75FCMC18R0013.pdf

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Medical Review Accuracy Contract Federal contract opportunity
Solicitation number
75FCMC18R0013
Issued by
Department of Health and Human Services Centers for Medicare and Medicaid Services

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SOLICITATION/CONTRACT 1. THIS CONTRACT IS A RATED

5. SOLICITATION TYPE2. CONTRACT NO. 4. SOLICITATION NUMBER

PAGE OF PAGES

7. ISSUED BY CODE 8. THIS ACQUISITION IS

BIDDER/OFFEROR TO COMPLETE BLOCKS 11, 13, 15, 21, 22, & 27

RATING

ORDER UNDER DPAS (15 CFR 700)

3. AWARD/

EFFECTIVE DATE ISSUE DATE

6. SOLICITATION

UNRESTRICTED OR SET ASIDE:

SMALL BUSINESS

SIZE STANDARD:

9. (AGENCY USE)

NO COLLECT CALLS

10. ITEMS TO BE PURCHASED (BRIEF DESCRIPTION)

SUPPLIES SERVICES

11. IF OFFER IS ACCEPTED BY THE GOVERNMENT WITHIN

CALENDAR DAYS (60 CALENDAR DAYS UNLESS OFFEROR INSERTS A DIFFERENT

PERIOD) FROM THE DATE SET FORTH IN BLOCK 9 ABOVE, THE CONTRACTOR

AGREES TO HOLD ITS OFFERED PRICES FIRM FOR THE ITEMS SOLICITED

HEREIN AND TO ACCEPT ANY RESULTING CONTRACT SUBJECT TO THE TERMS

AND CONDITIONS STATED HEREIN.

CODE 12. ADMINISTERED BY

13. CONTRACTOR FACILITY 14. PAYMENT WILL BE MADE BY CODE CODE

OFFEROR CODE

TELEPHONE NO.

UNIQUE ENTITY IDENTIFER

CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK:

15. PROMPT PAYMENT DISCOUNT 16. AUTHORITY FOR USING OTHER

THAN FULL AND OPEN COMPETITION

10 U.S.C. 2304 41 U.S.C. 253

NEGOTIATED

(RFP)

SEALED BIDS

(IFB)

1 105

CMS,OAGM,ASG,DPIFMC

7500 SECURITY BLVD., MS: B3-30-03

BALTIMORE MD 21244-1850

100.00 % FOR:

X

X x

ASG - DPIFMC

Review medical reviews to determine accuracy

75FCMC18R0013

NAICS:

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED VETERAN-

OWNED SMALL BUSINESS

8(A)X

WOMEN-OWNED SMALL BUSINESS (WOSB)

ELIGIBLE UNDER THE WOSB PROGRAM

EDWOSB

17.

ITEM NO.

18.

SCHEDULE OF SUPPLIES/SERVICES

19.

QUANTITY

20.

UNIT

21.

UNIT PRICE

22.

AMOUNT

27. SIGNATURE OF OFFEROR/CONTACTOR 28. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

NAME AND TITLE OF SIGNER (TYPE OR PRINT) DATE SIGNED NAME OF CONTRACTING OFFICER DATE SIGNED

25. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER ALL ITEMS SET

FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY CONTINUATION SHEETS

SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED HEREIN.

26. AWARD OF CONTRACT: YOUR OFFER ON SOLICITATION

NUMBER SHOWN IN BLOCK 4 INCLUDING ANY ADDITIONS

OR CHANGES WHICH ARE SET FORTH HEREIN, IS

ACCEPTED AS TO ITEMS:

23. ACCOUNTING AND APPROPRIATION DATA 24. TOTAL AWARD AMOUNT

(FOR GOVERNMENT USE ONLY)

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION NOT USABLE

STANDARD FORM 1447 (REV. 8/2016)

Prescribed by GSA - FAR (48 CFR) 53.214(d)

COPIES TO

TYPE OR PRINT NAME AND TITLE OF SIGNER

SIGNATURENAME AND ADDRESS OF FIRM (Include ZIP Code)

WE DO NOT, DESIRE TO BE RETAINED ON THE MAILING LIST FOR FUTURE PROCUREMENT OF THE TYPE OF ITEMS INVOLVEDWE DO

DO NOT REGULARLY MANUFACTURE OR SELL THE TYPE OF ITEMS INVOLVED

CANNOT MEET DELIVERY REQUIREMENT

OTHER (Specify)

UNABLE TO IDENTIFY THE ITEM(S)

CANNOT COMPLY WITH SPECIFICATIONS

PAGE

NO RESPONSE FOR REASONS CHECKED

105 2 OF

DATE AND LOCAL TIME

AFFIX

STAMP

HERE

TO:

FROM:

SOLICITATION NO.

CMS,OAGM,ASG,DPIFMC

7500 SECURITY BLVD., MS: B3-30-03

BALTIMORE MD 21244-1850

ASG - DPIFMC

75FCMC18R0013

STANDARD FORM 1447 (REV. 8/2016) BACK

TABLE OF CONTENTS

SECTION B – SUPPLIES OR SERVICES AND PRICES/COST

B.1 DESCRIPTION OF SERVICES

B.2 TYPE OF CONTRACT/PRICE/PAYMENT

B.3 SCHEDULE OF SUPPLIES/SERVICES

SECTION C – DESCRIPTION/SPECIFICATIONS/WORK STATEMENT

C.1 STATEMENT OF WORK

SECTION D – PACKAGING AND MARKING

D.1 PACKAGING AND MARKING

SECTION E – INSPECTION AND ACCEPTANCE

E.1 FAR 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

E.2 APROVALS BY THE CONTRACTING OFFICER’S REPRESENTATIVE (COR)

SECTION F – DELIVERIES OR PERFORMANCE

F.1 FAR 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

F.2 PERIOD OF PERFORMANCE (JAN 2014)

F.3 DELIVERABLES

SECTION G – CONTRACT ADMINISTRATION DATA

G.1 ACCOUNTING AND APPROPRIATION DATA

G.2 GOVERNMENT REPRESENTATIVES AND RESPONSIBILITIES (JUL 2016)

G.3 PROPERTY ADMINISTRATION

G.4 PAYMENTS-INVOICES-FIRM FIXED PRICE CONTRACTS (OCT 2015)

G.5 PAYMENTS-VOUCHERS-TIME & MATERIALS/LABOR HOUR CONTRACTS

(OCT 2015)

G.6 CORRESPONDENCE PROCEDURES

G.7 DATA TO BE DELIVERED

G.8 USE OF GOVERNMENT DATA (REPORTS/FILES/COMPUTER TAPES OR DISCS)

G.9 CONTRACTOR PAST PERFORMANCE EVALUATION(S) (OCT 2014)

G.10 CONTRACTOR WORK PERFORMED OUTSIDE THE UNITED STATES AND ITS

TERRITORIES (APR 2016)

G.11 SUBCONTRACT CONSENT

SECTION H- SPECIAL CONTRACT REQUIREMENTS

H.1 BUSINESS ETHICS, CONFLICT OF INTEREST AND COMPLIANCE (DEC 2015)

H.2 HIPAA BUSINESS ASSOCIATE CLAUSE (OCT 2014)

H.3 HHSAR 352.237-75 KEY PERSONNEL (DEC 2015)

H.4 CMS INFORMATION SECURITY (APR 2013)

H.5 CMS SECURITY CLAUSE

SECTION I – CONTRACT CLAUSES

I.1 FAR 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

I.2 DEPARTMENT OF HEALTH AND HUMAN SERVICES ACQUISITION

REGULATIONS (HHSAR) CLAUSES INCORPORATED BY REFERENCE

I.3 BASIC SAFEGUARDING OF COVERED CONTRACTOR INFORMATION

SYSTEMS (JUN 2016)

I.4 FAR 52.232-18 AVAILABILITY OF FUNDS (APR 1984)

I.5 FAR 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

I.6 FAR 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000)

I.7 FAR 52.219-17 - SECTION 8(a) AWARD (DEC 1996) I.8 FAR 52.219-18 - NOTIFICATION OF COMPETITION LIMITED TO ELIGIBLE 8(a)

CONCERNS (JUNE 2003)

I.9 FAR 52.222-35 EQUAL OPPORTUNITY FOR VETERANS (OCT 2015)

I.10 FAR 52.222-36 EQUAL OPPORTUNITY FOR WORKERS WITH DISABILITIES

(JUL 2014)

I.11 FAR 52.222-42 STATEMENT OF EQUIVALENT RATES FOR FEDERAL HIRES

(MAY 2014)

I.12 CONFIDENTIAL INFORMATION (DEC 2015)

I.13 HHSAR 352.239-74 ELECTRONIC INFORMATION AND TECHNOLOGY

ACCESSIBILITY (DEC 2015)

SECTION J – LIST OF ATTACHMENTS

J.1 MRAC SOW

J.2 Reserved for Incorporation of WAGE DETERMINATION J.3 Reserved for Incorporation of CONTRACTOR’S ORGANIZATIONAL CONFLICT OF

INTEREST (incorporate by reference only)

J.4 PAST PERFORMANCE QUESTIONNAIRE

J.5 CONTRACTOR PERSONAL CONFLICT OF INTEREST FINANCIAL DISCLOSURE

TEMPLATE

J.6 CONTRACTOR BUSINESS ETHICS COI AND COMPLIANCE PROGRAM

REQUIREMENTS

J.7 VIRUS DETECTION CERTIFICATION

J.8 RESPONSIBILITY QUESTIONNAIRE

J.9 QUESTIONS – ANSWERS (QAs) TEMPLATE

J.10 CONSENT TO SUBCONTRACT

J.11 NON-DISCLOSURE STATEMENT

J.12 LIST OF PRIME AND SUB

E.1 EXHIBIT 1: COST PROPOSAL SPREADSHEET

SECTION K – REPRESENTATIONS, CERTIFICATIONS, AND OTHER

STATEMENTS OF OFFERORS OR QUOTERS

K.1 FAR 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE

(FEB 1998)

K.2 TO BE COMPLETED BY THE OFFEROR: [THE REPRENTATIONS AND

CERTIFICATIONS MUST BE EXECUTED BY AN INDIVIDUAL AUTHORIZED TO

BIND THE OFFEROR]

K.3 FAR 52.203-2 CERTIFICATED OF INDEPENDENT PRICE DETERMINATION (APR

1985)

K.4 FAR 52.204-8 ANNUAL REPRESENTATIONS AND CERTIFICATIONS (JAN 2017)

K.5 FAR 52.204-20 PREDECESSOR OF OFFEROR (JUL 2016)

K.6 FAR 52.222-22 PREVIOUS CONTRACTS AND COMPLIANCE REPORTS (FEB

1999)

K.7 FAR 52.222-25 AFFIRMATIVE ACTION COMPLIANCE (APR 1984)

K.8 FAR 52.227-15 REPRESENTATION OF LIMITED RIGHTS DATA RESTRICTED

COMPUTER SOFTWARE (DEC 2007)

K.9 FAR 52.209-5 CERTIFICATION REGARDING RESPONSIBILITY MATTERS (OCT

2015)

K.10 FAR 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (JUL

2013)

K.11 FAR 52.219-1 SMALL BUSINESS PROGRAM REPRESENTATIONS (OCT 2014)

K.12 FAR 52.215-6 PLACE OF PERFORMANCE (OCT 1997)

SECTION L – INSTRUCTIONS, CONDITIONS, AND NOTICES O OFFERORS OR

QUOTERS

L.1 FAR 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE

(FEB 1998)

L.2 NAICS CODE AND SMALL BUSINESS STANDARD

L.3 FAR 52.215-1 INSTRUCTIONS TO OFFERORS – COMPETITIVE ACQUISITION

(JAN 2017)

L.4 FAR 52.216-1 TYPE OF CONTRACT (APR 1984)

L.5 FAR 52.233-2 SERVICE OF PROTEST (SEP 2006)

L.6 HHSAR 352.239-73 ELECTRONIC INFORMATION AND TECHNOLOGY

ACCESSIBILITY NOTICE (DEC 2015)

L.7 FEDERAL ACQUISITION REGULATION (FAR) CLAUSES – CONTRACT AWARD

L.8 COMMUNICATIONS PRIOR TO CONTRACT AWARD

L.9 GENERAL INSTRUCITONS

L.10 PROPOSAL ORGANIZATION

L.11 VOLUME I: TECHNICAL PROPOSAL INSTRUCTIONS

L.12 VOLUME II: BUSINESS PROPOSAL INSTRUCTIONS

L.13 VOLUME III: BUSINESS ETHICS, CONFLICT OF INTEREST AND COMPLIANCE

INSTRUCTIONS

SECTION M – EVALUATION FACTORS FOR AWARD

M.1 FAR 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE

(FEB 1998)

M.2 GENERAL PROCEDURES FOR AWARD OF CONRACTS

M.3 EVALUATION OF VOLUME I: TECHNICAL PROPOSAL

M.4 EVALUATION OF VOLUME II: BUSINESS PROPOSAL

M.5 EVALUATION OF VOLUME III: BUSINESS ETHICS, CONFLICT OF INTEREST

AND COMPLIANCE

PART I – THE SCHEDULE

SECTION B – SUPPLIES OR SERVICES AND PRICES/COSTS

B.1 DESCRIPTION OF SERVICES

The purpose of this order is to support the Centers for Medicare & Medicaid Services (hereafter referred to as CMS) by reviewing claims medically reviewed by Medicare Review Contractors (hereafter referred to as MRCs) for accuracy. In determining the MRCs accuracy, the Contractor will review the MRCs decision making and ability to implement Medicare coverage, coding and payment. There are two types of Medical Reviews being conducted: Standard and Program Integrity.

B.2 TYPE OF CONTRACT

This is a firm-fixed-priced (FFP) and Time and Materials type contract.

B.3 SCHEDULE OF SUPPLIES/SERVICES

CLIN TYPE OF REVIEW YEAR CONTRACT

TYPE

TOTAL* FUNDED

AMOUNT

0001AA

Standard Medical Reviews Base Firm Fixed-Price TBD TBD

0001AB

Program Integrity Medical Reviews Base Firm Fixed-Price TBD TBD

0001AC

Optional Standard Medical Reviews Base Time & Materials TBD TBD

0001 Base Year Total Base TBD TBD

0002AA

Standard Medical Reviews Option Year 1 Firm Fixed-Price TBD TBD

0002AB

Program Integrity Medical Reviews Option Year 1 Firm Fixed-Price TBD TBD

0002AC

Optional Standard Medical Reviews Option Year 1 Time & Materials TBD TBD

0002 Option Year 1 Total Option Year 1 TBD TBD

0003AA

Standard Medical Reviews Option Year 2 Firm Fixed-Price TBD TBD

0003AB

Program Integrity Medical Reviews Option Year 2 Firm Fixed-Price TBD TBD

0003AC

Optional Standard Medical Reviews Option Year 2 Time & Materials TBD TBD

0003 Option Year 2 Total Option Year 2 TBD TBD

0004AA

Standard Medical Reviews Option Year 3 Firm Fixed-Price TBD TBD

0004AB

Program Integrity Medical Reviews Option Year 3 Firm Fixed-Price TBD TBD

0004AC

Optional Standard Medical Reviews Option Year 3 Time & Materials TBD TBD

0004 Option Year 3 Total Option Year 3 TBD TBD

0005AA

Standard Medical Reviews Option Year 4 Firm Fixed-Price TBD TBD

0005AB

Program Integrity Medical Reviews Option Year 4 Firm Fixed-Price TBD TBD

0005AC

Optional Standard Medical Reviews Option Year 4 Time & Materials TBD TBD

0005 Option Year 4 Total Option Year 4 TBD TBD

GRAND

TOTAL TBD TBD

*The total is the estimated amount of visits at the prices per review listed below:

CLIN Visit Type Price per Review 0001AA Standard Medical Review $ TBD 0001AB Program Integrity Review $ TBD

0002AA Standard Medical Review $ TBD 0002AB Program Integrity Review $ TBD

0003AA Standard Medical Review $ TBD 0003AB Program Integrity Review $ TBD

0004AA Standard Medical Review $ TBD 0004AB Program Integrity Review $ TBD

0005AA Standard Medical Review $ TBD 0005AB Program Integrity Review $ TBD

The total not-to-exceed amount for the T&M SLINs is as follows:

Program Integrity Outreach & Education Role Rate Hours Total

Subtotal Direct Labor

Material/ODC/Travel Material / ODC / Travel Subtotal Material/ODC/Travel

Not to Exceed Amount

Program Integrity Outreach & Education Role Rate Hours Total

Subtotal Direct Labor

Material/ODC/Travel Material / ODC / Travel Subtotal Material/ODC/Travel

Program Integrity Outreach & Education Role Rate Hours Total

Subtotal Direct Labor

Material/ODC/Travel Material / ODC / Travel Subtotal Material/ODC/Travel

Not to Exceed Amount

Program Integrity Outreach & Education Role Rate Hours Total

Subtotal Direct Labor

Material/ODC/Travel Material / ODC / Travel Subtotal Material/ODC/Travel

Program Integrity Outreach & Education Role Rate Hours Total

Subtotal Direct Labor

Material/ODC/Travel Material / ODC / Travel Subtotal Material/ODC/Travel

SECTION C – DESCRIPTION/SPECIFICATIONS/WORK STATEMENT

C.1 STATEMENT OF WORK

Independently and not as an agent of the Government, the Contractor shall furnish all the necessary services, qualified personnel, material, equipment, facilities, and supplies, not otherwise provided by the Government as needed to perform the requirements set forth in the Statement of Work, Attachment J.1. The SOW is entitled “Medical Review Accuracy Contractor.”

(END OF SECTION C)

SECTION D – PACKAGING AND MARKING

D.1 PACKAGING AND MARKING

All deliverables required under this contract shall be packaged, marked and shipped in accordance with Government specifications. The Contractor shall guarantee that all required materials shall be delivered in immediate usable and acceptable condition.

(END OF SECTION D)

SECTION E – INSPECTION AND ACCEPTANCE

E.1 FAR 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available.

Number Title Date 52.246-4 Inspection of Services- Fixed-Price August 1996 52.246-5 Inspection -- Time-and-Material and Labor-Hour May 2001

E.2 APPROVALS BY THE CONTRACTING OFFICER’S REPRESENTATIVE (COR)

All services or supplies to be delivered to the COR will be deemed to have been accepted 30 calendar days after date of delivery, except as otherwise specified in this contract, if written approval or disapproval has not been given within such period. The COR's approval or revision to the services or supplies delivered shall be within the general scope of work stated in this contract.

(END OF SECTION E)

SECTION F – DELIVERIES OR PERFORMANCE

F.1 FAR 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available.

Number Title Date 52.242-15 Stop Work Order Aug 1989 52.242-17 Government Delay of Work Apr 1984

F.2 PERIOD OF PERFORMANCE (JAN 2014)

The period of performance of this contract is: March 19, 2018 through March 18, 2019 (estimated).

This contract includes the following Option Periods:

Option Year 1: March 19, 2019 through March 18, 2020 Option Year 2: March 19, 2020 through March 18, 2021 Option Year 3: March 19, 2021 through March 18, 2022 Option Year 4: March 19, 2022 through March 18, 2023

F.3 DELIVERABLES

A full list of the deliverables can be found in Attachment J.1, MRAC SOW, under section IV.

Deliverables.

(END OF SECTION F)

SECTION G – CONTRACT ADMINISTRATION DATA

G.1 ACCOUNTING AND APPROPRIATION DATA

CLIN Req. No. Can No. Appropriation No.

Object Class

Amount

TBD TBD TBD TBD TBD $TBD

TOTAL $TBD

G.2 GOVERNMENT REPRESENTATIVES AND RESPONSIBILITIES (JUL 2016)

Following are the Government Representatives and their respective roles and responsibilities on this contract:

a. Contracting Officer

As defined in Federal Acquisition Regulation (FAR) 2.101, Definitions, and in accordance with FAR 1.602-1, Authority, “Contracting officers have authority to enter into, administer, and/or terminate contracts and make related determinations and findings.” There is no other authorized representative or any other Administrative Contracting Officer assigned to this contract to carry out a Contracting Officer’s duties, except for technical direction assigned to the Contracting Officer’s Representative, if applicable.

The Contracting Officer is:

Centers for Medicare & Medicaid Services Office of Acquisition & Grants Management Acquisition Support Group (ASG) Division of Program Integrity and Financial Management Contracts (DPIFMC) ATTN: Nicole Hoey 7111 Security Blvd.

Mail-stop: B3-30-03 Baltimore, MD 21244-1850

Phone: 410-786-0489 Email Address: Nicole.Hoey@cms.hhs.gov

b. Contract Specialist

Notwithstanding any of the other provisions of this Contract, the Contract Specialist will assist the Contracting Officer with his/her responsibilities as defined in the FAR.

The Contract Specialist is:

Centers for Medicare & Medicaid Services Office of Acquisition & Grants Management mailto:Nicole.Hoey@cms.hhs.gov

Acquisition Support Group (ASG) Division of Program Integrity and Financial Management Contracts (DPIFMC) ATTN: David Hochendoner 7111 Security Blvd.

Mail-stop: B3-30-03 Baltimore, MD 21244-1850

Phone: 410-786-6648 Email Address: David.Hochendoner@cms.hhs.gov

c. Contracting Officer’s Representative

The Contracting Officer’s Representative (COR), as defined in FAR 2.101, Definitions, is:

Centers for Medicare & Medicaid Services The Center for Program Integrity Provider Compliance Group Division of Recovery Audit Operations

ATTN: TBD

7500 Security Blvd.

Mail-stop: TBD Baltimore, MD 21244-1850

Phone: TBD Email Address: TBD

In accordance with FAR 1.602-2(d), Responsibilities, the COR’s delegated responsibilities are identified in the Contracting Officer’s appointment memorandum, a copy of which will be furnished to the contractor.

Technical direction must be within the general scope of the work stated in the contract. The term "technical direction" is defined to include, without limitation, the following:

(1) Directions to the Contractor which direct the contract effort, shift work emphasis between work areas or tasks, require pursuit of certain lines of inquiry, fill in details or otherwise serve to accomplish the contractual technical requirements as identified in the Statement of Work or Performance Work Statement; or

(2) Provision of information to the Contractor, which assists in the interpretation of drawings, specifications, or technical portions of the work description.

The COR does not have the authority to:

1. Make changes to contract terms and conditions;

2. Direct the contractor to perform work or make deliveries not specifically required under the contract;

3. Waive or relax the Government’s rights with regard to the Contractor’s compliance mailto:David.Hochendoner@cms.hhs.gov mailto:john.jenkins@cms.hhs.gov with the specifications, price, delivery or any other terms or conditions of the contract;

4. Make any commitments or approve any actions that would create any financial obligation on the part of the Government; or

5. Issue direction that constitutes a “change” as defined in:

FAR 52.243-1, Changes – Fixed Price;

FAR 52.243-2, Changes – Cost Reimbursement;

FAR 52.243-3, Changes – Time and Material and Labor Hour;

FAR 52.243-4, Changes; or, FAR 52.243-5, Changes and Changed Conditions.

All technical direction shall be issued in writing by the COR or, if issued verbally, shall be confirmed in writing by the COR within five (5) business days after issuance. The Contractor shall proceed promptly with the performance of technical direction duly issued by the COR within the scope of his/her authority.

If, in the opinion of the Contractor, any instruction or direction issued by a Government representative constitutes a change to the contract or constitutes a “Change Order” as defined in FAR 2.101, Definitions, the Contractor shall follow the instructions identified in FAR 52.243-7 Notification of Changes.

G.3 PROPERTY ADMINISTRATION

A. The Contractor is responsible for an annual physical inventory accounting for all government property under this contract. The inventory must be conducted by September 30th and the Form 565 Report of Accountable Personal Property submitted by October 31st of each year.

B. The inventory report shall include all items acquired, furnished, rented or leased under the contract. Employees who conduct the inventories should not be the same individuals who maintain the property records. Following the physical inventory, the Contractor shall prepare an inventory report and submit the report to the CMS Property Administrator at the address on the following page:

Centers for Medicare & Medicaid Services OOM, Administrative Services Group Division of Property and Space Management Attn: Tyrone Harris, Sr.

7500 Security Boulevard, M/S SLL-13-12 Baltimore, Maryland 21244-1850

(410) 786-2923

C. Commercially leased software is subject to these reporting requirements.

D. The Contractor shall submit a consolidated report of all accountable government property under this contract, including subcontractor inventory information.

E. The final inventory report shall indicate that all items required for continued contract performance are acceptable and free from contamination. Property that is no longer usable or required shall be reported and disposition requested. The final inventory report shall be submitted upon the date of contract expiration.

G.4 PAYMENTS - INVOICES - Firm Fixed Price Contracts (OCT 2015)

a. GENERAL: The Contractor shall submit to the Government an invoice for payment in accordance with the instructions below.

b. METHOD OF PAYMENT: CMS shall only make an electronic payment of invoices in accordance with FAR 52.232-33, Payments by Electronic Funds Transfer – System for Award Management. In order to receive payments, the contractor shall register in the System for Award Management (SAM) database, in accordance with FAR 52.204-7, System for Award Management.

ADDRESS CHANGES: The contractor shall notify CMS’ Division of Accounting Operations of all banking and address changes in SAM via the following email address:

CCRChanges@cms.hhs.gov.

c. CONTENT OF INVOICE - Invoices shall include, at a minimum:

Contractor’s name and address;

Contractor’s Tax Identification Number (TIN);

Contractor’s DUNS Number;

Invoice date;

Invoice Number to include the designation of the Contract Payment Category Type as follows:

Contract Payment Category Type IA (All Small Businesses No $ Limit)

Contract and Order Number, as applicable;

Contract line item number and/or Subcontract line item number;

Description, quantity, unit of measure, unit price and extended price of the items actually delivered or services rendered;

Shipping and payment terms;

Terms of any discount for prompt payment offered;

Other substantiating documentation or information as required by the contract;

Name, title, phone number and complete mailing address of responsible official to whom payment is to be sent;

Name, title, phone number of person to notified in the event of a defective invoice; and, Period of performance or delivery date of goods or services provided.

d. MAILINGS: Invoices shall be submitted as follows:

1. ELECTRONIC MAIL: The contractor shall submit an electronic copy of the invoice to both of the following individuals:

Contract Specialist – Refer to Section G.3; and mailto:CCRChanges@cms.hhs.gov

COR – Refer to Section G.3.

2. REGULAR MAIL: An original hard copy shall be submitted to the address below:

Department of Health & Human Services Centers for Medicare & Medicaid Services OFM/Division of Accounting Operations P.O. Box 7520 Baltimore, MD 21207-0520

3. OVERNIGHT MAIL: If the contractor chooses to use an overnight mail carrier, the original hard copy of the invoice shall be submitted to the address below:

Department of Health & Human Services Centers for Medicare & Medicaid Services OFM/Division of Accounting Operations 7500 Security Boulevard/Mailstop: C3-11-03 Baltimore, MD 21244-1850

e. PAYMENTS: The Government shall make payment of all invoices in accordance with

FAR 52.232-1 Payments, and FAR 52.212-4 Contract Terms and Conditions – Commercial Items (If applicable)

Upon acceptance by the Contracting Officer’s Representative (COR) in accordance with the applicable FAR Inspection and Acceptance clause and the Contracting Officer’s approval, as appropriate.

Reimbursement for invoices submitted under this contract shall be made not later than thirty (30) calendar days after receipt of an acceptable invoice from the Contractor requested at the paying office designated above. Any discrepancies determined as a result of the audit could delay the processing of the invoice and may result in the invoice being returned to the Contractor for corrections.

f. INTEREST ON OVERDUE PAYMENT

The Prompt Payment Act, Public Law 97-177 (96 Stat.85.31 U.S.C. 1801) is applicable to payments under this contract and requires the payment of interest on payments made more than 30 calendar days after receipt of an invoice by the Division of Accounting Operations.

Determinations of interest due will be made in accordance with the provisions of the Prompt Payment Act and Office of Management and Budget Circular A-125.

G.5 PAYMENTS – VOUCHERS - Time & Materials/Labor Hour Contracts (OCT 2015)

a. GENERAL: The Contractor shall submit to the Government a voucher or Standard Form 1034, Public Voucher for Purchases and Services Other Than Personal, for payment in accordance with the instructions below.

b. METHOD OF PAYMENT: CMS shall only make an electronic payment for reimbursement of voucher submissions in accordance with FAR 52.232-33, Payments by Electronic Funds Transfer – System for Award Management. In order to receive payments, the contractor shall register in the System for Award Management (SAM) database, in accordance with FAR 52.204-7, System for Award Management.

ADDRESS CHANGES: The contractor shall notify CMS’ Division of Accounting Operations of all banking and address changes in SAM via the following email address: CCRChanges@cms.hhs.gov.

c. CONTENT OF VOUCHER - Vouchers shall include, at a minimum:

Contractor’s name and address Contractor’s Tax Identification Number (TIN) Contractor’s DUNS Number Voucher Number to include the designation of the Contract Payment Category

Type as follows:

Contract Payment Category Type IA (TBD upon award)

Contract and Order Number, as applicable;

Contract line item number and/or Subcontract line item number;

Description, quantity, unit of measure, unit price and extended price/cost of the items actually delivered or services rendered, i.e., Labor category and labor hours x labor rate = total direct labor dollars, subcontractor costs, travel, other direct costs, overhead rate(s), etc.;

Shipping and payment terms;

Terms of any discount for prompt payment offered;

Other substantiating documentation or information as required by the contract;

Name, title, phone number and complete mailing address of responsible official to whom payment is to be sent;

Name, title, phone number of person to notified in the event of a defective voucher; and, Period of performance for delivery date of goods or services provided.

d. MAILINGS: Vouchers shall be submitted as follows:

mailto:CCRChanges@cms.hhs.gov

1. ELECTRONIC MAIL: The contractor shall submit an electronic copy of the voucher to both of the following individuals:

Contract Specialist – Refer to Section G.3; and COR – Refer to Section G.3.

2. REGULAR MAIL: An original hard copy of the voucher shall be submitted to the address below:

Department of Health & Human Services Centers for Medicare & Medicaid Services OFM/Division of Accounting Operations P.O. Box 7520 Baltimore, MD 21207-0520

3. OVERNIGHT MAIL: If the contractor chooses to use an overnight mail carrier, the original hard copy of the voucher shall be submitted to the address below:

Department of Health & Human Services Centers for Medicare & Medicaid Services OFM/Division of Accounting Operations 7500 Security Boulevard/Mailstop: C3-11-03 Baltimore, MD 21244-1850

e. PAYMENTS: The Government shall make payments on all vouchers in accordance with –

FAR 52.212-4, Contract Terms and Conditions – Commercial Items, (if applicable), FAR 52.216-7, Allowable Cost & Payment FAR 52.232-1, Payments, and FAR 52.232-7, Payments under Time-and-Materials and Labor-Hour

Contracts upon acceptance by the Contracting Officer’s Representative (COR) of the required supplies/services in accordance with the applicable FAR Inspection and Acceptance clause and the Contracting Officer’s approval.

Reimbursement for vouchers submitted under this contract shall be made not later than thirty (30) calendar days after receipt of an acceptable voucher from the Contractor at the paying office designated above. Any discrepancies determined as a result of the audit could delay the processing of the voucher and may result in the voucher being returned to the Contractor for corrections.

f. INTEREST ON OVERDUE PAYMENT

The Prompt Payment Act, Public Law 97-177 (96 Stat.85.31 U.S.C. 1801) is applicable to payments under this contract and requires the payment of interest on payments made more than 30 calendar days after receipt of an voucher by the Division of Accounting Operations.

Determinations of interest due will be made in accordance with the provisions of the Prompt Payment Act and Office of Management and Budget Circular A-125.

G.6 CORRESPONDENCE PROCEDURES

To promote timely and effective administration, correspondence (except for invoices), submitted under this contact shall be subject to the following procedures:

(a) Technical Correspondence - Technical correspondence (as used herein, this term excludes correspondence which proposes or otherwise involves waivers, deviations or modifications to the requirements, terms or conditions of this contract) shall be addressed to the Contracting Officer’s Representative (COR) with an informational copy of the basic correspondence to the Contracting Officer.

(b) Other Correspondence - All other correspondence shall be addressed to the Contracting Officer with an informational copy of the basic correspondence to the COR.

(c) Subject Lines - All correspondence shall contain a subject line, commencing with the contract number and assigning consecutive numbers (serial numbers to permit accountability), as illustrated below:

EXAMPLE: Contract No. - 75FCMCXXXXXX

Sequence # - XX (YEAR) - XXXX Subject - Request for Subcontract Consent

G.7 DATA TO BE DELIVERED

Any working papers, interim reports, data given by the Government or first produced by the Contractor under the contract or collected or otherwise obtained by the Contractor under the contract, or results obtained or developed by the Contractor (subcontractor or consultants) pursuant to the fulfillment of this contract are to be delivered, documented, and formatted as directed by the Contracting Officer.

In addition, information and/or data, which are held by the Contractor related to the operation of their business and/or institution and which are obtained without the use of Federal funds, shall be considered "PROPRIETARY DATA" and are not "subject data" to be delivered under this contract.

G.8 USE OF GOVERNMENT DATA (REPORTS/FILES/COMPUTER TAPES OR

DISCS)

Any data given to the contractor by the Government shall be used only for the performance of the contract unless the Contracting Officer specifically permits another use, in writing. Should the Contracting Officer permit the contractor the use of Government-supplied data for a purpose other than solely for performance of this contract and if such use could result in a commercially viable product, the Contracting Officer and the contractor must negotiate a financial benefit to the Government. This benefit should most often be in the form of a reduction in the price of the contract; however, the Contracting Officer may negotiate any other benefits he/she determines are adequate compensation for the use of these data.

Upon the request of the Contracting Officer or the expiration date of this contract, whichever shall come first, the contractor shall, upon instructions from the Contracting Officer, return or destroy all data given to the contractor by the Government. However, the Contracting Officer may direct that the data be retained by the contractor for a specific period of time, which period shall be subject to agreement by the contractor. Whether the data are returned, retained, or destroyed shall be the decision of the Contracting Officer with the exception that the contractor may refuse to retain the data. The contractor shall retain no data, copies of data, or parts thereof, in any form, when the Contracting Officer directs that the data be returned or destroyed. If the data are to be destroyed, the contractor shall directly furnish evidence of such destruction in a form the Contracting Officer shall determine is adequate.

G.9 CONTRACTOR PAST PERFORMANCE EVALUATION(S) (OCT 2014)

a. General:

In accordance with Federal Acquisition Regulation (FAR) 42.15, Contractor Performance Information, past performance evaluations shall be prepared at least annually and at the time the work under a contract or order is completed. Additional interim performance evaluations may be prepared at Contracting Officer discretion, as necessary.

CMS will utilize the Contractor Performance Assessment Reporting System (CPARS), the Government wide evaluation reporting tool for all past performance reports on contracts and orders, as appropriate. CPARS is a secure Internet website located at https://www.cpars.gov.

b. CPARS Process:

1. CPARS Training: Contractors may obtain CPARS training material and register for on-line training https://www.cpars.gov.

2. Post-Award Contract Registration: CMS is responsible for registering the contract in CPARS within 30 calendar days of contract award. The Contractor shall:

i. Designate at least one (1) point of contact that will be responsible for serving as the Contractor’s Representative (CR). Additional CRs may also be identified; and, https://www.cpars.gov/ https://www.cpars.gov/

ii. Provide the CMS Contract Specialist with the name(s) and email address(es) of the CPARS point(s) of contact.

Once CMS registers the contract in CPARS, the CR(s) will receive an automated CPARS email message that contains User IDs and instructions for creating a password for future past performance evaluation processing.

3. Interim, Annual and Final Past Performance Evaluation Reports:

a. Issuing the Evaluation: Once the CMS Assessing Official (AO) issues an evaluation to the Contractor in CPARS, the CR(s) will receive an email instructing them to login to CPARS to review the evaluation.

b. Contractor Comments: The CR has the option to provide comments on the evaluation, indicate if they concur or do not concur with the evaluation, sign, and then return the evaluation to the AO. The CR has a total of 60 days following the AO’s evaluation signature date to submit comments. If the CR submits comments within the first 14 days following the AO’s signature date and the AO closes the evaluation, the evaluation will become available in Past Performance Information Retrieval System - Report Card (PPIRS-RC) within 1 day.

On day 15 following the AO’s evaluation signature date, the evaluation will become available in PPIRS-RC with or without CR comments and whether or not it has been closed by the AO. If no CR comments have been sent and the evaluation has not been closed, it will be marked as “Pending” in PPIRS-RC.

If the CR sends comments at any time prior to 61 days following the AO’s evaluation signature date, those comments will be reflected in PPIRS-RC within 1 day. On day 61 following the AO’s evaluation signature date, the CR will be “locked out” of the evaluation and may no longer send comments.

G.10 Contractor Work Performed Outside the United States and its Territories (APR 2016)

To comply with requirements of Homeland Security Presidential Directive -12 (HSPD-12) and Personal Identity Verification (PIV) of Federal Employees and Contractors, CMS must achieve appropriate security assurance for multiple CMS information systems by efficiently verifying the claimed identity of individuals working on the contract. The Contractor and its subcontractor(s) shall not perform any activities under this contract, including the transmission of data or other information, outside of the United States (U.S.) and its Territories without the prior written approval of the Contracting Officer. If work must be performed outside the U.S., the Contractor shall submit a request to the Contracting Officer, in writing, at least 45 calendar days prior to the work beginning.

The Contracting Officer will consider the following factors in making a decision whether to authorize the performance of work outside the U.S. and its Territories:

1. Statement of Work requirements, which are being requested to be completed outside the U.S.

and its Territories;

2. Total projected dollar value of the work to be performed outside the U.S.;

3. The desired country/location where the work will be performed;

4. FAR Part 25, Foreign Acquisitions, and all other laws and regulations applicable to the performance of work outside the United States;

5. Whether the contractor and/or its subcontractor(s) have plans in place to adequately protect and secure CMS data, as well as abide by all applicable laws and regulations when work is performed outside of the U.S. and its Territories. Plans shall include -

a. Adequate contract terms regarding system security;

b. Adequate contract terms regarding the confidentiality and privacy requirements for information and data protection;

c. Adequate contract terms that are otherwise relevant, including the requirements of the

Statement of Work;

d. The Contractor’s corporate compliance plan and internal policies and procedures designed to prevent and detect violations of applicable law, regulations, rules and ethical standards by employees, agents and others; and,

6. Whether the approval would be in best interests of the United States.

The Contractor’s request for authorization to perform work outside the U.S. shall demonstrate that the performance of the work outside the U.S. satisfies all of the above factors. Contracting Officer approval to perform work outside the U.S. may require additional Statement of Work requirements, additional contract terms and conditions and/or Federal Acquisition Regulation (FAR) clauses to be incorporated into the contract.

G.11 SUBCONTRACT CONSENT

To facilitate the review of a proposed subcontract, by the COR and the Contracting Officer, the Contractor shall submit the information required by the FAR Clause 52.244-2 entitled, “Subcontracts”, to the assigned COR (Copy the CO), who shall in turn forward the information, with his/her recommendation to the Contracting officer. The Contractor shall complete the attached Subcontract Checklist (Attachment J-10) to facilitate this request either prior to, or after award. The Contracting Officer shall review the request for subcontract approval and the COR recommendation, and shall advise the Contractor of his/her decision to consent or dissent from the proposed subcontract, in writing.

Consent is granted to the following subcontractors: TBD

(END OF SECTION G)

SECTION H – SPECIAL CONTRACT REQUIREMENTS

H.1 BUSINESS ETHICS, CONFLICT OF INTEREST AND COMPLIANCE

(DEC 2015)

a. General: It is imperative that the Contractor and the services provided under this contract be free, to the greatest extent possible, of all Organizational and Personal Conflicts of Interest. In this clause, all references to Organizational and/or Personal Conflicts of Interests will be referred to individually or collectively, as the text justifies, as Conflicts of Interest (COI). Except as provided below, the Contracting Officer shall not maintain a contract with a Contractor that the Contracting Officer determines has, or has the potential for, an unresolved COI. However, in accordance with FAR 9.503 Waiver, the Contracting Officer may contract with a Contractor that has an unresolved COI if the Contracting Officer determines that it is in the best interest of the Government to do so.

b. Definitions:

Actual COI– means that the COI is currently in existence as determined by the Offeror’s or Contractor’s Compliance Officer and/or as determined by CMS. This form of COI will require avoidance, neutralization or mitigation acceptable to CMS.

Affiliates – As defined in FAR 2.101 means associated business concerns or individual(s) if, directly or indirectly either one controls or can control the other; or a third party controls or can control both.

For purposes of this contract, affiliate control or influence may include, but is not limited to:

(a) Interlocking management or ownership (e.g., individuals serving in similar capacities in several companies);

(b) Identity of interests among family members such as spouse/domestic partner and/or any dependent of the respondent;

(c) Shared facilities and equipment;

(d) Common use of employees; or

(e) A business concern organized just prior to, or immediately following, the release of a solicitation or request for information, which has the same or similar management, ownership, or principal employees as the offeror or Contractor.

Any business, whether or not it is organized for profit or located in the United States or its outlying areas, or person may be found to be an affiliate. Control may be affirmative or negative and it is immaterial whether it is exercised so long as the power to control exists.

Apparent (Perceived) COI – means that the COI on first observation appears to be an actual or potential COI, but may or may not be after analysis. Even if the apparent COI is determined to be non-existent, this perception may still require further explanation.

Avoidance – means Government action taken in one acquisition that is intended to prevent a COI in that acquisition or in a future action. Methods of avoiding COIs include, but are not limited to:

Drafting the statement of work (SOW) to exclude tasks that require Contractors to utilize subjective judgment; or

Obtaining advice from more than one source on any issue on which there are concerns about an COI so that there is no area in which the Government is relying solely on the advice of any one of the sources; or

Excluding an Offeror from participation in a contract award.

Financial Interests/Relationships – means a healthcare related direct or indirect ownership or investment interest (including an option or non-vested interest) in any entity that exists through equity, debt, or other means and includes any indirect ownership or investment interest no matter how many levels removed from a direct interest.

A financial interest/relationship may arise from the following non-exclusive examples:

(a) Compensation, including wages, salaries, commissions, professional fees, or fees for business referrals;

(b) Current or known future arrangements or requirements for which you are defined as an interested party, including, but not limited to, an entity that may create one or more of the three forms of COI;

(c) Consulting relationships, including commercial and professional consulting and service arrangements, scientific and technical advisory board memberships, or serving as an expert witness in litigation;

(d) Services provided in exchange for honorariums including travel expense reimbursements;

(e) Research funding or other forms of research support;

(f) Healthcare related investment in the form of stock or bond ownership, including healthcare sector investment only mutual funds;

(g) Healthcare business ownership or partnership interests;

(h) Patents, copyrights, and other intellectual property interests;

(i) Seeking or negotiating for prospective employment or business; or

(j) Gifts, including travel.

Mitigation– means action taken by the Contractor to reduce the COI risk to a level acceptable to CMS on a present contract.

Neutralization – means excluding or restricting a Contractor from offering, as a prime or subcontractor, on future contracts while allowing the Contractor to perform on the instant contract. This method protects the Government’s interests in cases where the Contractor’s work on the instant contract could be biased or impaired by virtue of its expectation of future work, or when the Contractor would have an unfair advantage in competing for award of the future work.

Organizational Conflict of Interest – In accordance with FAR 2.101 Definitions, means that because of other activities or relationships with other persons, a person is unable, or potentially unable, to render impartial assistance or advice to the Government, or the person’s objectivity in performing the contract work is, or might be, otherwise impaired, or a person has an unfair competitive advantage.

For purposes of this contract, the conflict of interest definition includes direct or indirect relationships including, but not limited to, the Contractor and its parent company, subsidiaries, affiliates, subcontractors, clients and principals.

Personal Conflicts of Interest – A situation in which a person has a financial interest, personal activity, or relationship that could impair the person’s ability to act impartially and in the best interest of the Government when performing under this contract.

1. Among the sources of personal conflicts of interest are—

(a) Financial interests of the person, spouse/domestic partner and/or any other dependent of the person, as defined for Federal tax purposes;

(b) Other employment or financial relationships (including seeking or negotiating for prospective employment or business) and,

(c) Gifts, including travel.

2. For example, financial interests referred to in paragraph (1)(a) of this definition may arise from—

(a) Compensation, including wages, salaries, commissions, professional fees, or fees for business referrals;

(b) Consulting relationships;

(c) Services provided in exchange for honoraria or travel expense reimbursements;

(d) Research funding or other forms of research support;

(e) Healthcare related investments;

(f) Real estate investments;

(g) Patents, copyrights, and other intellectual property interests; or

(h) Business ownership and investment interests.

Potential COI – means that the COI could become an actual COI due to contingency events and/or as determined by CMS. This form of COI will require avoidance, neutralization or mitigation acceptable to CMS.

Principal – As defined in FAR 52.203-13, Contractor Code of Business Ethics and Conduct, means an officer, director, owner, partner, or a person having primary management or supervisory responsibilities within a business entity (e.g., general manager, plant manager, head of a division or business segment, and similar positions).

Three (3) Types of COIs include:

Conflict Types Definitions

Biased Ground Rules

Consists of situations in which a firm, as part of its performance of a Government contract, has helped (or is in a position to help) set the ground rules for another Government contract by, for example, writing the statement of work or the specifications, or establishing source-selection criteria. In these “biased ground rules” cases, the primary concern is that the firm could skew the competition, whether intentionally or not, in favor of itself and/or its affiliates.

Impaired Objectivity

Consists of situations where a firm has an interest (typically financial) that may conflict with the interest of the Government to whom the firm has a contractual obligation, and the firm’s work under the Government contract could give the firm the opportunity to benefit its other business interests. If the firm is providing recommendations, judgment or advice, and its other business interests could be affected by that recommendation, judgment or advice, the firm’s objectivity may be impaired. An example is where the firm was evaluating itself, an affiliate or a competitor, either through an assessment of performance under another contract or an evaluation of proposals.

Unequal Access to Information

“Unfair” access to non-public information – Consists of situations in which a firm has access to nonpublic information (including proprietary information and non-public source-selection information) as part of its performance of a Government contract and that information may provide the firm with a competitive advantage in a later competition for a Government contract. In these “unequal access to information” cases, the concern is limited to the risk of the firm gaining an unfair competitive advantage;

there is no issue of bias. Note: Incumbency alone does not constitute “unequal access to information.”

c. Significant Potential Conflict of Interest: The Contracting Officer has determined that this contract may involve significant potential COIs.

1. Nature of Potential Conflict: Although not all inclusive, the Contracting Officer has determined that the following activities are considered to be an actual, potential or apparent COI with the work to be performed under this contract. The Contractor shall promptly notify the Contracting Officer of any relationships with any of the following entities:

For the purpose of identifying entities with actual, potential or apparent COIs, at a minimum, the entity is one that-

a) Would review or does review, under the contract, Medicare and/or Medicaid services furnished by a provider or supplier that is a direct competitor of the Contractor; or

b) Prepared work or is under contract to prepare work that would be reviewed under the contract; or

c) Is affiliated or has a financial relationship, as these terms are explained above, with an entity to be reviewed under the contract.

d) Holds any of the following contracts and grants:

i. MAC

ii. SMRC

iii. CERT

iv. ZPIC/UPIC

v. BFCC-QIO

vi. QIC

vii. MEDIC

2. Proposed Restraint on Future Contractor Activities: CMS is proposing to restrain future Contractor activities as follows:

A MRAC may not become a MAC, SMRC, CERT, ZPIC/UPIC, BFCC-QIO, QIC or MEDIC while holding the MRAC contract.

d. Contractor Business Ethics, Conflict of Interest and Compliance Program Requirements: FAR 3.10 and FAR 52.203-13, Contractor Code of Business Ethics and Conduct, identify “…policies and procedures for establishment of Contractor codes of business ethics and conduct, and display of agency Office of Inspector General (OIG) hotline posters.” (See Section I, FAR 52.203-14 fill-in information for the website where you can find the HHS OIG fraud hotline poster).

The following chart is provided to clarify requirements under this contract:

FAR 52.203-13 Requirements Applicability (X = Applicable)

Contracts < $5 Million

Contracts ≥$5 Million with a Small Business

OR for Commercial

Items (as Defined in

FAR 2.101)

Contracts ≥$5 Million with a

Large Business (No Commercial

Item Contracts)

CMS COI DISCLOSURES X X X

PLAN FOR

MONITORING/REPORTING

COIs (Large Businesses Shall Incorporate COI Monitoring/Reporting as Part of Its Compliance Program) X X X

CODE OF CONDUCT Not Required X X

COMPLIANCE PROGRAM Not Required Not Required X

1. COI Oversight Program: The Contractor shall maintain an effective COI Oversight Program. As part of the program, the contractor shall implement company business practices, procedures, polices and internal controls for compliance with COI requirements, such as:

(a) Preventing conflicts of interest, prohibiting the use of…

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