E.1_Business_Proposal_Template01172018.xlsx

XLSX spreadsheet 193 KB Posted

Attached to
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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Amendment 0002 Revised E.1 Business Proposal Template

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75FCMC18R0013_amendment_0002.pdf PDF
E.1_Business_Proposal_Template.xlsx XLSX spreadsheet
75FCMC18R0013_Amendment_0001.pdf PDF
E.2_MRAC_Answers_to_Questions.docx DOCX document
J.1_MRAC_SOW_Updated.docx DOCX document
E.1_Business_Proposal_Template.xlsx XLSX spreadsheet
J.9__-_Questions_-_Answers_Template.docx DOCX document
J.5_CONTRACTOR_PERSONAL_CONFLICT_OF_INTEREST_FINANCIAL_DISCLOSURE_TEMPLATE.docx DOCX document
75FCMC18R0013.pdf PDF
J.8_-_Responsibility_Questionnaire.doc DOC document
J.4_-_Past_Performance_Questionnaire.docx DOCX document
J.11_Non_Disclosure_Statement.docx DOCX document
J.10_Consent_to_Subcontract.docx DOCX document
J.7_-_Virus_Detection_Certification.doc DOC document
J.1_MRAC_SOW.docx DOCX document
J.12_-_List_of_Prime_and_Sub.xlsx XLSX spreadsheet
J.6_Contractor_Business_Ethics_COI_and_Compliance_Program_Requirements.docx DOCX document
Presolicitation_Notice_-_MRAC.docx DOCX document
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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 0001BA - Program Integrity Medical Review (Medicare) Base Year
CLIN 0001BB - Program Integrity Medical Review (Medicaid) Base Year
CLIN 0001BC - Program Integrity Medical Review (Medi-Medi) Base Year
CLIN 0001AB - Optional Standard Medical Review Base Year (T&M)
CLIN 0001 - BASE YEAR TOTAL
CLIN 0002AA - Standard Medical Review Option Year 1
CLIN 0002BA - Program Integrity Medical Review (Medicare) Option Year 1
CLIN 0002BB - Program Integrity Medical Review (Medicaid) Option Year 1
CLIN 0002BC - Program Integrity Medical Review (Medi-Medi) Option Year 1
CLIN 0002AB - Optional Standard Medical Review Option Year 1 (T&M)
CLIN 0002 - OPTION YEAR 1 TOTAL
CLIN 0003AA - Standard Medical Review Option Year 2
CLIN 0003BA - Program Integrity Medical Review (Medicare) Option Year 2
CLIN 0003BB - Program Integrity Medical Review (Medicaid) Option Year 2
CLIN 0003BC - Program Integrity Medical Review (Medi-Medi) Option Year 2
CLIN 0003AB - Optional Standard Medical Review Option Year 2 (T&M)
CLIN 0003 - OPTION YEAR 2 TOTAL
CLIN 0004AA - Standard Medical Review Option Year 3
CLIN 0004BA - Program Integrity Medical Review (Medicare) Option Year 3
CLIN 0004BB - Program Integrity Medical Review (Medicaid) Option Year 3
CLIN 0004BC - Program Integrity Medical Review (Medi-Medi) Option Year 3
CLIN 0004AB - Optional Standard Medical Review Option Year 3 (T&M)
CLIN 0004 - OPTION YEAR 3 TOTAL
CLIN 0005AA - Standard Medical Review Option Year 4
CLIN 0005BA - Program Integrity Medical Review (Medicare) Option Year 4
CLIN 0005BB - Program Integrity Medical Review (Medicaid) Option Year 4
CLIN 0005BC - Program Integrity Medical Review (Medi-Medi) Option Year 4
CLIN 0005AB - 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 DescriptionCLIN 0001AA Base Period (Transition)CLIN 0001AA Base Period (Fully Operational)CLIN 0002AA Option Year OneCLIN 0003AA Option Year TwoCLIN 0004AA Option Year ThreeCLIN 0005AA Option Year FourGrand Total
QuantityUnitUnit PriceTotal PriceQuantityUnitUnit PriceTotal PriceQuantityUnitUnit PriceTotal PriceQuantityUnitUnit PriceTotal PriceQuantityUnitUnit PriceTotal PriceQuantityUnitUnit PriceTotal PriceQuantityTotal Price
Task 1 - Administrative3Each$ -1Each$ -1Each$ -1Each$ -1Each$ -1Each$ -8$ -
Task 2 - Transition3Each$ -0Each$ -0Each$ -0Each$ -0Each$ -0Each$ -3$ -
Task 3 - Meetings/Conference Calls3Each$ -9Each$ -12Each$ -12Each$ -12Each$ -12Each$ -60$ -
Task 4 - Standard Medical Review Part A23Each$ -2000Each$ -2600Each$ -2600Each$ -2600Each$ -2600Each$ -12423$ -
Task 4 - Standard Medical Review Part B7Each$ -3300Each$ -4600Each$ -4600Each$ -4600Each$ -4600Each$ -21707$ -
Task 5 - Disagreement Process0$ -470Each$ -460Each$ -442Each$ -431Each$ -414Each$ -2216$ -
Task 6 - Status Reports3Each$ -10Each$ -13Each$ -13Each$ -13Each$ -13Each$ -65$ -
Direct Labor$ -$ -$ -$ -$ -$ -$ -
ODC's
Travel$ -
Subcontracts$ -
Materials$ -
Subtotal ODCs$ -
Total Estimated Yearly Values$ -

Assumptions:

Contract Line Item DescriptionCLIN 0001AA Base Period (Transition)CLIN 0001AA Base Period (Fully Operational)CLIN 0002AA Option Year OneCLIN 0003AA Option Year TwoCLIN 0004AA Option Year ThreeCLIN 0005AA Option Year FourGrand Total
Total FTEFTEHoursRatesTotal PriceFTEHoursRatesTotal PriceFTEHoursRatesTotal PriceFTEHoursRatesTotal PriceHoursRatesTotal PriceFTEHoursRatesTotal PriceHoursTotal Price
$ -$ -$ -$ -$ -$ -0$ -
$ -$ -$ -$ -$ -$ -0$ -
$ -$ -$ -$ -$ -$ -0$ -
$ -$ -$ -$ -$ -$ -0$ -
$ -$ -$ -$ -$ -$ -0$ -
$ -$ -$ -$ -$ -$ -0$ -
$ -$ -$ -$ -$ -$ -0$ -
$ -$ -$ -$ -$ -$ -0$ -
$ -$ -$ -$ -$ -$ -0$ -
Total FTE0.00
Direct Labor$ -$ -$ -$ -$ -$ -$ -
Labor Category Crossover
Proposed Labor Category (Bureau of Labor Statistics Equivalent)

PI MEDICARE

PROJECT TITLE: Medical Review Accuracy Contractor
Firm-Fixed Price (FFP)
Program Integrity Medical Reviews
Medicare
Contract Line Item DescriptionCLIN 0001BA Base Period (Transition)CLIN 0001BA Base Period (Fully Operational)CLIN 0002BA Option Year OneCLIN 0003BA Option Year TwoCLIN 0004BA Option Year ThreeCLIN 0005BA Option Year FourGrand Total
QuantityUnitUnit PriceTotal PriceQuantityUnitUnit PriceTotal PriceQuantityUnitUnit PriceTotal PriceQuantityUnitUnit PriceTotal PriceQuantityUnitUnit PriceTotal PriceQuantityUnitUnit PriceTotal PriceQuantityTotal Price
Task 1 - Administrative3Each$ -1Each$ -1Each$ -1Each$ -1Each$ -1Each$ -8$ -
Task 2 - Transition3Each$ -0Each$ -0Each$ -0Each$ -0Each$ -0Each$ -3$ -
Task 3 - Meetings/Conference Calls3Each$ -9Each$ -9Each$ -9Each$ -9Each$ -9Each$ -48$ -
Task 4 - Program Integrity Medical Review Part A23Each$ -1450Each$ -1900Each$ -1900Each$ -1900Each$ -1900Each$ -9073$ -
Task 4 - Program Integrity Medical Review Part B6Each$ -4100Each$ -6000Each$ -6000Each$ -6000Each$ -6000Each$ -28106$ -
Task 4 - Program Integrity Medical Review Medicaid1Each$ -50Each$ -100Each$ -100Each$ -100Each$ -100Each$ -451$ -
Task 5 - Disagreement Process25$ -25Each$ -25Each$ -25Each$ -25Each$ -25Each$ -150$ -
Task 6 - Status Reports3$ -10Each$ -13Each$ -13Each$ -13Each$ -13Each$ -65$ -
Direct Labor$ -$ -$ -$ -$ -$ -$ -
ODC's
Travel$ -
Subcontracts$ -
Materials$ -
Subtotal ODCs$ -
Total Estimated Yearly Values$ -

Assumptions:

Contract Line Item DescriptionCLIN 0001AB Base Period (Transition)CLIN 0001AB Base Period (Fully Operational)CLIN 0002AB Option Year OneCLIN 0003AB Option Year TwoCLIN 0004AB Option Year ThreeCLIN 0005AB Option Year FourGrand Total
Total FTEFTEHoursRatesTotal PriceFTEHoursRatesTotal PriceFTEHoursRatesTotal PriceFTEHoursRatesTotal PriceHoursRatesTotal PriceFTEHoursRatesTotal PriceHoursTotal Price
$ -$ -$ -$ -$ -$ -0$ -
$ -$ -$ -$ -$ -$ -0$ -
$ -$ -$ -$ -$ -$ -0$ -
$ -$ -$ -$ -$ -$ -0$ -
$ -$ -$ -$ -$ -$ -0$ -
$ -$ -$ -$ -$ -$ -0$ -
$ -$ -$ -$ -$ -$ -0$ -
$ -$ -$ -$ -$ -$ -0$ -
$ -$ -$ -$ -$ -$ -0$ -
Total FTE0.00
Direct Labor$ -$ -$ -$ -$ -$ -$ -
Labor Category Crossover
Proposed Labor Category (Bureau of Labor Statistics Equivalent)

&F&D&T

&F&D&T

&F&D&T

&F&D&T

&F&D&T

PI MEDICAID

PROJECT TITLE: Medical Review Accuracy Contractor
Firm-Fixed Price (FFP)
Program Integrity Medical Reviews
Medicaid
Contract Line Item DescriptionCLIN 0001BB Base Period (Transition)CLIN 0001BB Base Period (Fully Operational)CLIN 0002BB Option Year OneCLIN 0003BB Option Year TwoCLIN 0004BB Option Year ThreeCLIN 0005BB Option Year FourGrand Total
QuantityUnitUnit PriceTotal PriceQuantityUnitUnit PriceTotal PriceQuantityUnitUnit PriceTotal PriceQuantityUnitUnit PriceTotal PriceQuantityUnitUnit PriceTotal PriceQuantityUnitUnit PriceTotal PriceQuantityTotal Price
Task 1 - Administrative3Each$ -1Each$ -1Each$ -1Each$ -1Each$ -1Each$ -8$ -
Task 2 - Transition3Each$ -0Each$ -0Each$ -0Each$ -0Each$ -0Each$ -3$ -
Task 3 - Meetings/Conference Calls3Each$ -9Each$ -9Each$ -9Each$ -9Each$ -9Each$ -48$ -
Task 4 - Program Integrity Medical Review Medicaid1Each$ -20Each$ -40Each$ -40Each$ -40Each$ -40Each$ -181$ -
Task 5 - Disagreement Process5$ -5Each$ -5Each$ -5Each$ -5Each$ -25Each$ -50$ -
Task 6 - Status Reports3$ -10Each$ -13Each$ -13Each$ -13Each$ -13Each$ -65$ -
Direct Labor$ -$ -$ -$ -$ -$ -$ -
ODC's
Travel$ -
Subcontracts$ -
Materials$ -
Subtotal ODCs$ -
Total Estimated Yearly Values$ -

Assumptions:

Contract Line Item DescriptionCLIN 0001AB Base Period (Transition)CLIN 0001AB Base Period (Fully Operational)CLIN 0002AB Option Year OneCLIN 0003AB Option Year TwoCLIN 0004AB Option Year ThreeCLIN 0005AB Option Year FourGrand Total
Total FTEFTEHoursRatesTotal PriceFTEHoursRatesTotal PriceFTEHoursRatesTotal PriceFTEHoursRatesTotal PriceHoursRatesTotal PriceFTEHoursRatesTotal PriceHoursTotal Price
$ -$ -$ -$ -$ -$ -0$ -
$ -$ -$ -$ -$ -$ -0$ -
$ -$ -$ -$ -$ -$ -0$ -
$ -$ -$ -$ -$ -$ -0$ -
$ -$ -$ -$ -$ -$ -0$ -
$ -$ -$ -$ -$ -$ -0$ -
$ -$ -$ -$ -$ -$ -0$ -
$ -$ -$ -$ -$ -$ -0$ -
$ -$ -$ -$ -$ -$ -0$ -
Total FTE0.00
Direct Labor$ -$ -$ -$ -$ -$ -$ -
Labor Category Crossover
Proposed Labor Category (Bureau of Labor Statistics Equivalent)

PI MEDI-MEDI

PROJECT TITLE: Medical Review Accuracy Contractor
Firm-Fixed Price (FFP)
Program Integrity Medical Reviews
Medi-Medi
Contract Line Item DescriptionCLIN 0001BC Base Period (Transition)CLIN 0001BC Base Period (Fully Operational)CLIN 0002BC Option Year OneCLIN 0003BC Option Year TwoCLIN 0004BC Option Year ThreeCLIN 0005BC Option Year FourGrand Total
QuantityUnitUnit PriceTotal PriceQuantityUnitUnit PriceTotal PriceQuantityUnitUnit PriceTotal PriceQuantityUnitUnit PriceTotal PriceQuantityUnitUnit PriceTotal PriceQuantityUnitUnit PriceTotal PriceQuantityTotal Price
Task 1 - Administrative3Each$ -1Each$ -1Each$ -1Each$ -1Each$ -1Each$ -8$ -
Task 2 - Transition3Each$ -0Each$ -0Each$ -0Each$ -0Each$ -0Each$ -3$ -
Task 3 - Meetings/Conference Calls3Each$ -9Each$ -9Each$ -9Each$ -9Each$ -9Each$ -48$ -
Task 4 - Program Integrity Medical Review Medi-Medi1Each$ -30Each$ -60Each$ -60Each$ -60Each$ -60Each$ -271$ -
Task 5 - Disagreement Process20$ -20Each$ -20Each$ -20Each$ -20Each$ -100Each$ -200$ -
Task 6 - Status Reports3$ -10Each$ -13Each$ -13Each$ -13Each$ -13Each$ -65$ -
Direct Labor$ -$ -$ -$ -$ -$ -$ -
ODC's
Travel$ -
Subcontracts$ -
Materials$ -
Subtotal ODCs$ -
Total Estimated Yearly Values$ -

Assumptions:

Contract Line Item DescriptionCLIN 0001AB Base Period (Transition)CLIN 0001AB Base Period (Fully Operational)CLIN 0002AB Option Year OneCLIN 0003AB Option Year TwoCLIN 0004AB Option Year ThreeCLIN 0005AB Option Year FourGrand Total
Total FTEFTEHoursRatesTotal PriceFTEHoursRatesTotal PriceFTEHoursRatesTotal PriceFTEHoursRatesTotal PriceHoursRatesTotal PriceFTEHoursRatesTotal PriceHoursTotal Price
$ -$ -$ -$ -$ -$ -0$ -
$ -$ -$ -$ -$ -$ -0$ -
$ -$ -$ -$ -$ -$ -0$ -
$ -$ -$ -$ -$ -$ -0$ -
$ -$ -$ -$ -$ -$ -0$ -
$ -$ -$ -$ -$ -$ -0$ -
$ -$ -$ -$ -$ -$ -0$ -
$ -$ -$ -$ -$ -$ -0$ -
$ -$ -$ -$ -$ -$ -0$ -
Total FTE0.00
Direct Labor$ -$ -$ -$ -$ -$ -$ -
Labor Category Crossover
Proposed Labor Category (Bureau of Labor Statistics Equivalent)

OPTIONAL STANDARD

PROJECT TITLE: Medical Review Accuracy Contractor
Time & Materials (T&M)
Optional Standard Medical Reviews

Assumptions:

Labor CategoryFTECLIN 001AB Base Period (Optional Task)CLIN 0002AB Option Year One (Optional Task)CLIN 0003AB Option Year Two (Optional Task)CLIN 0004AB Option Year Three (Optional Task)CLIN 0005AB Option Year Four (Optional Task)Grand Total
HoursRatesTotal PriceHoursRatesTotal PriceHoursRatesTotal PriceHoursRatesTotal PriceHoursRatesTotal PriceHoursTotal 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 TripSLINFromToNumber of PeopleTimes per PoPAirfare/TrainHotelNumber of NightsMeals & Incidentals Per DiemCar RentalHome Airport/train ParkingMilage/Tolls/ Parking/Misc*Sub-Total
0001AA
TOTAL0001AA
0001BA
TOTAL0001BA
0001BB
TOTAL0001BB
0001BC
TOTAL0001BC
TOTAL0001
Travel Estimates - Option Period 1
Reason for TripSLINFromToNumber of PeopleTimes per PoPAirfare/TrainHotelNumber of NightsMeals & Incidentals Per DiemCar RentalHome Airport/train ParkingMilage/Tolls/ Parking/Misc*Sub-Total
0002AA
TOTAL0002AA
0002BA
TOTAL0002BA
0002BB
TOTAL0002BB
0002BC
TOTAL0002BC
TOTAL0002
Travel Estimates - Option Period 2
Reason for TripSLINFromToNumber of PeopleTimes per PoPAirfare/TrainHotelNumber of NightsMeals & Incidentals Per DiemCar RentalHome Airport/train ParkingMilage/Tolls/ Parking/Misc*Sub-Total
0003AA
TOTAL0003AA
0003BA
TOTAL0003BA
0003BB
TOTAL0003BB
0003BC
TOTAL0003BC
TOTAL0003
Travel Estimates - Option Period 3
Reason for TripSLINFromToNumber of PeopleTimes per PoPAirfare/TrainHotelNumber of NightsMeals & Incidentals Per Diem Per FTRCar RentalHome Airport/train ParkingMilage/Tolls/Parking/Misc*Total
0004AA
TOTAL0004AA
0004BA
TOTAL0004BA
0004BB
TOTAL0004BB
0004BC
TOTAL0004BC
TOTAL0004
Travel Estimates - Option Period 4
Reason for TripSLINFromToNumber of PeopleTimes per PoPAirfare/TrainHotelNumber of NightsMeals & Incidentals Per Diem Per FTRCar RentalHome Airport/train ParkingMilage/Tolls/Parking/Misc*Total
0005AA
TOTAL0005AA
0005BA
TOTAL0005BA
0005BB
TOTAL0005BB
0005BC
TOTAL0005BC
TOTAL0005
Total Travel Estimates
Total

Materials Materials

CLIN 0001Contract YearItem DescriptionQuantityUnit CostOverheadG&AOther Indirect (Specify)FeeTotal Cost
(Optional Task) 'SLIN 1AB Part ABase650
(Optional Task) 'SLIN 1AB Part BBase2,000
Total2,650$0$0$0$0$0$0
CLIN 0002Contract YearItem DescriptionQuantityUnit CostOverheadG&AOther Indirect (Specify)FeeTotal Cost
(Optional Task) 'SLIN 1AB Part AOption Year 1650
(Optional Task) 'SLIN 1AB Part BOption Year 12,000
Total2,650$0$0$0$0$0$0
CLIN 0003Contract YearItem DescriptionQuantityUnit CostOverheadG&AOther Indirect (Specify)FeeTotal Cost
(Optional Task) 'SLIN 1AB Part AOption Year 2650
(Optional Task) 'SLIN 1AB Part BOption Year 22,000
Total2,650$0$0$0$0$0$0
CLIN 0004Contract YearItem DescriptionQuantityUnit CostOverheadG&AOther Indirect (Specify)FeeTotal Cost
(Optional Task) 'SLIN 1AB Part AOption Year 3650
(Optional Task) 'SLIN 1AB Part BOption Year 32,000
Total2,650$0$0$0$0$0$0
CLIN 0005Contract YearItem DescriptionQuantityUnit CostOverheadG&AOther Indirect (Specify)FeeTotal Cost
(Optional Task) 'SLIN 1AB Part AOption Year 4650
(Optional Task) 'SLIN 1AB Part BOption Year 42,000
Total2,650$0$0$0$0$0$0

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