E.1 - Solicitation Sections L & M_Amendment 1.docx

Exhibit E.1 – Solicitation Sections L & M – Amendment 1 75FCMC26R0041 Solicitation Sections L & M

SECTION L – INSTRUCTIONS, CONDITIONS, AND NOTICES TO OFFERORS OR QUOTERS

L.1 GENERAL INSTRUCTIONS AND INFORMATION

(a) Proposals Included in the Official Contract File: The Offeror is advised that its proposal may become part of the official contract file and incorporated by reference.

(b) Compliance with these solicitation instructions is mandatory and failure to furnish a complete proposal at the time of proposal submission may result in the proposal being non-responsive to the Government and may eliminate the Offeror from further consideration for award. It is the Offeror's responsibility to ensure the completeness of the proposal submitted (see Section L.3 regarding late proposals).

(c) If an Offeror believes that the requirements in these instructions contain an error, omission, or are otherwise unsound, the Offeror shall immediately notify the Contracting Officer in writing with supporting rationale as well as the remedies the Offeror is asking the Contracting Officer to consider as related to the omission or error.

(d) The Offeror’s proposal must stipulate that it is predicated upon all the terms and conditions of this RFP. In addition, it must contain a statement to the effect that it is valid for a period of at least 180 days from the date specified for receipt of offers by the Government.

(e) Costs for Proposal Submission: This solicitation does not commit the Government to pay any cost for the preparation and submission of a proposal. In addition, the Contracting Officer is the only individual who can legally commit the Government to the expenditure of public funds in connection with the proposed acquisition.

(f) Award without Discussion: Offerors are advised that award may be made without discussions. Offeror’s are cautioned it is the Government’s intent, if determined to be in the Government’s best interest, to award on INITIAL PROPOSAL SUBMISSIONS. Proposals should be submitted initially on the most favorable terms from a price/cost and technical standpoint.

(g) Signature: The proposal shall be signed by an official authorized to bind its organization.

(h) Amendment/Cancellation: CMS reserves the right to amend or cancel the solicitation as necessary to meet CMS requirements.

(i) Any Assumptions, Conditions, or Exceptions: The Offeror must submit all (if any) assumptions, conditions, or expectations upon which the Technical and Business Proposal volumes are based.

(j) Communications Prior To Contract Award: Offerors shall direct all communications to the attention of the Contract Specialists/Contracting Officer cited in the solicitation unless otherwise amended. Communications with other officials may compromise the integrity of this acquisition and result in cancellation of the requirement.

L.2 SOLICITATION QUESTIONS AND NOTICE OF INTENT

(a) QUESTIONS: Must be received no later than April 8, 2026, 10:00:00 AM (local time, Baltimore, MD). Questions on this RFP shall be submitted via e-mail to each of the following individuals:

Mr. Kyle Patton, kyle.patton@cms.hhs.gov Ms. Jennifer Kuhn, Jennifer.Kuhn@cms.hhs.gov

Any questions submitted by telephone or verbally will not be honored.

Answers to questions that CMS determines to be necessary for proposal preparation may be conveyed in the form of a solicitation amendment and posted on the System for Award Management website (https://sam.gov/content/home).

Submission of Questions shall be provided utilizing, Exhibit E.2 – PPI MEDIC Questions Submission Template, only and shall include at a minimum:

· Company name, Unique Entity ID (UEI), Small Business Designation, and Designated Point of Contact (including Name, Title, Phone Number, and Email Address).

· For each question submitted, the Offeror shall provide the applicable document name (i.e. Solicitation, Attachment J.1, Exhibit, Miscellaneous), section name and number (including subparagraph designations), and page number.

(b) NOTICE of INTENT (Phase 1): Offerors that intend to submit a Phase 1 proposal in response to this solicitation are requested to submit a Notice of Intent to Submit a Proposal no later than April 17, 2026, by 10:00:00 AM, local time, Baltimore, MD. This notice shall be submitted via e-mail to the points of contact listed above under “a”. The subject of the email shall be “Intent to Submit a Proposal for RFP- 75FCMC26R0041 – PPI MEDIC.” Offerors are requested to provide the name of the company/ team/entity intending to submit a proposal and a point-of-contact with phone number and email address.

The notice of intent to submit a proposal is not binding. It is for Government planning purposes only. Failure to indicate intent to submit a proposal does not preclude an Offeror from submitting a proposal or the Government from considering such proposal for award.

(c) NOTICE of INTENT (Phase 2): Following the Advisory Notification (as described below in Section M.4), Offerors are required to notify the Contracting Officer, via e-mail, of their intent to participate in Phase 2 within three-business days after receipt of the notification, otherwise the Government will assume that the offeror does not intend to participate further and will not attempt further communication with the offeror.

L.3 PROPOSAL SUBMISSION

Offerors shall submit their proposals electronically to the email addresses below:

· Jennifer.Kuhn@cms.hhs.gov

· Kyle.Patton@cms.hhs.gov

If a subcontractor submits a proposal separately from the prime offeror, the submission/proposal must clearly identify the prime offeror. It is the Offeror’s responsibility to confirm the Government has received both the prime and any applicable subcontractor proposals prior to the due date and time established below.

Phase 1: Phase 1 proposals (Volume I) shall be received no later than April 22, 2026, 10:00:00 AM local time, Baltimore, MD.

Phase 2: Phase 2 proposals (Volume II, III & IV) TBD.

For planning purposes, the timing of the Phase 2 proposal submissions will be due approximately two weeks following the Advisory Notification.

Late Proposals: For this provision, a proposal includes all proposal submissions from the Offeror and its subcontractors to the points of contact identified in this solicitation. If any portion of the proposal (Prime Contractor AND Subcontractor) is not received by the specified date and time, the Contracting Officer will promptly notify the Offeror that its proposal was received late and will state whether the proposal will still be considered after applying the following analysis:

Any proposal, modification, or revision, that is received at the designated Government office after the exact time specified for receipt of proposals is "late" and will not be considered unless it is received before award is made, the contracting officer determines that accepting the late proposal would not unduly delay the acquisition; and-

(i) If it was transmitted through an electronic commerce method authorized by the solicitation, it was received at the initial point of entry to the Government infrastructure not later than 5:00 p.m. one working day prior to the date specified for receipt of proposals; or

(ii) There is acceptable evidence to establish that it was received at the Government installation designated for receipt of proposals and was under the Government’s control prior to the time set for receipt of proposals; or

(iii) It was the only proposal received.

However, a late modification of an otherwise successful proposal, that makes its terms more favorable to the Government, will be considered at any time it is received and may be accepted.

L.4 PROPOSAL INSTRUCTIONS

(a) General:

The following instructions will establish the acceptable minimum requirements for the format and contents of the proposal. The proposal shall be organized to clearly identify the contents within each volume. The Offeror’s proposal shall be submitted in separate volumes as identified below:

Each of these volumes shall be separate and complete in and of itself so that the evaluation of one may be accomplished independently of the evaluation of the other.

Electronic Proposals: All submissions should be fully functional (except PDF’s) and should not contain blocked or hidden content. Each proposal shall be compatible with Microsoft Office 365 (MS Word, MS Excel, and PowerPoint with formats of .docx, .xlsx, .pptx.)

(b) Format:

1. Page size shall be 8.5 by 11 inches unless otherwise indicated.

2. The proposal shall be page numbered.

3. Type size shall not be less than 11-point font type Calibri.

4. Charts, graphs, and tables may be no less than 9-point font Calibri.

5. Each page shall be single-spaced and shall not be compressed.

6. Each page shall have a 1” margin on all 4 sides; header and footer information may be contained within the 1” area.

7. Signed documents such as conflict of interest shall be submitted in Adobe Acrobat or “PDF” format. Organizational charts may be provided in PowerPoint.

8. Price proposal spreadsheets shall be submitted in Microsoft Excel.

If the Offeror uses a different format (font size, margin, etc.), the Government reserves the right to adjust the proposal to fit the parameters of the format as stated in the RFP, and if this results in the proposal exceeding the page limitations in any one area, the Government will not consider any excess pages.

(c) Assumptions:

Offerors shall utilize the “Assumptions: Projected Workload” described in Exhibit E.3 – Assumptions in the preparation of proposals.

L.5 TECHNICAL PROPOSAL INSTRUCTIONS (VOLUME I & II)

The Government intends to conduct the evaluation and selection process utilizing a two-phased approach, as described below in Section M.4, in order to select the most capable Offeror, based on established evaluation criteria for each phase. The purpose of the phased approach is to streamline the process for Offerors and minimize traditional costs and burdens associated with lengthy paper-based submissions.

Offerors shall submit their written Technical Proposal as prescribed below. Offerors must adhere to the page limits defined below. Pages provided beyond the limits defined will be discarded and not reviewed or evaluated.

In order to facilitate review and evaluation, the Offeror shall submit a technical proposal with, at a minimum, the following sections in the order in which they are listed:

(b) Factor 1: Technical Understanding and Approach (Phase 1)

1. Scenario Responses

(a) Cover Letter/ Table of Contents (Page limit: two-pages, not included in the Total Page Count / Unlimited, not included in the Total Page Count)

Offerors shall include a Table of Contents that identifies and clearly labels the various technical proposal sections with each Phase submission. Offerors may include a two-page cover letter with each Phase submission.

(b) Factor 1: Technical Understanding and Approach

1. Scenario Responses The Offeror shall provide responses to the scenarios that follow to demonstrate their technical understanding of the work required under the PPI MEDIC SOW. When completing the responses, the Offeror shall clearly and concisely include appropriate information for each scenario. The Offeror’s response to each scenario should be in the format specified and should fully defend the response. The Offeror must include any assumptions used in developing the response.

i. Scenario #1 (Page limit: 3-pages) CMS has asked you, as the PPI MEDIC, to provide an audit methodology to address a current Medicare Part C fraud, waste and abuse (FWA) concern. The Offeror’s audit methodology shall include the following, at a minimum:

· How the Part C FWA concern was identified and why it was selected to provide an audit methodology.

· The Medicare Part C policies or applicable guidance that provides support for the audit methodology, the sources of these policies, and any policy limitations that may impact the audit.

· The data sources and systems needed to create a viable audit universe including any Part C or other Medicare data needed and an explanation for why they were selected. Include what Part C encounter data fields would be utilized for evaluation and if any data limitations exist.

ii. Scenario #2 (Page limit: 3 pages) CMS has asked that you, as the PPI MEDIC, provide an audit methodology to ensure Immunosuppressant drugs being submitted to the Medicare Part D program were eligible for Part D payment based on Part D policies. The Offeror’s audit methodology shall include the following, at a minimum:

· The Medicare Part D policies or applicable guidance that provides support for the audit methodology, the sources of these policies, and any policy limitations that may impact the audit.

· The data sources and systems needed to create a viable audit universe including any Part D or other Medicare data needed and an explanation for why they were selected. Include what prescription drug event (PDE) record data fields would be utilized for evaluation and if any data limitation exist.

· How to ensure return on investment (ROI) for this audit is high, including a method for calculating audit ROI.

2. Technical Approach (page limit: 6-pages) The Offeror shall prepare and submit a document addressing their technical approach to the specific Statement of Work (SOW) tasks as specified below:

· Task 2.6.1.1 – Self-Audits

· Task 2.6.1.2 – National Audits

· Task 2.6.1.3 – Appeals

· Task 2.6.2 – Program Integrity Audits

· Task 2.6.3.1 – Part C Oversight Audits For each task above, include the following:

· Provide your technical understanding and previous experience with conducting research, performing data analysis, providing critical evaluations, and completing audit tasks in an effective and timely manner.

· Explain how you will build successful partnerships with internal and external stakeholders (i.e. CMS, CMS contractors, plan sponsors, law enforcement, etc.) while supporting CMS’s audits and program integrity oversight activities related to fraud, waste, and abuse efforts within the Medicare Parts C and D programs.

(c) Factor 2: Key Personnel and Staffing Plan (Page limit: 6-pages) (NOT INCLUDED IN TOTAL PAGE COUNT: Organizational Charts (Page limit: 2-page), Resumes for Key Personnel (Page limit: 2-page, each) and Letters of Commitment (Page limit: 2-page, each).

1. Staffing Plan (Page limit: 6-pages) The offeror shall submit a staffing plan that outlines the total proposed staffing (inclusive of any key personnel, existing staff, projected hires, subcontractors, as applicable) to perform and manage the tasks listed in the SOW. The offeror shall at a minimum provide the following information:

i. An explanation to support that the proposed labor categories, subcontracting arrangements (if applicable), and full-time equivalents (FTEs) (hours) per labor category are reasonable and realistic for the required effort and are consistent with the goals outlined in the Offeror’s technical approach (see example below or you can provide a chart with similar information) for all contract periods of performance. This should include a description of the roles/ responsibilities and rational for the proposed labor categories. For Key Personnel, the rationale for each proposed candidate shall include how the candidates’ educational background, certifications/licenses, skills, and professional work experience, makes them qualified to fulfill the Key Personnel roles and responsibilities.

For example, purposes only:

per year

ii. A description of the Offeror’s approach to organizing, managing, and maintaining the necessary resources to handle the workload outlined in the SOW.

iii. If the staffing plan includes hiring additional employees, subcontracting work, or any other form of labor acquisition, provide the process and give examples of similar situations where you have been successful in acquiring and maintaining the necessary labor to successfully perform a contract of similar size and complexity.

2. Resumes (Page limit: 2-page, each – NOT INCLUDED IN TOTAL PAGE COUNT)

The Offeror shall submit resumes (included as appendices) for each proposed Key Personnel position. Resumes shall include sufficient detail about relevant professional work experience, skills, certifications/licenses, education, and qualifications necessary to determine if the proposed candidate is qualified to perform the roles and responsibilities described in the Offeror’s technical approach.

3. Letters of Commitment (Page limit: 2-pages, each - NOT INCLUDED IN TOTAL PAGE COUNT)

The Offeror shall provide a standard letter of commitment for each Key Personnel not currently on staff. Letters of commitment shall include the date of availability, the salary accepted, how long the individual's commitment is binding, and signed by the individual and the Offeror’s corporate authorized official.

4. Organizational Chart (Page limit: 2-pages - NOT INCLUDED IN TOTAL PAGE COUNT)

The organizational chart should be sufficient to provide an understanding of the roles and responsibilities, management structure, and placement of proposed personnel, including identification of “Key” personnel. In the event that the Offeror utilizes Subcontractors, the organizational chart shall identify which staff are Subcontractors.

(d) Factor 3: Past Performance (Page limit: Unlimited Table Format)

INSTRUCTIONS FOR SUBMITTING PAST PERFORMANCE INFORMATION

1. Definitions:

Relevant – Relevant past performance information is described in FAR 42.1501, General. For the purposes of this solicitation, ‘relevant’ is also past performance information which is similar in size, scope and complexity to this contract.

Significant Subcontractor – A subcontractor performing major or critical aspects of the requirements relevant to the prospective contract.

2. Instructions

The Offeror and all its significant subcontractor(s) identified in the proposal are required to provide a summary in the table format below to disclose no more than three total for the prime contractor and no more than two total for each significant subcontractor(s) of the most relevant contracts from the following for past performance information with a period of performance end date within the last three years of the date of this solicitation:

a. CMS contracts/task orders greater than the simplified acquisition threshold.

b. Relevant contracts/orders entered into with:

• Other Federal Government Agencies,

• State Agencies,

• Local Governments, and

• Commercial Customers

The Offeror’s and proposed significant subcontractor(s) summary shall provide the following information:

1. Customer or Agency

2. Contract number (if applicable)

3. Point of Contact (Contracting Officer or other for Commercial Contract)

4. Approximate total contract value

5. Contract period of performance, by base and option year(s)

6. Description of contracted services/supplies

7. Relevant (Y/N) o If the past performance is relevant, describe how the disclosed contract’s past performance is relevant to the subject solicitation.

8. Additional information: If performance was less than satisfactory, the Offeror shall provide a summary of the identified steps taken to resolve the problem and processes in place to improve future performance.

The table below should be used when providing a summary of the past performance information. (Table will be provided to CMS in Microsoft Excel and will not be counted toward the page limit):

Offerors and proposed significant subcontractors without relevant Federal government past performance may ask customers to submit no more than three Past Performance Questionnaires (PPQ) for the same or similar work directly to the Contracting Officer (See Exhibit E.4 – Past Performance Questionnaire). It is the responsibility of the Offeror to ensure timely return of any/all PPQs to the Contracting Officer in accordance with the proposal due date and time established within this solicitation. Contracts may include those entered into with the State/Local Governments and/or commercial customers.

L.6 BUSINESS PROPOSAL (VOLUME III) INSTRUCTIONS (PHASE 2)

Follow the below format to the best degree possible and LABEL EACH SECTION (and any applicable subsections) INCLUDING TITLE as designated below. The Business Proposal is unlimited in page count.

(a) VOLUME III - BUSINESS PROPOSAL: The Business Proposal shall consist of the following elements, at a minimum:

1. Table of Contents

Offerors shall include a Table of Contents that identifies and clearly labels the various business proposal sections.

2. Contract Forms (Prime Only)

Signed, dated, and fully executed package consisting of:

· SF-33, Solicitation/Contract (Block 12: Please note that offers are valid for a period of no less than 180 days);

· RFP Section “Supplies or Services and Price/Cost” and B.4 - Fixed Fee Payment Schedule (utilize “Fill-Ins” Tab within Exhibit E.8, Business Proposal Template);

· RFP Section “HHSAR 352.242-70 Key Personnel”, shall be used to identify the Offeror’s proposed Key Personnel consistent with their technical approach; and

· RFP Section “Representations, Certification, and other Statements of Offerors” (Section K) shall be completed in its entirety.

3. Indirect Cost Rate Agreements and Rate History

i. The Offeror is instructed to provide any approved provisional / indirect billing rates by a cognizant Government agency. The Offeror is instructed to provide a copy of any forward pricing rate agreements and government approved indirect cost rate agreements used in pricing herein (if available).

ii. If the Contractor has no prior history of government approved indirect cost rates or if the Offeror is proposing indirect rates which significantly deviate from current actuals, then the Offeror SHALL provide support documentation for the prior 3 years consisting of their current year operating budget and a forecast covering the anticipated period of performance. The budget should also detail the indirect expenses and show the relationship of direct labor (or other indirect expenses allocation bases) to sales projections. (Source: DCAAP 7641.90) The Offeror shall also provide all data (Bases and Pools), methodology (accounting practices), and relevant information that supports the proposed indirect rates as fair and reasonable. For more information on the data points that need to be provided to enable the Government to be able to review the Offeror’s calculations for the proposed indirect rates see FAR Part 31.

4. Service Contract Act

The Offeror should identify those proposed labor categories subject to the Service Contract Act of 1965, as Amended (FAR 22.10) and provide a crosswalk to the labor category including the Wage Determination number, Wage Determination Category and county, state in which the labor category will perform. The Offeror may obtain Wage Determinations at https://sam.gov/wage-determinations.

5. Adequate Accounting and Estimating Systems

The Offeror’s accounting system must be determined acceptable or adequate at the time of Phase 2 proposal submission.

An accounting system is the contractor’s system or systems for accounting methods, procedures, and controls established to gather, record, classify, analyze, summarize, interpret, and present accurate and timely financial data for reporting in compliance with applicable laws, regulations, and management decisions, and may include subsystems for specific areas such as indirect and other direct costs, compensation, billing, labor, and general information technology.

An offeror will only be eligible for award if, at the time of proposal submission, its accounting system is either acceptable for award of a prospective contract (as recommended by a preaward accounting system survey/audit or as determined by a Contracting Officer), or adequate for accumulating and billing costs on Government contracts (as recommended by a postaward accounting system audit or as determined by a Contracting Officer).

The following definitions apply:

The Offeror must select one of the following four options, listed in descending order of preference, and provide copies of the document(s) stated in that option in this section of the proposal:

(1) A written determination by a Federal Government Contracting Officer that the offeror’s accounting system is acceptable for award of a prospective contract or adequate for accumulating and billing costs on Government contracts, or

(2) A post-award accounting system audit performed by a Federal Government Agency, finding the offeror’s accounting system adequate for accumulating and billing costs on Government contracts, or

(3) A pre-award accounting system audit performed by a Federal Government Agency (such as the Defense Contract Audit Agency) finding the offeror’s accounting system acceptable for award of a prospective contract, or

(4) A Standard Form (SF) 1408, Preaward Survey of Prospective Contractor - Accounting System, completed and signed by an independent Certified Public Accountant (CPA) Firm, recommending that the offeror’s accounting system is acceptable for award of a prospective contract. All documentation must be dated within three years of proposal submission. The SF 1408 can be found at: https://www.gsa.gov/reference/forms/preaward-survey-of-prospective-contractor-accounting-system

Proposals that do not include all documentation required for the above option selected by the Offeror may not be further considered for award.

6. Uncompensated Overtime (FAR 52.237-10 (Mar 2015))

The Offeror is required to include a copy of its policy on “uncompensated overtime” with its proposal. Uncompensated overtime is defined as “…hours worked without additional compensation in excess of an average of 40 hours per week by direct charge employees who are exempt from the Fair Labor Standards Act.”

7. Responsibility Questionnaire (Exhibit E.5):

The Offeror shall submit Exhibit E.5 – Responsibility Questionnaire filled out in its entirety.

8. Prime Proposal Checklist (Exhibit E.6):

The Offeror shall submit Exhibit E.6 – Prime Proposal Checklist filled out in its entirety.

9. Consent to Subcontract (Exhibit E.7):

If applicable, the Offeror shall submit Exhibit E.7 – Consent to Subcontract filled out in its entirety for each subcontractor.

10. Joint Ventures or Teaming Arrangements (if applicable)

An agreement shall be submitted at time of proposal. In accordance with FAR 19.107-1(c), a joint venture may be considered a WOSB concern eligible under the WOSB Program if the WOSB participant is certified in SAM and the joint venture meets the requirements of 13 CFR 127.506. A joint venture is binding upon award of the contract and the Government views valid joint ventures the same as a Prime Offeror. A joint venture shall state if it is populated or unpopulated.

11. Business Proposal Spreadsheet (Exhibit E.8 – Business Proposal Template)

The Offeror shall use the business proposal spreadsheet (see Exhibit E.8 – Business Proposal Template). The spreadsheet serves the purpose of providing the breakout of all cost elements in the prime and subcontractor’s proposals. Note that Exhibit E.8 may be altered by the Offeror as needed.

· The Offeror shall not make the business proposal spreadsheets submitted “Read Only.”

· All spreadsheets will be in Office 365 excel format, be fully functional, and unlocked.

· The Offeror SHALL submit excel documents with active formulas that can be reviewed and traced using Microsoft excel functions.

· Offerors are instructed to review all excel formulas for accuracy prior to submitting a proposal, as the Offerors are responsible for the accuracy of all formulas within the spread sheet provided.

· The Offeror’s Spreadsheet TAKES PRECEDENT FOR COST INFORMATION.

· In every excel “cell” no number shall go beyond two decimal places. This does not mean that the cell should merely display two decimal places, but instead that the value in the cell should be rounded to the hundredth. The Government reserves the right to adjust price proposal spreadsheets to round all numbers to the hundredth and evaluate proposed price based on an adjustment to price.

· Facilities Capital Cost of Money: When facilities capital cost of money (cost of capital committed to facilities) is included as an item of cost, a reduction in the profit objective shall be made in an amount equal to the amount of facilities capital cost of money proposed/claimed. This effectively makes the inclusion of cost of money in a proposal as an element of cost irrelevant.

The Offeror and each subcontractor shall use the business proposal spreadsheet (Exhibit E.8), including all tabs, for all cost/price and shall include the following:

i. Labor: Offerors shall provide direct labor rates for all labor categories that are expected to be used in the performance of the contract. For each labor category please show the “number of labor hours times hourly labor rate equals resultant total dollar amount” by year. Subcontract direct labor shall be shown in the same manner (“number of labor hours times hourly labor rate equals resultant total dollar amount”), however, under the subcontract line item. Such labor rates shall be projected for the base year and all option years. The Offerors are also requested to provide the following:

· For each labor category in a separate column provide the projected Full Time Equivalent (FTE) level. This is to help CMS understand the total number of FTEs when multiple staff is accommodated in one line item.

· The productive labor hours (yearly) for exempt and non-exempt employees used to calculate FTEs for the prime and each subcontractor. For example (1880 = 1 FTE, or 1920 = 1 FTE, etc.)

ii. Labor Rollup: The business volume shall include a completed copy of the “Labor Rollup” spreadsheet (a tab within Exhibit E.8 – Business Proposal Template) summarizing all proposed prime and subcontractor labor. Detailed instructions are provided in the spreadsheet including cell notes and examples. Do not insert new columns or delete existing columns.

iii. Travel: All travel costs proposed shall be reimbursed on a cost reimbursement basis in accordance with the Federal Travel Regulation (FTR). The Contractor shall consolidate travel costs into one line item. However, a separate schedule (tab within Exhibit E.8) shall be provided for travel cost breakdown of proposed travel expenses consisting of the following: departure and arrival locations, number, purpose of trips, number of travelers and head count if known, and duration of trip for each destination, mileage, per diem, and air fare. A similar breakout is required for any subcontractor that proposes travel expenses (this information may be provided in either a sealed package sent separately to CMS or be a part of the prime’s proposal submission).

iv. Other Direct Costs (ODCs): These include materials, equipment, etc. The Offeror shall consolidate ODCs into one line item. However, a separate schedule (tab within Exhibit E.8) shall be provided to break down ODCs. The separate schedule shall provide a detailed itemization of each ODC along with supporting quotes. A similar break out is required for any subcontractor that proposes ODCs (this information may be provided in either a sealed package sent separately to CMS or be a part of the prime’s proposal submission).

v. Subcontracts: The Offeror shall provide subcontract cost information per subcontractor as prescribed above under “Labor.” In addition, all proposed subcontractors shall submit a separate and complete business proposal spreadsheet in the same format as the Offeror’s business proposal spreadsheet no matter the dollar value. Subcontractors may submit their business proposal spreadsheet showing the breakdown of costs, buildup of fully burdened rates, etc. to CMS in a separate email submission.

vi. Indirect Rates: The Offeror shall provide the indirect rates as applicable along with the relative percentages for each period on the business proposal spreadsheet.

vii. Fee: The Offeror shall provide each fee separately along with the relative percentages on the business proposal spreadsheet.

viii. Summary Rollup of All Costs: In addition to the individual contract line item summaries, the Offeror shall include a summary sheet inclusive of all costs, FTEs, hours and period of performance (tab within Exhibit E.8).

ix. Fill-Ins: In accordance with Solicitation Section L.6(a)(2), Offerors shall complete the “Supplies or Services and Price/Cost” and B.4 - Fixed Fee Payment Schedule tables.

12. Business Proposal Narrative

i. General The business proposal is presumed to represent an Offeror’s best effort to respond to the solicitation. The Offeror may utilize this section to provide any additional information that is necessary to support the Offeror’s proposed price, if this information will assist the Government in understanding the derivation of the pricing proposed.

ii. Business Proposal Assumptions

The Offeror shall describe any assumptions, conditions, or exceptions upon which the business proposal is based. If not noted in this section of your proposal, it will be assumed that the Offeror proposes no assumptions, conditions, or exceptions for award, and agrees to comply with all the terms and conditions as set forth herein.

iii. Base of Estimate (BOE)

For all proposed costs (direct labor, indirect, ODC’s, Subcontract Costs, etc.) it is incumbent on the Offeror to clearly describe the BOE used to establish those estimates as fair and reasonable. This includes providing all assumptions used to establish proposed costs, if historical actuals were used an explanation as to why those actuals are still accurate, and any and all empirical data which can provide further support to the proposed costs as fair and reasonable.

A. Direct Labor Rates & Escalation

The Offeror’s proposed labor rates shall be supported with payroll information or letters of intent. If the Offeror proposes bid rates or composite rates, the breakdown of the rate and explanation supporting the fairness and reasonableness of the rate must be provided.

Note: It is not enough to simply state that proposed costs are based on market research. The Offeror needs to provide supporting documentation for their market research data, analysis, and conclusion.

If the labor rates are escalated, the Offeror shall provide the escalation rate and the rationale for the proposed escalation rate.

The Offeror’s shall provide the productive labor hours for exempt and non-exempt employees used to calculate the FTEs.

The Offeror shall provide detailed labor rationale by labor category and should describe how the basis of the hours was determined (e.g. historical data, technical experience, etc.).

B. Indirect Rates (Overhead Rate, General & Administrative, Fringe, etc. as appropriate)

The Offeror shall provide the indirect cost rate percentages and what the rate is applied to, i.e. Fringe is applied to Direct Labor.

C. Travel

The Offeror shall provide the basis of the estimate and detailed rationale for all travel including the detailed rationale for the chosen labor categories traveling. CMS should be able to understand from this narrative the reason for, rationale for and importance of the travel (i.e. Command Center Mission).

The Offeror is instructed not to propose “commuting costs” as these travel expenses are not considered “official company business” expenses. Commuting costs may not become indirect costs unless there is a company policy, offered to all employees, in which it is a company benefit (fringe pool) that the company pays or stipends commuter costs. Otherwise, such costs may not be included as indirect, as they are unallowable. Commuting costs are defined as travel costs used to move individuals from their place of residence to their place of work.

D. Other Direct Costs (ODCs)

The Offeror shall provide the basis of estimate and detailed rationale for each item of ODC. This detailed rationale should clearly explain as to why costs are fair and reasonable and should accompany supporting documentation like market research analysis, quotes, etc.

Note: It is not enough to simply state that proposed costs are based on market research or quotes. The Offeror needs to provide the supporting documentation for their market research data, analysis, and conclusion. In the case of quotes, the Offeror is instructed to provide the actual quotes to support the proposed cost or price.

E. Fee

The Offeror shall provide the basis of estimate and detailed rationale for each proposed fee. The Offeror shall also disclose if any fees are added to the subcontractors.

L.7 508 COMPLIANCE & CONFLICT OF INTEREST PROPOSAL (VOLUME IV) INSTRUCTIONS (PHASE 2)

(a) 508 Compliance (no page limit)

Based on the applicable 508 standards associated with this requirement (See SOW Appendix C), it has been determined that the 508 risk level is Low. Low Risk includes information and communications technology (ICT) that is considered as an outcome under product or service contracts as a deliverable document submitted in Adobe PDF, HTML or other Microsoft Office (or compatible) format. The Offeror shall demonstrate Section 508 compliance by submitting the applicable completed CMS Accessibility Checklist(s) found in Exhibits E.10 – E.14, in accordance with the instruction provided in Exhibit E.9, 508 Checklist Instructions. See HHSAR 352.239-78, Information and Communication Technology Accessibility Notice, for additional details.

Note: For this Solicitation, Offeror’s shall submit applicable CMS Accessibility Checklists and not the HHS Accessibility Checklist as referenced in Section HHSAR 352.239-78, Information and Communication Technology Accessibility Notice.

(b) Business Ethics, Conflicts of Interest and Compliance (no page limit)

In accordance with Section H.1 of the solicitation, the offeror shall complete and submit Attachment J.2 Contractor Offeror Conflict of Interest Template as part of Volume IV, with its proposal (or a document containing similar information). A response must be provided for all sections of the form even if no conflict exists. The Prime Contractor/Offeror shall conduct an analysis of each of its subcontractors’ COI submissions (attachment J.2 or similar information) in order to ensure that the subcontractor can perform services conflict-free. The Prime Contractor/Offeror shall include each of its subcontractors’ analysis with its proposal. The Prime Contractor shall not submit the underlying J.2 for subcontractor disclosures to CMS; however, the Contracting Officer may request a copy of the subcontractor submission.

(END OF SECTION L)

SECTION M - EVALUATION FACTORS FOR AWARD

M.1 EVALUATION OF OPTIONS (FAR 52.217-8)

The evaluation of options under FAR 52.217-8 will be accomplished by using the prices offered in the last active (fully operational) option period to determine the price for a 6-month option period (i.e. (CPFF for OY4 “CLIN 0005”/12-months) *6-months = CPFF for 6-month option period). Evaluation of the options will not oblige the government to exercise the option(s). For the purposes of source selection, the price of this option period will not be considered in the Offeror’s total proposed price.

M.2 ELIGIBILITY FOR AWARD

In order to be eligible for award, Offerors are required to comply with the terms and conditions of the solicitation and must be deemed responsible in accordance with FAR Part 9. If an Offeror fails to meet the solicitation requirements, including the submission of applicable contract documentation, the Government will not make an award to that Offeror. To be eligible for award, Offeror’s must be certified by the SBA as a Women Owned Small Business (WOSB) at the time of their Phase 1 Submission, at the time of their Phase 2 Submission, and at time of award.

CMS will not enter into a contract with an entity that it determines has, or has the potential for, an unresolved organizational conflict of interest unless it is determined to be in the best interest of the Government to do so.

M.3 GENERAL PROCEDURES FOR AWARD

The Government intends to award one Cost-Plus-Fixed-Fee contract resulting from this solicitation using a Best Value Tradeoff Process as described in FAR Part 15.103-1 “Tradeoff Approach.” This tradeoff technique allows the Government to consider award to other than the lowest priced/cost Offeror or other than the highest technically rated Offeror. It permits tradeoffs among cost/price and non-cost/price evaluation factors. In making this comparison the Government is more concerned with obtaining superior technical/management features than with making an award at the lowest overall cost to the Government. All evaluation factors other than cost or price, when combined, are significantly more important than cost or price. However, the Government will not make an award at a significantly higher overall price to the Government to achieve slightly or moderately superior technical management features. In addition, as the degree of technical equality (i.e. all factors other than price) increases between proposals, price will become more important.

M.4 TWO-PHASED APPROACH

The Government intends to conduct the evaluation and selection process utilizing a two-phased approach as follows:

Once the evaluation for Phase 1 is complete, Offerors will receive an Advisory Notification via e-mail from the Contracting Officer. This notification will advise the Offeror of the Government’s advisory recommendation to proceed or not to proceed with the Phase II submission. Offerors who are the most highly rated for Factor 1 will be advised to proceed to Phase II of the proposal submission process. Offerors who were not among the most highly rated will be advised that they are unlikely to be viable competitors, along with the general basis for the Government’s advisory recommendation. The intent of this distinction is to minimize quote development costs for those vendors with little or no chance of receiving an award.

However, notwithstanding the advice provided by the Government in response to their Phase 1 submissions, all respondents who submitted a Phase 1 proposal may participate in Phase 2. Offerors are required to notify the Contracting Officer of their intent to participate in Phase 2 within three business days after receipt of the above described Advisory Notification, otherwise the Government will assume that the Offeror does not intend to participate further and will not attempt further communication with the Offeror.

NOTE: The Advisory Notification is the only notice the Government will provide from Phase I. Debriefings will not occur at the end of Phase I.

M. 5 TECHNICAL PROPOSAL EVALUATION

The Government will conduct a comprehensive evaluation of each proposal. Based on the proposal evaluations from both Phase 1 and Phase 2 the “tradeoff” analysis described above will be used to determine which proposal offers the best combination of technical capabilities and price to the Government. The following Technical Factors are listed in descending order of importance:

Factor 3: Past Performance

The Government will assign a confidence rating for each Technical Evaluation Factor referenced above.

Offerors will be evaluated as follows:

(a) Technical Understanding and Approach (Phase 1)

1. Scenario Responses CMS will evaluate the Offeror’s Scenario responses to determine the offeror’s capability and suitability to perform the work required in the SOW and to determine the likelihood that the prospective contract will be performed successfully. In addition, each scenario will be evaluated as follows:

i. Scenario 1:

· The reasonableness of proposed assumptions.

· The reasonableness of the Offeror’s approach to identifying the FWA concern and explanation for its selection.

· The appropriateness of the Medicare Part C policies and guidance used in the audit methodology and the appropriateness of the sources for the policies and guidance.

· The reasonableness of the identified policy limitations that may impact the audit.

· The reasonableness of the data sources and systems used to create a viable universe and the reasonableness of the explanation for why they were selected.

· The reasonableness of the Part C encounter data fields used for evaluation and the reasonableness of any identified data limitations.

ii. Scenario 2:

· The reasonableness of proposed assumptions.

· The appropriateness of the Medicare Part D policies and guidance used in the audit methodology and the appropriateness of the sources for the policies and guidance.

· The reasonableness of the identified policy limitations that may impact the audit.

· The reasonableness of the data sources, systems, and Part D or other Medicare data used to create a viable universe and the reasonableness of the explanation for why they were selected.

· The reasonableness of the Part D PDE data fields used for evaluation and the reasonableness of any identified data limitations.

· The reasonableness of the Offeror’s approach to ensuring high ROI and the reasonableness of explanation for how they would calculate ROI for audits.

2. Technical Approach For each task, the Offeror will be evaluated as follows:

· The reasonableness of the Offeror’s approach to meeting the SOW requirements for the Task.

· The reasonableness of the Offeror’s technical understanding and the extent of their demonstrated capability to conduct research, perform data analysis, provide critical evaluations and complete audit tasks in an effective and timely manner

· The reasonableness of the Offeror’s approach to interfacing and building successful partnerships with CMS and other stakeholders, while supporting CMS’s audits and program integrity oversight activities related to fraud, waste, and abuse efforts within the Medicare Parts C and D programs.

(b) Key Personnel and Staffing (Phase 2)

CMS will evaluate the Offeror’s proposed Key Personnel and staffing plan to determine the offeror’s capability and suitability to perform the work required in the SOW, to include:

1. Key Personnel

CMS will evaluate the Offerors identified Key Personnel positions, including their roles and responsibilities, to determine if the proposed approach is reasonable to manage and provide the expertise necessary to meet the SOW requirements. CMS will also evaluate the proposed candidates’ educational background, certifications/licenses, skills, and professional experience, to determine if their qualifications are reasonable to fulfill the Key Personnel roles and responsibilities identified in the Offeror’s technical approach.

2. Staffing Plan

The Offeror will be evaluated on whether the proposed staffing plan is logical and appropriate to meet the requirements as stated in the SOW, to include:

· How well the proposed labor categories, FTEs, and Subcontracting approach align with the Offeror’s technical approach.

· How reasonable and realistic the proposed labor categories, Subcontracting approach and FTE per labor category are for the required effort.

· Whether the Offeror’s proposal depicts a reasonable and realistic approach to organizing, managing, and maintaining the necessary resources to handle the workload outlined in the SOW. If the staffing plan includes hiring additional employees, subcontracting work, or any other form of labor acquisition, the Offeror will be evaluated on the reasonableness of their proposed approach to labor acquisition and the extent of their experience in successfully acquiring and maintaining the necessary labor to successfully perform a contract of similar size and complexity.

(c) Past Performance (Phase 2)

CMS will evaluate the Offeror’s past performance information, which is expected to demonstrate the likelihood that the prospective contract will be performed successfully.

The CO reserves the right to limit its review of past performance information to what he/she has been determined to be relevant, which may include the review of any available CPARs (within the last three years of the date of this solicitation) that the CO has determined to be relevant. The Offeror is advised that the Contracting Officer, using sound business judgment, may consider Federal contract past performance to be more relevant than State Agencies, Local Government or Commercial Customer performance assessments.

In the case of an Offeror without a record of relevant past performance, or for which information on past performance is not available, the Offeror’s Past Performance may…