Attachment J.08 Key Personnel Attestation.docx

1. Key Personnel Attestation Offeror understands and unconditionally assents to the requirements of the Statement of Work (SOW), section B.1 through B.6, under Personnel Requirements and attests that its proposal includes individuals in the Key Personnel positions who meet all of the requirements as outlined in the SOW. Specifically, the Offeror attests that each and every individual (named below) proposed for the respective Key Personnel positions of this solicitation possesses all of the minimum work, experience, licensure, and educational requirements applicable to the specific position as reflected in the table below. Further, the Offeror attests that signed letters of commitment for proposed key personnel (indicate the positions below) not currently employed by the Offeror or subcontractor are on file. Any exceptions to this attestation shall be identified and fully explained in an addendum to this attestation.

Project Director- Section B.1

Insert the name of the proposed individual for this key personnel position and indicate with a check that the candidate meets each of the following requirements of the SOW.

Shall be fully dedicated to the Pricing, Data Analysis, and Coding contract (PDAC) specified in this Request For Proposal (RFP).

Possesses ten (10) or more years of professional experience with at least three (3) years as a manager responsible for managing complex systems and work flow.

Possesses a bachelor’s degree from an accredited institution.

Medical Director- Section B.2

Insert the name of the proposed individual for this key personnel position and indicate with a check that the candidate meets each of the following requirements of the SOW.

Shall be fully dedicated to the PDAC contract specified in this RFP

Possesses a minimum of three (3) years prior work experience in the health insurance industry, a utilization review firm or other administrative experience in a health-related field that involved developing coverage and coding policies and guidelines. Experience involving development of coverage and coding policies and guidelines under a Medicare program contract is preferred.

Shall possess three or more years of experience practicing medicine as a board-certified doctor of medicine or doctor of osteopathy, and shall possess a current medical license

Special Projects Coordinator- Section B.3

Insert the name of the proposed individual for this key personnel position and indicate with a check that the candidate meets each of the following requirements of the SOW.

Shall be fully dedicated to the PDAC contract specified in this RFP

Directly responsible and accountable for assuring special projects as described in the SOW are carried out.

Shall have one or more years of experience managing complex projects involving multiple entities. Experience managing complex projects involving multiple entities under a Medicare program contract is preferred.

HCPCS Coding Specialist- Section B.4

Insert the name of the proposed individual for this key personnel position and indicate with a check that the candidate meets each of the following requirements of the SOW.

Shall be fully dedicated to the PDAC contract specified in this RFP

Accountable for assuring the HCPCS Level II coding function as described in the SOW Sections E.1 and E.2 are met.

Possesses a minimum of three (3) years’ experience in the health industry, a utilization review firm or other administrative experience in a health-related field that involved developing coverage and coding policies and guidelines. This experience is preferred under a Medicare program. Clinical experience as a register nurse is preferred.

Shall possess state licensure as a registered nurse with a bachelor’s degree in nursing preferred. Shall maintain active and current licensure as a registered nurse.

Orthotist/Prosthetist (O/P)- Section B.5

Insert the name of the proposed individual for this key personnel position and indicate with a check that the candidate meets each of the following requirements of the SOW.

Shall be fully dedicated to the PDAC contract specified in this RFP

Possesses a minimum of three (3) years’ experience as a certified Orthotist and certified Prosthetist. The O/P shall possess three or more years of experience in the health industry, a utilization review firm or other administrative experience in a health-related field that involved developing coverage and/or coding policies and guidelines. The O/P shall possess knowledge of the Medicare program as referenced in the SOW.

Holds a certification as a certified Orthotist and certified Prosthetist from one of the approved Boards within the SOW. The certification shall maintain active and current.

Biomedical Engineer –Section B.6

Insert the name of the proposed individual for this key personnel position and indicate with a check that the candidate meets each of the following requirements of the SOW.

Shall be fully dedicated to the PDAC contract specified in this RFP

Possesses three or more years of experience in a bioengineering or biomedical engineering position.

Possess a Bachelor’s degree or higher in Bioengineering or Biomedical Engineering

(Insert Offeror/Company Name) agrees that this Attestation and any attached addendum documenting exceptions to this Attestation will become a part of the organization’s proposal. As an individual with authority to bind the (Insert Offeror/Company Name), I accept responsibility for this written document. Please note, should award be made to the Offeror and any of the information supporting this attestation is found to be inaccurate, repercussions to the Offeror may include but are not limited to the following: the contract may be terminated for default pursuant to FAR 52.249-6(b), Offeror may be responsible for the government’s procurement costs and/or the Offeror may be suspended or debarred from Government contracting. Offerors are wholly responsible for verifying information provided to them by third parties including but not limited to subcontractors, employees, consultants and/or potential employees, subcontractors and/or consultants.

(Signature)_______________________ (Type full name) (Title) (Company)