departmental Appeals Board (Appeals Council), and notifying Medicare Administrative Contractors (MACs) to effectuate Administrative Law Judges (ALJ) and Appeals Council decisions.

The establishment of the QICs is a statutory requirement. Section 521 of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act (BIPA) of 2000, Public Law 106-554, requires CMS to contract with QICs to conduct reconsiderations (second level appeals) of MACs initial determinations and redeterminations (first level appeals).

3. Authority and Rationale:

The Contracting Officer shall give every awardee a fair opportunity to be considered for a delivery/task order exceeding $3,000 unless one of the following statutory exceptions applies. FAR 16.505(b)(2).

Mark the applicable exception:

☐ The agency need for the supplies or services is so urgent that providing a fair opportunity would result in unacceptable delays [FAR 16.505(b)(2)(i)(A)];

☐ Only one awardee is capable of providing the supplies or services required at the level of quality required because the supplies or services are unique or highly specialized [FAR 16.505(b)(2)(ii)(B)];

☒ The order must be issued on a sole-source basis in the interest of economy and efficiency because it is a logical follow-on to an order already issued under the contract, provided that all awardees were given a fair opportunity to be considered for the original order [FAR 16.505(b)(2)(i)(C)];

Current Ad QIC Task Order (HHSM-500-2004-000010I/HHSM-500-T0003):

The activities under the proposed LFO task order are essentially the same as the existing Ad QIC task order scope of work. As described in Section 2 above, the proposed LFO Ad QIC task order allows for the continued performance of all of the tasks associated with providing administrative services in support of the QICs, including providing appeals training and coordination, long term case file storage, referrals to the Medicare Appeals Council within the Appeals Council, and notifying MACs to effectuate ALJ and Appeals Council decisions.

It is noted that Q2A’s past performance on Task Order HHSM-500-2004-00010I/HHSM-500-T0003 has been of high quality.

Additional Justification for the LFO:

CMS has been unable to start the procurement process for the re-competition of the AdQIC because of a protest filed against the award of the Durable Medical Equipment (DME) task order under the QIC IDIQ.

During the initial review and consideration of DME QIC protest, CMS determined that it would be imprudent to issue any future solicitations under the QIC IDIQ until the corrective action was completed. In addition to the Ad QIC, the B South Jurisdiction is also due for re-compete in fiscal year (FY) 2019. Four (4) additional task orders are due for re-competition in FY 2020 (Part B North, A East Jurisdiction, A West Jurisdiction, Part D).

CMS plans to initiate the recompete of the AdQIC task order in FY ‘2020 but is structuring the LFO as a 1-year base period of performance with a 12-month option period to enable continuity of services should unforeseen circumstances emerge.

☐ It is necessary to place the order to satisfy a minimum guarantee [FAR 16.505(b)(2)(i)(D)].

☐ A statute expressly authorizes or requires that the purchase be made from a specified source. [FAR 16.505(b)(2)(i)(E)].