E.1_Business_Proposal_Template.xlsx

XLSX spreadsheet 158 KB Posted Dec 22, 2017

Attached to: Medical Review Accuracy Contract
Solicitation number: 75FCMC18R0013
Issued by: Department of Health and Human Services Centers for Medicare and Medicaid Services

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From the source

Exhibit E.1

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Other files

File	Type	Posted
E.1_Business_Proposal_Template01172018.xlsx	XLSX spreadsheet	Jan 17, 2018
75FCMC18R0013_amendment_0002.pdf	PDF	Jan 17, 2018
J.1_MRAC_SOW_Updated.docx	DOCX document	Jan 12, 2018
E.1_Business_Proposal_Template.xlsx	XLSX spreadsheet	Jan 12, 2018
75FCMC18R0013_Amendment_0001.pdf	PDF	Jan 12, 2018
E.2_MRAC_Answers_to_Questions.docx	DOCX document	Jan 12, 2018
75FCMC18R0013.pdf	PDF	Dec 22, 2017
J.10_Consent_to_Subcontract.docx	DOCX document	Dec 22, 2017
J.11_Non_Disclosure_Statement.docx	DOCX document	Dec 22, 2017
J.7_-_Virus_Detection_Certification.doc	DOC document	Dec 22, 2017
J.8_-_Responsibility_Questionnaire.doc	DOC document	Dec 22, 2017
J.1_MRAC_SOW.docx	DOCX document	Dec 22, 2017
J.12_-_List_of_Prime_and_Sub.xlsx	XLSX spreadsheet	Dec 22, 2017
J.4_-_Past_Performance_Questionnaire.docx	DOCX document	Dec 22, 2017
J.6_Contractor_Business_Ethics_COI_and_Compliance_Program_Requirements.docx	DOCX document	Dec 22, 2017
J.5_CONTRACTOR_PERSONAL_CONFLICT_OF_INTEREST_FINANCIAL_DISCLOSURE_TEMPLATE.docx	DOCX document	Dec 22, 2017
J.9__-_Questions_-_Answers_Template.docx	DOCX document	Dec 22, 2017
Presolicitation_Notice_-_MRAC.docx	DOCX document	Nov 30, 2017

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SUMMARY

PROJECT TITLE: Medical Review Accuracy Contract

Firm-Fixed Price (FFP) / Time & Materials (T&M)

Detailed Price Summary

Contract Line Item Description
	Total Price
CLIN 0001AA - Standard Medical Review Base Year
CLIN 0001AB - Program Integrity Medical Review Base Year
CLIN 0001AC - Optional Standard Medical Review Base Year (T&M)
CLIN 0001 - BASE YEAR TOTAL
CLIN 0002AA - Standard Medical Review Option Year 1
CLIN 0002AB - Program Integrity Medical Review Option Year 1
CLIN 0002AC - Optional Standard Medical Review Option Year 1 (T&M)
CLIN 0002 - OPTON YEAR 1 TOTAL
CLIN 0003AA - Standard Medical Review Option Year 2
CLIN 0003AB - Program Integrity Medical Review Option Year 2
CLIN 0003AC - Optional Standard Medical Review Option Year 2 (T&M)
CLIN 0003 - OPTION YEAR 2 TOTAL
CLIN 0004AA - Standard Medical Review Option Year 3
CLIN 0004AB - Program Integrity Medical Review Option Year 3
CLIN 0004AC - Optional Standard Medical Review Option Year 3 (T&M)
CLIN 0004 - OPTION YEAR 3 TOTAL
CLIN 0005AA - Standard Medical Review Option Year 4
CLIN 0005AB - Program Integrity Medical Review Option Year 4
CLIN 0005AC - Optional Standard Medical Review Option Year 4 (T&M)
CLIN 0005 - OPTION YEAR 4 TOTAL
TOTAL VALUE OF CONTRACT

STANDARD MEDICAL REVIEW

PROJECT TITLE: Medical Review Accuracy Contractor

Firm-Fixed Price (FFP)

Standard Medical Reviews

Contract Line Item Description	CLIN 0001AA Base Period (Transition)				CLIN 0001AA Base Period (Fully Operational)				CLIN 0002AA Option Year One				CLIN 0003AA Option Year Two				CLIN 0004AA Option Year Three				CLIN 0005AA Option Year Four				Grand Total
	Quantity	Unit	Unit Price	Total Price	Quantity	Unit	Unit Price	Total Price	Quantity	Unit	Unit Price	Total Price	Quantity	Unit	Unit Price	Total Price	Quantity	Unit	Unit Price	Total Price	Quantity	Unit	Unit Price	Total Price	Quantity	Total Price
Task 1 - Administrative	3	Each		$ -	1	Each		$ -	1	Each		$ -	1	Each		$ -	1	Each		$ -	1	Each		$ -	8	$ -
Task 2 - Transition	4	Each		$ -	1	Each		$ -	1	Each		$ -	1	Each		$ -	1	Each		$ -	1	Each		$ -	7	$ -
Task 3 - Meetings/Conference Calls	3	Each		$ -	9	Each		$ -	12	Each		$ -	12	Each		$ -	12	Each		$ -	12	Each		$ -	60	$ -
Task 4 - Standard Medical Review Part A				$ -	2000	Each		$ -	2600	Each		$ -	2600	Each		$ -	2600	Each		$ -	2600	Each		$ -	12400	$ -
Task 4 - Standard Medical Review Part B				$ -	3300	Each		$ -	4600	Each		$ -	4600	Each		$ -	4600	Each		$ -	4600	Each		$ -	21700	$ -
Task 5 - Disagreement Process				$ -	470	Each		$ -	460	Each		$ -	442	Each		$ -	431	Each		$ -	414	Each		$ -	2216	$ -
Task 6 - Status Reports				$ -	10	Each		$ -	13	Each		$ -	13	Each		$ -	13	Each		$ -	13	Each		$ -	62	$ -

Direct Labor	$ -	$ -	$ -	$ -	$ -	$ -	$ -
ODC's
Travel							$ -
Subcontracts							$ -
Materials							$ -
Subtotal ODCs							$ -
Total Estimated Yearly Values							$ -

Assumptions:

Contract Line Item Description		CLIN 0001AA Base Period (Transition)				CLIN 0001AA Base Period (Fully Operational)				CLIN 0002AA Option Year One				CLIN 0003AA Option Year Two				CLIN 0004AA Option Year Three				CLIN 0005AA Option Year Four				Grand Total
	Total FTE	FTE	Hours	Rates	Total Price	FTE	Hours	Rates	Total Price	FTE	Hours	Rates	Total Price	FTE	Hours	Rates	Total Price		Hours	Rates	Total Price	FTE	Hours	Rates	Total Price	Hours	Total Price
					$ -				$ -				$ -				$ -				$ -				$ -	0	$ -
					$ -				$ -				$ -				$ -				$ -				$ -	0	$ -
					$ -				$ -				$ -				$ -				$ -				$ -	0	$ -
					$ -				$ -				$ -				$ -				$ -				$ -	0	$ -
					$ -				$ -				$ -				$ -				$ -				$ -	0	$ -
					$ -				$ -				$ -				$ -				$ -				$ -	0	$ -
					$ -				$ -				$ -				$ -				$ -				$ -	0	$ -
					$ -				$ -				$ -				$ -				$ -				$ -	0	$ -
					$ -				$ -				$ -				$ -				$ -				$ -	0	$ -
Total FTE	0.00
Direct Labor					$ -				$ -				$ -				$ -				$ -				$ -		$ -

Labor Category Crossover

Proposed Labor Category (Bureau of Labor Statistics Equivalent)

PROGRAM INTEGRITY

PROJECT TITLE: Medical Review Accuracy Contractor

Firm-Fixed Price (FFP)

Program Integrity Medical Reviews

Contract Line Item Description	CLIN 0001AB Base Period (Transition)				CLIN 0001AB Base Period (Fully Operational)				CLIN 0002AB Option Year One				CLIN 0003AB Option Year Two				CLIN 0004AB Option Year Three				CLIN 0005AB Option Year Four				Grand Total
	Quantity	Unit	Unit Price	Total Price	Quantity	Unit	Unit Price	Total Price	Quantity	Unit	Unit Price	Total Price	Quantity	Unit	Unit Price	Total Price	Quantity	Unit	Unit Price	Total Price	Quantity	Unit	Unit Price	Total Price	Quantity	Total Price
Task 1 - Administrative	3	Each		$ -	1	Each		$ -	1	Each		$ -	1	Each		$ -	1	Each		$ -	1	Each		$ -	8	$ -
Task 2 - Transition	4	Each		$ -	1	Each		$ -	1	Each		$ -	1	Each		$ -	1	Each		$ -	1	Each		$ -	7	$ -
Task 3 - Meetings/Conference Calls	3	Each		$ -	9	Each		$ -	9	Each		$ -	9	Each		$ -	9	Each		$ -	9	Each		$ -	48	$ -
Task 4 - Program Integrity Medical Review Part A				$ -	2000	Each		$ -	3200	Each		$ -	3200	Each		$ -	3200	Each		$ -	3200	Each		$ -	14800	$ -
Task 4 - Program Integrity Medical Review Part B				$ -	5500	Each		$ -	7229	Each		$ -	7229	Each		$ -	7229	Each		$ -	7229	Each		$ -	34414	$ -
Task 5 - Disagreement Process				$ -	836	Each		$ -	884	Each		$ -	884	Each		$ -	890	Each		$ -	890	Each		$ -	4385	$ -
Task 6 - Status Reports				$ -	10	Each		$ -	13	Each		$ -	13	Each		$ -	13	Each		$ -	13	Each		$ -	62	$ -

Direct Labor	$ -	$ -	$ -	$ -	$ -	$ -	$ -
ODC's
Travel							$ -
Subcontracts							$ -
Materials							$ -
Subtotal ODCs							$ -
Total Estimated Yearly Values							$ -

Assumptions:

Contract Line Item Description		CLIN 0001AB Base Period (Transition)				CLIN 0001AB Base Period (Fully Operational)				CLIN 0002AB Option Year One				CLIN 0003AB Option Year Two				CLIN 0004AB Option Year Three				CLIN 0005AB Option Year Four				Grand Total
	Total FTE	FTE	Hours	Rates	Total Price	FTE	Hours	Rates	Total Price	FTE	Hours	Rates	Total Price	FTE	Hours	Rates	Total Price		Hours	Rates	Total Price	FTE	Hours	Rates	Total Price	Hours	Total Price
					$ -				$ -				$ -				$ -				$ -				$ -	0	$ -
					$ -				$ -				$ -				$ -				$ -				$ -	0	$ -
					$ -				$ -				$ -				$ -				$ -				$ -	0	$ -
					$ -				$ -				$ -				$ -				$ -				$ -	0	$ -
					$ -				$ -				$ -				$ -				$ -				$ -	0	$ -
					$ -				$ -				$ -				$ -				$ -				$ -	0	$ -
					$ -				$ -				$ -				$ -				$ -				$ -	0	$ -
					$ -				$ -				$ -				$ -				$ -				$ -	0	$ -
					$ -				$ -				$ -				$ -				$ -				$ -	0	$ -
Total FTE	0.00
Direct Labor					$ -				$ -				$ -				$ -				$ -				$ -		$ -

Labor Category Crossover

Proposed Labor Category (Bureau of Labor Statistics Equivalent)

&F&D&T

OPTIONAL STANDARD

PROJECT TITLE: Medical Review Accuracy Contractor

Time & Materials (T&M)

Optional Standard Medical Reviews

Assumptions:

Labor Category

FTE

CLIN 001AC Base Period (Optional Task)

CLIN 0002AC Option Year One (Optional Task)

CLIN 0003AC Option Year Two (Optional Task)

CLIN 0004AC Option Year Three (Optional Task)

CLIN 0005AC Option Year Four (Optional Task)

Grand Total

Hours

Rates

Total Price

Hours

Rates

Total Price

Hours

Rates

Total Price

Hours

Rates

Total Price

Hours

Rates

Total Price

Hours

Total Price

Total FTEs

Direct Labor

ODC's

Travel

Subcontracts

Materials

Subtotal ODCs

Total Estimated Yearly Values

Labor Category Crossover

Proposed Labor Category (Bureau of Labor Statistics Equivalent)

Travel

Travel Estimates - Base Period

Reason for Trip

SLIN

From

Number of People

Times per PoP

Airfare/Train

Hotel

Number of Nights

Meals & Incidentals Per Diem

Car Rental

Home Airport/train Parking

Milage/Tolls/ Parking/Misc*

Sub-Total

0001AA

TOTAL

0001AA

0001AB

TOTAL

0001AB

0001AC

TOTAL

0001AC

TOTAL

0001

Travel Estimates - Option Period 1

Reason for Trip

SLIN

From

Number of People

Times per PoP

Airfare/Train

Hotel

Number of Nights

Meals & Incidentals Per Diem

Car Rental

Home Airport/train Parking

Milage/Tolls/ Parking/Misc*

Sub-Total

0002AA

TOTAL

0002AA

0002AB

TOTAL

0002AB

0002AC

TOTAL

0002AC

TOTAL

0002

Travel Estimates - Option Period 2

Reason for Trip

SLIN

From

Number of People

Times per PoP

Airfare/Train

Hotel

Number of Nights

Meals & Incidentals Per Diem

Car Rental

Home Airport/train Parking

Milage/Tolls/ Parking/Misc*

Sub-Total

0003AA

TOTAL

0003AA

0003AB

TOTAL

0003AB

0003AC

TOTAL

0003AC

TOTAL

0003

Travel Estimates - Option Period 3

Reason for Trip

SLIN

From

Number of People

Times per PoP

Airfare/Train

Hotel

Number of Nights

Meals & Incidentals Per Diem Per FTR

Car Rental

Home Airport/train Parking

Milage/Tolls/Parking/Misc*

Total

0004AA

TOTAL

0004AA

0004AB

TOTAL

0004AB

0004AC

TOTAL

0004AC

TOTAL

0004

Travel Estimates - Option Period 4

Reason for Trip

SLIN

From

Number of People

Times per PoP

Airfare/Train

Hotel

Number of Nights

Meals & Incidentals Per Diem Per FTR

Car Rental

Home Airport/train Parking

Milage/Tolls/Parking/Misc*

Total

0005AA

TOTAL

0005AA

0005AB

TOTAL

0005AB

0005AC

TOTAL

0005AC

TOTAL

0005

Total Travel Estimates
	Total

Materials Materials

CLIN 0001	Contract Year	Item Description	Quantity	Unit Cost	Overhead	G&A	Other Indirect (Specify)	Fee	Total Cost
SLIN 1AA	Base
SLIN 1AA	Base
SLIN 1AA	Base
Total
SLIN 1AB	Base
SLIN 1AB	Base
SLIN 1AB	Base
Total
(Optional Task) 'SLIN 1AC	Base
(Optional Task) 'SLIN 1AC	Base
(Optional Task) 'SLIN 1AC	Base
Total
Total			$ - 0	$0	$0	$0	$0	$0	$0

CLIN 0002	Contract Year	Item Description	Quantity	Unit Cost	Overhead	G&A	Other Indirect (Specify)	Fee	Total Cost
SLIN 1AA	Option Year 1
SLIN 1AA	Option Year 1
SLIN 1AA	Option Year 1
Total
SLIN 1AB	Option Year 1
SLIN 1AB	Option Year 1
SLIN 1AB	Option Year 1
Total
(Optional Task) 'SLIN 1AC	Option Year 1
(Optional Task) 'SLIN 1AC	Option Year 1
(Optional Task) 'SLIN 1AC	Option Year 1
Total
Total			$ - 0	$0	$0	$0	$0	$0	$0

CLIN 0003	Contract Year	Item Description	Quantity	Unit Cost	Overhead	G&A	Other Indirect (Specify)	Fee	Total Cost
SLIN 1AA	Option Year 2
SLIN 1AA	Option Year 2
SLIN 1AA	Option Year 2
Total
SLIN 1AB	Option Year 2
SLIN 1AB	Option Year 2
SLIN 1AB	Option Year 2
Total
(Optional Task) 'SLIN 1AC	Option Year 2
(Optional Task) 'SLIN 1AC	Option Year 2
(Optional Task) 'SLIN 1AC	Option Year 2
Total
Total			$ - 0	$0	$0	$0	$0	$0	$0

CLIN 0004	Contract Year	Item Description	Quantity	Unit Cost	Overhead	G&A	Other Indirect (Specify)	Fee	Total Cost
SLIN 1AA	Option Year 3
SLIN 1AA	Option Year 3
SLIN 1AA	Option Year 3
Total
SLIN 1AB	Option Year 3
SLIN 1AB	Option Year 3
SLIN 1AB	Option Year 3
Total
(Optional Task) 'SLIN 1AC	Option Year 3
(Optional Task) 'SLIN 1AC	Option Year 3
(Optional Task) 'SLIN 1AC	Option Year 3
Total
Total			$ - 0	$0	$0	$0	$0	$0	$0

CLIN 0005	Contract Year	Item Description	Quantity	Unit Cost	Overhead	G&A	Other Indirect (Specify)	Fee	Total Cost
SLIN 1AA	Option Year 4
SLIN 1AA	Option Year 4
SLIN 1AA	Option Year 4
Total
SLIN 1AB	Option Year 4
SLIN 1AB	Option Year 4
SLIN 1AB	Option Year 4
Total
(Optional Task) 'SLIN 1AC	Option Year 4
(Optional Task) 'SLIN 1AC	Option Year 4
(Optional Task) 'SLIN 1AC	Option Year 4
Total
Total			$ - 0	$0	$0	$0	$0	$0	$0

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