FAQ_Draft_NQIIC_IDIQ_Solicitation.pdf

75FCMC18R0016 05/11/2018

NQIIC Frequently Asked Questions (FAQ)

RFP

Section & Title

Page No.

Question Response

1. Attachment J.1 (NQIIC IDIQ Statement of Work), Background and Overview

The table starting on p.47 of the draft RFP indicates several types of contracts for which being an NQIIC contractor would constitute a conflict of interest. To help contractors make a decision on whether to bid for the NQIIC IDIQ, can CMS indicate which of the types of contracts listed in table 47 will be issued under a separate RFP, and which will be issued as task orders under the NQIIC IDIQ vehicle?

The overarching support contract(s) are currently under development. CMS does not anticipate that any support work will be competed under the NQIIC IDIQ Umbrella. At this time, the contract limitations under consideration for the structure of the forthcoming support contract(s) indicates that prime NQIIC awardees will not be eligible to be awarded as prime contractor because of conflicts. CMS does anticipate that NQIIC prime contractors may be eligible to serve as subcontractors under the Overarching support contract(s) for portions of the work where conflicts can potentially be mitigated.

2. Statement of Work, J.1,2.0.b., Health Information Technology

Request clarification on the statement, "…supporting and training end-users on various health information systems." Is there an example of what level of training might be required and for what systems?

NQIIC offerors should be proficient in health information technology and be prepared to train front-line providers to increase their level of proficiency in order to support quality improvement efforts.

3. Attachment J.1, Section vii, Transparency

(NQIIC IDIQ SOW)

11 Please clarify RFP Section G.24 in the NQIIC IDIQ SOW, page 40, where 45-day notice and CMS permission must be given to share results of research, studies and analysis.

In Section I.24, the clause is specific to confidential information which means information or data of a personal nature about an individual, or proprietary information or data submitted by or pertaining to an institution or organization.

4. Attachment J.1, Section 3.0, g. i

(NQIIC IDIQ SOW)

12 Please clarify what is meant by the following statement in the NQIIC IDIQ SOW: "Task Orders will involve multiple concurrent tasks and may involve multiple levels of subcontracting".

CMS will be providing the flexibility to our NQIIC awardees to set-up a variety of subcontracting relationships to perform the tasks outlined in Task Order(s).

5. Attachment J.11 (Sample Task Order SOW)

2 For the sample test scenario TO, can CMS provide more clarification as to the sample sources of data that would be available to the contractor?

The CDC would be the authority to confirm and validate data but it is expected that the contractor would also collect data locally from the community to determine progress toward metrics.

6. Attachment J.11

(Sample Task Order SOW)

4 For the “Test” Scenario Task Order, where in the technical response would specific examples, in real life, of a quality improvement project that illustrates the approach best be displayed? Is it considered part of the 5 page response limit or can it be listed as an attachment?

At least one “real life” quality improvement project, to include the parameters as written in section 5.0 Task Order QI Outcomes, should be included within this response area, and would be included within the specified page limit response referenced in Section M. The Offeror may also include an attached table, as reference, if you believe it will help clarify the information.

7. Attachment J.11, Section 5.1.2

(Sample Task Order SOW)

6 In the Sample TO, should Table 1 reflect just the population-based improvement to reach the 25,000 Medicare beneficiaries in rural areas or the entire reach of this TO?

Entire reach

8. Attachment J.11, Section Table 1

(Sample Task Order SOW)

8 Please clarify how to complete the select one or two provider types and specify if rural applies to any subset.

Please provide justification if there are cost variances for rural providers". Can CMS provide more guidance as to how only one or two providers are the right approach to an intervention that appears to require more of a community-based approach?

Select one or more provider types your organization is best suited to reach. We want to know what type of providers you have experience working with and how you can impact those providers and associated beneficiaries.

9. Attachment J.11, Sample Task Order

6, 9 For Table 2 in the sample TO, it is referenced as a part of monthly item. Is it CMS' expectation that Table 2 be

The target population row and the goal columns should be filled out for the proposal.

included as part of the offeror's proposal?

10. Attachment J.11, Sample

Does CMS want the offeror to provide a paragraph narrative of overall strategies and interventions for the sample task order or does CMS prefer a table format?

The offeror may choose how to present the strategies.

11. Draft RFP Document, Section C, Sample Task Order, Table 1.

8 For the sample Task Order, does CMS require the bidder to demonstrate its national reach in only one or two provider types or for each provider type listed?

CMS requires for bidder to select as many provider types as applicable to perform the work.

12. Draft RFP Document, Section L.12

138 In Section C, p. 2, CMS defines NQIICs " as a set of quality improvement contractors that have the capability to achieve large scale improvement results using effective and innovative quality improvement strategies that are data driven, transparent, and empower patients, families and clinicians to make decisions about their healthcare." As defined, the breath of the NQIIC requires teams of companies to be able to address these important requirements. Will CMS consider revising its position in the final RFP and allow large companies to present the capabilities of their partners in addressing Phase 1 "NQIIC Contractor Capability" of RFP? This approach would allow respondents to present the full set of capabilities a bidding team offers CMS

Prime offerors should be able to demonstrate the outcomes they achieved and how they achieved them. If subcontractors contributed to the outcomes and results generated, those results can be included in the prime offerors response. In other words, if an offeror had led prior improvement projects encompassing regions where the direct quality improvement work was performed by their subcontractors, the results achieved by those subcontractors can be included in the prime contractor's proposal submission under NQIIC for a more accurate evaluation.

13. RFP Document, Section L.13

140 Are organizations allowed to agree to subcontract with multiple NQIIC prime bidders for the purposes of the sample task order? We believe this should be allowed because it is consistent with CMS guidance that organizations should not make any binding commitments to potential NQIIC primes until individual task orders are released. We do not believe it is in CMS’s best interest to force organizations to affiliate with a single prime during this phase because it would limit competition that typically produces better value for the government.

Yes

14. Draft RFP Document, Section L.13

140 Will CMS authorize existing prime contractors for activities that will be included in NQIIC to either implicitly or explicitly require their existing subcontractors to consent to exclusive partnering relationships with them as a condition of continuing their current subcontracts, having contract options exercised, or as a requirement for any future contracting relationships?

After award of the IDIQ, It is at the discretion of the Prime contractor to partner with any existing or potential subcontractors. CMS will not mandate these subcontracting arrangements.

15. IDIQ SOW, Attachment J.1., 2.0 NQIIC Services, f.

iii. Data Driven

10 The foundation of any effective quality improvement effort is accurate and timely data. Therefore, the NQIIC shall collect, aggregate, analyze, display, and

NQIIC Awardees will be accountable for using a system that meet s the requirement of the Task Order openly share data (i.e., to achieve or work toward transparency) with other CMS contractors. By creating a transparent approach to the work, the NQIIC Contractor will assist the Learning and Action Network (LAN) constituents, as well as other CMS-identified support contractors and parties in using data in other data-related efforts. NQIICs shall be data-driven in all facets of the task orders to ensure the implemented interventions have the greatest possibility of success.

Question: Will CMS provide a platform for sharing data among contractors or specifications for contractors to adhere to?

NQIIC awardees may work with community based entities to support sharing of Non-PII results to benchmark results at local, state, and regional levels.

NQIIC Awardees should keep in mind that CMS shared an intent that includes:

• improvement focus in meeting the bold AIMS,

• shared that there would be less deliverables, and more of a focus on just enough to see that improvement is occurring

16. IDIQ SOW, Attachment J.1., 2.0 NQIIC Services, f.

iv. Data Collection, a.

10 It is imperative to have sound, regular, and secure means to collect data related to the projects in order to monitor and define performance. To accomplish this, NQIICs will:

a. Use available data sources to achieve the contract goals, including but may not be limited to: CMS claims data, beneficiary complaint data, CMS survey and certification data, third party payer data, provider data, practitioner data, medical record abstracted data, census tract and disparities data, data directly provided by beneficiaries, registry data, and other NQIIC and/or partner data.

Not at this time.

Question: To date, all data from CMS includes only FFS Beneficiaries. Does CMS have a plan to gain direct access to data from ACOs and Medicare Advantage plans to share with contractors?

17. J.1 SOW, Section 2 5 What % of task orders does CMS anticipate will be released by state, what % by region, what % at a national level, what % at the community level?

This information is not available for the life of the contract.

18. NQIIC IDIQ Draft SOW, 2.0 NQIIC Services, a. Direct Technical Assistance, 5 - 6 Within the context of Direct Technical Assistance and Person and Family Engagement, is CMS interested in data-driven technology solutions to engage with beneficiaries for quality and cost management activities such as preventive care, medication adherence, and post-hospital discharge care management?

All solutions should be data-driven but the specific technical assistance will depend on the aims and outcomes within task orders.

19. Attachment J.11, Section 1.0

2 Is the provided test scenario meant to imply that diagnostics to identify the V123 infection are already in place?

Yes, assume all diagnostics are in place.

20. Attachment J.11, Section 1.0

2 The background and overview is missing some standard clinical parameters about the V123 infection. May the Offeror add clinical assumptions about the V123 infection to the test scenario? If yes, do we document these assumptions in the assumptions section of the cover page in Volume 2A? If they are not to be

All assumptions needed are provided in the test scenario.

documented on the cover page, where should they be documented?

21. Attachment J.11, Section 5.0

5 Given the limited pages in the Sample Task Order Technical Response, can the past performance example for a "real-life" project be referenced from the IDIQ Corporate Capacity and Oversight volume?

Each volume should be independent of one another.

22. Attachment J.11, Section 5.0

5 Is the baseline data expected to be national or NQIIC geographic region-specific?

The baseline should be based on the geographic region of the Offeror choosing. Ideally, this should be a geographic region in which the offeror has some knowledge and/or experience of healthcare quality improvement.

23. Attachment J.11, Section 5.0

5 Should the baseline data be based upon a similar known infection?

This is sample test TO. All of the content needed is already provided. Mortality and incidence will be provided in the TO.

24. Attachment J.11, Section 5.1.4.c

7 Since the final contract report is due 30 days prior to contract end, does that mean that all operational activities need to be completed well before that date in order to generate the final report on time?

Yes; however, CMS expects the Offeror to perform all work awarded until the last day of the period of the performance of the contract.

25. Attachment J.11, Table 1 8 Can an Offeror use actual provider population data from a state (e.g., New York State) to estimate value of national reach for Table 1 in Sample TO?

26. Attachment J.11 - Sample Task Order, 2e

8 Are LANs only regionally-based, or does the government anticipate there to be national LANs?

Some national LANs may be established but most will be developed by the offeror for the service area it covers..

27. Attachment J.11 - Sample

Task Order, General Please confirm that the contractor may use data and relationships outside of the U.S. to source evidence (data, literature, best practices) for its response to the sample task order.

Offerors may use data that has clear relevance or applicability to the United States and align with the quality improvement requirements under the NQIIC.

28. Attachment J.11 - Sample Task Order, (3.0)

3 On page 3 of the sample Task Order, CMS states: “All QI activities must be linked to two or more of the CMS Strategic goals, grounded in evidence (data, literature, and/or root cause analysis) with baseline data and community trends, and include rigorous quality improvement interventions and an evaluation strategy.” Is the contractor limited to using only publicly available data as evidence for proposed interventions and other aspects of the study (e.g. region, population, etc.)?

You may use data available to you to respond to this RFP.

29. Attachment J.1, (2.e) 9 In Attachment J.11, page 6, CMS states:

“Refer to section 2.e of the IDIQ NQIIC SOW contract for further information regarding LAN requirements.” Can CMS provide relevant requirements for LAN conference and meeting approvals for the sample TO?

CMS will work toward a blanket approval for all LAN activities but is currently working on this strategy. There may be meetings that may not fit under this definition that the offeror will have to request approval for.

30. Attachment J.1. NQIIC IDIQ Statement of Work.

Section 2.f.

9 NQIICs are to "aggressively pursue meeting CMS Aims by identifying challenges/problems in real time. . ."

What is meant by "real time"?

NQIICs should understand and have access to relevant data as it is available and be able to address challenges and problems based on the data

31. Attachment J.1 (NQIIC IDIQ Statement of Work), Continuous Improvement, Measurement, Data, and Reporting iv Data Collection

Would the data collection potentially include surveys?

Surveys are a potential source of information, though they would not be considered a primary source of data. Any survey collection would have to follow CMS information collection policies and procedures.

32. Attachment J.1, IDIQ SOW, Section f.iv.

10 Will CMS grant NQIIC task order recipients access to any applicable clinical data it collects via hybrid quality measures and eCQM reporting?

CMS will provide applicable data for task order aims though it is expected that the offeror will have the means to collect data in as close to real-time as possible to monitor performance.

33. Draft Statement of Work 13 Is population of interest restricted to Medicare beneficiaries?

Yes, unless otherwise stated.

34. Draft Statement of Work 9 Will there be standardized outcome measures by TORP?

Yes.

35. Draft Statement of Work 12 Will there be a standardized CIQIP Template?

No

36. Should letters of support be submitted with this response or held for TORP?

Letters of support are not required.

37. Should letters of commitment from partnering organizations be submitted for the Sample SOW?

Letters of commitment are not required from organizations or personnel under this NQIIC IDIQ evaluation.

38. For the sample SOW, should we use current staff and propose additional staff to build the staffing model?

39. Should resumes of current staff be submitted for the sample SOW? If needed, can they be included as attachments and not included in the page limit?

Yes, current staff resumes are encouraged and they can be part of the appendix

40. SOW Attachment J.1 2.0 e. 8 - 9 The RFP states: "The NQIIC shall adhere to the following minimum requirements for a LAN:"

Question: Is an NQIIC required to operate LANs, or is that optional?

This is a requirement.

41. SOW Attachment J.1 2.0 g i.

12 The RFP states: "The management plan shall include a Continuous Internal Quality Improvement Program Plan (CIQIP) which is updated as necessary for additional task orders."

Question: Does the government anticipate that bidders will submit the CIQIP as a part of the IDIQ or Task Order responses?

This will be a deliverable within the task orders and should be maintained continually. Please refer to the task orders when they are released for specific directions.

42. Sample TO, Section J .11 2 The Draft TO states: “When treated within the first two days of infection, the prognosis is favorable for infected individuals. For the purposes of the test scenario, does CMS envision a “Tamiflu” type antidote to arrest the infection?

It can be assumed that there is a treatment of some type.

43. NQIIC IDIQ SOW, J.1,

General

Please differentiate which activities in the SOW are specifically for work that falls under Section 1153 and Section 1154 of the Social Security Act. The IDIQ SOW makes no reference to it.

NQIIC awardees are organizations that have knowledge/skills to be able to drive large scale quality improvement. A future task order may be posted that falls into the referenced sections of the SSA.

44. NQIIC IDIQ SOW, J.1.2.0. a.

i-iii. p. 6 6 CMS states: NQIICs are expected to maintain a focus on vulnerable populations, rural health and patient and family engagement activities. For the purpose of planning, shall each of these foci be expressly included across the NQIIC and within each task order response under the IDIQ vehicle?

45. Statement of Work, Expectations-goals and operations

2 Can HHS/CMS clarify the expectation for large-scale and broad improvement with the need for sub-contracting? It appears HHS/CMS is looking for contractors to do most of the task order work, but the general requirements outline partnerships across different entities and broad collaboration - is there a preference for the prime to do the large share of the work without multiple subcontractors?

The expectation is for the NQIIC contractor to perform the management of the IDIQ contract. However, the amount of work that will subcontracted at the task order levels is not addressed in this solicitation. Offerors will be able to propose a business model that best meets the needs of their organization and the tasks outlined.

46. Attachment J.1 NQIIC IDIQ Statement of Work, 2.0 NQIIC Services (a)(i) - Vulnerable populations and disparities focus

6 Assist community members & additional regional participants - Please describe the activity where an awardee would assist community members in focusing on vulnerable populations and disparities.

The offeror will design interventions across task orders that incorporate these populations.

47. Attachment J.1 NQIIC IDIQ Statement of Work, 2.0 NQIIC Services (f)(iv) - Data analytics

10 Example of target populations - Can population include those not eligible for Medicare/Medicaid or will it need to reflect only CMS beneficiaries? If all payor population can be reflected, will the awardee need to stratify by payor?

Target population will be Medicare beneficiaries unless otherwise specified in the task order.

48. Attachment J.1 NQIIC IDIQ Statement of Work, 2.0 NQIIC Services (f)(vi) - Reporting

10 Improvement at both the intervention and community level - Please describe in detail (or provide example) what reporting "community level improvement" would look like.

This would depend on the task order but it would be a defined measure of improvement in a specified community.

49. Attachment J.1 NQIIC IDIQ Statement of Work, 2.0 NQIIC Services Section (d)

- Community coalitions

8 Assist communities in achieving goals (last paragraph) - Please define: a) expectations of "assist", what form would this take (i.e. webinars, face to face) and b) would the awardee be responsible for community healthcare goals?

NQIICs are responsible to drive community improvement and meet contract goals by assisting in the form that best suits the need of the community to meet the outcome.

50. Attachment J.1 NQIIC IDIQ Statement of Work, 2.0 NQIIC Services Section (e) - Community coalitions

8 Is there an expectation that LANS bridge across multiple task orders?

CMS would encourage teaming across LANs if appropriate but this is not a requirement.

51. Attachment J.1 NQIIC IDIQ Statement of Work, 2.0 NQIIC Services Section (f) - Continuous Improvement, Measurement, Data, and Reporting

9 For hospital focused large scale improvement work, clinician-focused technical assistance work, and other quality improvement work, will CMS be providing any equipment such as computers for access to Medicare billing data?

No

52. TO, Page 2, Paragraph 3 For purposes of the sample TO, can we make assumptions about the nature of the CDC guidelines as these will inform the intervention and spread strategy?

53. Draft SOW 7 Does CMS intend to include transplant centers among the list of quality improvement participants?

The list provided is not all-inclusive and may include providers not listed.

54. RFP document, Section L.13

142 We are unclear as to the information being requested in Columns 4 (Total Proposed Cost for Sample TO) and 5 (Average Cost per beneficiary proposed).

Is it CMS' intent that we break out costs by each provider type? If so, how should offerors account for activities that may involve multiple provider types, or beneficiaries who may seek care from multiple provider types?

The offeror should propose costs to achieve the outcomes and then divide by the number of beneficiaries to calculate and average cost per beneficiary and do the same per provider type.

55. RFP document, Section L.13

142 Can CMS provide an example of a completed Table 1 so offerors can better understand the information being requested in their proposals?

CMS will not be providing a sample.

56. Attachment J.11 Sample TO SOW, Section 1.0

2 The purpose of the Task Order is to test effectiveness of interventions which if implemented at scale would greatly improve healthcare quality. Is it correct to infer from this that the Task Order is for a pilot study?

The purpose of the sample task order is to allow CMS to assess an organization’s capability to provide healthcare quality improvement to drive return on investment and achieve outcomes.

57. Attachment J.11 Sample TO SOW, Section 3.0

3, 4 Should offerors include a response to each of the 16 activities under Quality Improvement Tasks in their response to the TO or follow the instructions in L.13B, M.4 by responding to Reach and Recruitment and Value and Impact?

Offeror should follow instructions in section L and ensure answer covers activities under sample task order .

58. Attachment J.11, 5.0 Outcomes, p.5 and RFP L.13.B Recruitment and Reach p. 140

5, 140 "Targeted community" is mentioned twice in the Task Order, whereas the IDIQ says that the contractor should select a provider type OR select communities.

Targeted community should be the overall region selected by the offeror.

Does CMS require the contractor to select a target community? If so, is there a specification for the size or composition of the community, or is the contractor free to select one based on the results of research conducted under items 1,2, and 3 under 3.0, Quality Improvement Tasks?

59. NQIIC Statement of Work (J.1), Section 2.0 NQIIC Services

5 The SOW states "Task order(s) will be released under this IDIQ contract with defined service areas on a state, regional, national or otherwise defined level by CMS or by the proposing contractor and approved by CMS." Should this be interpreted as NQIICs will be able to define or propose their own service areas (based on local data, needs, populations, etc.)? Should the referenced statement be interpreted as CMS will consider alternatives on an exception basis?

Each task order will specify the work required and the services areas/regions will be defined at that time. The statement is broad and will depend on the needs described in each independent task order.

60. NQIIC Statement of Work (J.1), Section 2.0 NQIIC Services, subsection b.

Health Information Technology

7 States are at various stages of HIT adoption/implementation and at different stages of Health Information Network development. Will CMS allow NQIICs the flexibility to tailor its activities and support to individual states, while promoting CMS' national interoperability agenda?

All task order activities should be tailored to the needs of providers/communities/patients.

61. J.1. 2.1 NQIIC Services, 1st paragraph.

The text indicates that "IDIQ task orders will include work for the Quality

CMS will not be commenting on the content of specific task orders at this point. Please refer to the list of topic areas.

Improvement Organization Program, End-Stage Renal Disease (ESRD) Network Program, large scale long term care improvement efforts, large scale hospital improvement efforts, clinician focused technical assistance, and other, yet to-be defined quality improvement activities of a NQIIC."

Can you clarify whether CMS is planning to continue to include nursing home, hospital, and clinician focused work within the QIO work?"

62. J.1. IDIQ SOW, ii. Cross-cutting Focus

3 Please provide more detail on your expectations for inclusion of the cross-cutting foci.

The offeror will be focused on these areas in all task order submissions and throughout their work as an NQIIC.

63. J.1. iii. Data-driven 10 With respect to openly sharing data, can you clarify CMS' expectations and the need for data use agreements and business associate agreements, and between whom?

Each Contract would need to have its own DUA. Please refer to CMS website for full explanation of DUA:

Data Use Agreements

64. J.11 Sample Task Order

SOW, 1.1

2 Re: Test Scenario Can we propose additional approaches to containment not listed? For example, patient and family targeted interventions, public quarantine support (close schools), etc.?

Yes. Please see number 6 in the list.

65. J.11. Sample Task Order

SOW

2 The Test Scenario, second paragraph, can you advise what are the "QI provider networks"?

Networks of providers with which the offeror works to provide quality improvement expertise.

https://www.cms.gov/Research-Statistics-Data-and-Systems/Files-for-Order/Data-Disclosures-Data-Agreements/Overview.html

66. J.11. Sample TO SOW. 5.1

Task Order QI Core Requirements

Will the specific requirements for recruitment and LAN targets be specified in the sample task order?

Recruitment targets are specified already. LANs should be used to support the interventions.

67. J.11. Sample TO SOW.

5.1.3 Learning and Action

Networks (LAN)

1. Can you advise if all of the red italicized text in the below paragraph is considered a LAN activity rather than preparatory work required for LANs

LANs will also work to identify communities with the highest rates of infection and mortality due to V123, complete root cause analyses for these communities, and find interventions appropriate to reduce infection and mortality rates.

2. Can you advise if the below is considered a LAN activity? We can certainly Identify them and bring them to the LAN, but the LAN itself is not a tool to identify high performers.

LANs should also identify areas of high performance, and quantitate and

3. What do you mean by ""quantitate"" in the statement: LANs should also identify areas of high performance, and quantitate

1. Please refer to the NQIIC SOW for further definition of LANs.

2. LANs should highlight high performers.

3. Quantitate=quantify

68. J.11. Sample TO SOW. 2 RE: Test Scenario, third paragraph

The same incidence rate and mortality rate will be assumed for all areas.

Should we assume our area has a high rate?

69. IDIQ SOW, 1.0 NQIIC

Overview, Align with and Generate Results on CMS Goals, i. Flexibility & Agility in Operations and Teaming with CMS and Others

3 Teaming with other stakeholders suggests there are no limitations as to with which stakeholders the NQIIC contractors may team. Is this open-ended where teaming may include anyone from industry, other quality contractors, etc.?

These stakeholders should be appropriate to assist with meeting the QI goals of the task orders.

70. Sample SOW, 5.0 Task Order QI Outcomes

5 The Quality Improvement Tasks under

3.0 (Pages 3-4) are well developed and comprehensive. Given the level of effort and number of requirements, is a 12-month period for such levels of improvement a reasonable time frame?

(Of course, this is only a sample task order, but such a question might arise if it was a real task order.)

The timeframe was chosen due to the nature of the test case.

71. Attachment J.11 Sample Task Order Statement of Work, Section 3.0, third bullet

3 Please clarify "within the NQIICs region." For the purposes of the sample TO- The offeror may propose on a geographic region of their choosing. Ideally, this should be a geographic region in which the offeror has some knowledge and/or experience of healthcare quality improvement.

72. SOW 4 Are NQIIC offerors required to identify Community Coalition partners prior to the submission of a proposal for NQIIC?

No. Offerors may choose to identify types of coalition stakeholders engaged during previous improvement work but do not need to define community coalition partners prior to submission of the proposal.

73. SOW 2.0 NQIIC Services 5 Is a minimum or maximum number of topic areas required to be addressed by a NQIIC Contractor?

The topic areas listed are not all-inclusive and there may be areas of focus within task orders.

74. Sample Task Order - Test Scenario

Based on the description ov V123 infection with chronic duration and high mortality, can we assume patients would exist in every health care sector (inpatient, long term care, clinician/ambulatory, home health, etc.)

and should therefore design interventions for every provider type? Or should we focus on the provider types we are specifically recruiting based on our NQIIC capability and coordinate and partner with other NQIIC contractors addressing other provider types as long as we can reach the 25,000 beneficiary minimum?

It is assumed that patients will be present in every healthcare sector and you should propose addressing provider types based on your healthcare QI expertise/knowledge.

75. Attachment J.1 NQIIC IDIQ 5 Will there be task orders which non- QIO/QINs are eligible to bid?

76. NQIIC Draft RFP, Section G.12.F

23 With regard to the following:

"Contractors are expected to provide all equipment, materials, facilities, etc.

necessary for performance of this contract. In some instances, an exception may be granted to furnish Government owned property or to authorize purchase with contract funds. If additional equipment must be acquired, it will be determined and approved at the task order level" If the contractor hires new staff, not currently employed by the contractor, or possesses staff whose only responsibilities relate to a particular TO.

Is the equipment needed for their

CMS will determine the Allowability of equipment costs, on a case-by-case basis, in accordance with OMB Uniform Guidance and FAR Part 31 and are based on your organization type. Per FAR Contract Cost Principles and Procedures, if it determined to be a direct cost of the contract, then it can be charged directly to the contract.

performance of the TO appropriate to bill directly to the TO?

77. NQIIC Draft RFP, Section H.5

62 Are all contractor and subcontractor staff required to read HHS Rules of Behavior and sign the accompanying acknowledgment?

yes

78. NQIIC Draft RFP, Section H.23.C.

85 Can former QIN QIO governing body members be considered for election/appointment after one three-year absence, similar to what as currently described in the Governance and Compliance Requirements Applicable to ESRD’s section (H.24.3 page 87)?

yes

79. NQIIC Draft RFP, Section L.13

140 Will CMS give recruitment numbers for any of the real task orders? If not, will any guidance regarding recruitment be provided other than the minimum 5%?

There will be specific criterion put out for each task order. The 5% is specific to this sample task order.

80. NQIIC Draft RFP, Section L.14 C.

146 In the list of information to be provided for non CPARs past performance information, please clarify – “Program Manager and Telephone” – Is CMS requesting the program manager and telephone of the non CPARs contract reference or of the organizations program manager responsible for managing the contract work?

Program Manager of the contracting activity.

81. Draft RFP #75FCMC18R0016, Section L.8

132 When CMS issues its final NQIIC solicitation, will the due date for the Notice of Intent to Bid be at 11:00am ET on May 25, 2018?

This will be answered with the release of the final RFP

82. Draft RFP, Section H.12 76 H.12 states that "Any and all costs, proposed or incurred, for conferences, travel to/from conferences, are currently not authorized or allowed unless authorized in writing." Is the intention to exclude costs related to conferences and travel for conferences from indirect costs?

Yes for the purpose of proposing on the IDIQ

83. Draft RFP, Section I.1 92 FAR Clause 52.222-2 Payment of Overtime Premiums (a) Zero: Will this be amended for any fixed-price task orders awarded?

No

84. Draft RFP, Section I.1 92 FAR Clause 52.222-2 Payment of Overtime Premiums (a) Zero: Will this be amended for any time-and-materials task orders awarded?

85. Draft RFP, Section I.2 93 HHSAR Clause 352.231-70 Salary Rate Limitation: Will CMS consider higher paid salaries for positions such as the CMO or physicians, if they are paid in accordance with salary surveys? The highest hourly rate allowed in the clause is below the presently approved rate for subject matter experts and physicians on CMS contracts.

Not at this time. Should the salaries and wages pay tables on the Office of Personnel Management website be revised then CMS will consider the new salaries under contract.

86. Draft RFP, Section I.2 93 HHSAR Clause 352.231-70 Salary Rate Limitation: Will the salary cap be determined at the IDIQ contract level or the task order level?

87. Draft RFP, Section J, List of

Attachments 102 Will offerors need Attachment J.5 for the sample task order?

No

88. Draft RFP, Section K.4 110 Does CMS want offerors to incorporate a current organizational chart that includes task order descriptions or a high-level organizational chart?

High-level organizational chart

89. Draft RFP, Section L.7.D 130 "Offerors must submit an HHS Section 508 Product Assessment Template…."

Are offerors to submit this separately or incorporate it into one of the volumes?

The Product Assessment Template should be used when applicable at the task order level. The submission instructions will be provided at that time.

90. Draft RFP, Sections I.15.d and e, page 101 & Draft RFP, Section L.7.D, page

101, The RFP states that instructions for documenting accessibility via the HHS Section 508 Product Assessment Template may be found under Section 508 policy on the HHS website:

(http://www.hhs.gov/web/508). This site is automatically redirected to https://www.hhs.gov/web/section- 508/index.html. The Product Assessment Template found on this page does not align with the 2017 Final Rule, which updated the 508 compliance Standards and is not the same as the Attachment J.13_508_Compliance_(VPAT). Which Product Assessment Template should be used?

The link referenced was updated in April 2018. Please use the HHS VPAT template under Helpful Resources, which matches the Attachment in the solicitation.

91. Draft RFP, Section L.10 (b) 1.A

133 For Volume I, may offerors add an appendix that would be excluded from the page count? If so, what is the page limit for the appendix?

There is no appendix in Volume I.

92. Draft RFP, Section L.10 (b) 1.A, page 133 & Section L.11 (b), page 138

133, May the cover letter/page extend beyond one page?

No page limit

93. Draft RFP, Section L.13, pages 141-142, Table 1 & Attachment J.11, Table 1, 141 – 142, TO

Pg 8

The instructions for Table 1 indicate for offerors to select one or two provider types. May offerors propose to work with more than two provider types to accomplish the work of the task order?

Yes. Select one or more provider types your organization is best suited to reach. We want to know what type of providers you have experience working with and how you can impact those providers and associated beneficiaries.

94. Draft RFP, Section L.13.C, Personnel

143 Does each resume have a page limit? NO

95. Draft RFP, Section L.14.C, Past Performance

146 On page 146, CMS clearly delineates non- CPARS information that is required.

Would CMS delineate the requirements for contracts that are in CPARS? For example, in past RFPs, CMS has included a table with required elements such as Agency, Contracting Activity, Contract Number, Total Contract Value.

Please provide the same information

96. Draft RFP, Section L.10, page 132 & Section L.14.C

146 In the table on page 132, the page limit for Volume IIB, which includes past performance, states 15 pages. On page 146, it states there is no page limit for past performance. Is past performance excluded from the 15-page limit for Volume IIB?

Past Performance is not included in the page limit and can be included in the appendix

97. Draft RFP Document, Section B.1

6 Because NQIIC is an IDIQ and the exact task orders that will be awarded under it are not known to potential bidders, we do not believe, except for BFCC contract holders, that there should be any blanket conflict of interest determinations that keep any organization that meets NQIICs

Correct other requirements from submitting a bid as a prime contractor. Instead, we believe that these determinations should be made on a task order-specific basis.

98. Draft RFP Document, Section G.7.C

25 CMS approval is required for all contracts that are not fixed price, all fixed price contracts over 150K or 5% of the prime contract, and for individuals with fully loaded labor rates above specified caps.

If the contracts with these individuals are fixed price and below the limits specified in G.7.c.2, is CMS permission still required? We do not believe it should be and would recommend clarifying that such fixed price agreements (which would encompass many experts’ honorarium) do not require CMS approval.

Approval is not required below those limits.

99. Draft RFP Document, Section L.2

93 The RFP references HHS Salary Rate limitations (352.231-70). To this point HIIN contracts have not had to comply with these limits while QIN prime contracts have. Would CMS clarify whether these limitations will apply to all NQIIC task orders, including those that are fixed price? If NQIIC fixed price contracts do not have to comply with these limits, will contractors that must comply with these limits on cost reimbursement contracts be allowed to exceed them on NQIIC fixed price task orders? We believe this would be important to maintain a level playing

Yes, these limitations will apply to the task orders for all types of contracts.

Note that the salary rate limitation does not restrict the salary that an organization may pay an individual working under an HHS contract or order; it merely limits the portion of that salary that may be paid with contract funds and is for direct salary.

field when evaluating bids for fixed price task orders.

100 Draft RFP Document, Section L.14.C

146 This section states that past performance information should be provided for “any proposed subcontractors performing at least 25% effort.” Earlier sections seemed to suggest the proposal would be evaluated exclusively based on the qualifications of the proposed prime contractor. So could you please confirm that information about subcontractors should only be provided by bidders that are small businesses?

101 Draft RFP Section L.10.4, General Instructions – Volume III – Business Proposal (page 133), and RFP Section L.15, Business Proposal Organization and Content (Volume III) (page 147)

133, Sections L.10.4, General Instructions – Volume III – Business Proposal, and L.15, Business Proposal Organization and Content (Volume III), require completion of Sections G and H of the solicitation, “as applicable”. Can CMS please clarify what is required to comply with this request, given that the tables in these sections are to be completed at the task order level?

Correct that Sections G and H will mostly be applicable to the task order level. However, H.1 for COI and its referenced Attachment, and H.7 for Data Use Agreement apply to the IDIQ.

102 Draft RFP Document, Section M.3.A

154 The phase one evaluation indicates that only work performed as a prime contractor will be considered. We believe this is inconsistent with the earlier emphasis in the RFP on only considering work the offeror has performed on their own. So if an offeror has been a subcontractor to another organization and in that capacity has led

• We are not evaluating subcontractor performance separately as part of the IDIQ award.

• Offerors are able to show past performance outcomes that have been generated with contributions from subocntractors.

improvement activities in their area, they should be allowed to use these accomplishments to establish their capabilities as a qualified bidder. As written, this section seems to prevent state hospital associations that may have affiliated with a larger HIIN from claiming responsibility for achievements in their state for which they had primary or sole responsibility.

103 Draft RFP Document, Section M.3.C

155 Evaluation Section C indicates that “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. . .”

Because this is an IDIQ and the government is not committing to funding any specific task orders at this time, we do not believe the government is capable of fairly and transparently making this determination at the time it makes the IDIQ awards. Instead, we believe that decisions about COIs and whether they can be mitigated should be addressed at the task order level. If CMS believes it can make a blanket determination that a potential bidder has irreconcilable conflicts of interest for ALL task orders that will be released under NQIIC than we request they provide the list of all task orders so that this assertion can be evaluated by potential bidders.

While most COIs will be addressed at the task order level. The contract limitation chart referenced in Sections H.1 and L.10 must be adhered to.

104 Draft RFP Document, Section M.6.B

160 The RFP indicates that awards will be made to successful bidders unless they have COIs that cannot be “avoided, neutralized, or mitigated” and that bidders will be allowed to respond to CMS concerns about COIs that might prevent receiving an NQIIC prime contract. Section C and D further indicate that the government may choose to waive COIs if they determine it is in their best interest. Could CMS confirm that these sections mean they will accept proposals from all bidders, regardless of conflicts noted in the chart that begins on page 47, will allow all bidders to propose neutralization and mitigation strategies for potential COIs, and will consider whether accepting proposals from bidders with potential COIs because doing so is in the best interest of the government?

CMS will accept proposals from all bidders but must consider all potential conflicts and mitigation plans prior to awarding a contract or task order, depending on what the conflict may be.

105 Past Performance 146 A list of all contracts and/or subcontracts for same or similar work. . . within the last five (5) years shall be provided for the prime contractor…

"(1) Please clarify that the agency intends the phrase “prime contractor” to refer to the IDIQ offeror in response to the RFP.

The Prime contractor is responsible for the contract. In this case, the prime contractor referenced is the IDIQ offeror.

106 Draft RFP document, Section M.3

154 Will there be separate due dates for the Phase 1 evaluation Volume (Volume I) and the Phase 2 evaluation Volumes (Volumes IIA, IIB, and III) such that only

Proposals that are being submitted should contain all Volumes at the time of submission.

Volume 1 is required to be submitted initially with the remaining Volumes being due prior to the start of the Phase II evaluation?

107 Draft RFP, Section H (pp.

41-88) and Section I (pp. 89-101), general

41-88, 89-101

How will the Government decide to exercise an option? Option clauses are missing.

Refer to FAR 17.207 and 52.217-9

108 Draft RFP, Section H.6, p.

62 Does CMS envision PIV cards to be required for physical access to contractor facilities?

109 Draft RFP, Section H.23.A,

p. 83

83 Will the compliance program described in this section apply to all NQIIC awardees?

If not, please provide a rationale for why this would not be the case.

The Social Security Act and Government policy require contractor governance for certain programs. The governance requirements apply to only those programs. It is expected that some of the NQIIC task orders will not have the Governance requirements.

110 Draft RFP, Section H.23.C,

p. 85

85 Will CMS be flexible regarding the size of an NQIIC board if organization's federal contracts are less than 50% of its book of business?

111 Draft RFP, Section J.13 102 The asterisk states that a VPAT attachment is not required for the IDIQ;

however it will be required at the TO level, upon request.

1) Does this include the Sample TO level?

2) Are we required to submit a VPAT for the V123 Sample TO?

3) Please confirm we are not required to submit a VPAT for the IDIQ submission.

(1) VPAT is NOT required for the sample task order.

(2) VPATis NOT required for the IDIQ submission.

112 Draft RFP, Section L.8.D, p.

131 Must we submit a "Notice of Intent to Submit a Proposal" e-mail for the Draft IDIQ/Sample TO?

No. Notice of Intent is specific to submit a proposal for the

NQIIC IDIQ

113 Draft RFP, Section L.11.a 137 If proposals are sent after core work hours the day before the submission deadline, will they be successfully received by CMS by the start of business on the due date?

As long as proposals are received prior to the due date, they are deemed successfully received on time.

114 Draft RFP, Section L.11.b 138 1) Are cover letter and cover page used interchangeably in this RFP? If not, please clarify the difference between the two.

2) Does the government require a transmittal letter on company letterhead in addition to the required cover page/letter, described in the RFP?

The cover page is a title page whereas the cover letter is typically on company letter.

115 Draft RFP, Section L.11.b 138 1) Please explain the intended meaning of “assumptions” in this section.

What types of assumptions are we required to include?

The word “assumptions” has been updated to “exceptions”. This would include any exceptions that your company takes to the requirements of the solicitation.

116 Draft RFP, Section L.12 138 "“The Technical is divided into three sections I, IIA, IIB…” May we make reference(s) from one Technical volume to another?

Each volume should be independent of the others. Any references made may be general statements, however, should not be refereed to for the purpose of additional information to be considered.

117 DRAFT RFP, Section L.14.E 143 1) May we add our completed Table 2 to the Appendix of Volume IIB?

2) What other types of information would be permissible to place in the Appendix of Volume IIB?

3) Section L.14.C states that there is no page limit for past performance

Since there is no page limit for past performance information;

the past performance information required in this section (L.14.C) may be placed into the Appendix of Vol IIB?

information; therefore, are we to include all of the past performance information required in this section (L.14.C) into the Appendix of Vol IIB?

118 RFP, Section L.14.B 144 The second sentence states, ""The Offeror must provide clear and concise evidence of proven capability to address the following:"" With the exception of instructions to complete Table 2, nothing follows.

1) Is this correct?

2) Is Table 2 the only item we are required to submit in order to comply with the Corporate Experience section?

1) Yes

2) Yes

119 RFP, Section L.14.D 147 Please specify key personnel requirements for the IDIQ or confirm that there are no such requirements for the

IDIQ.

There are not key personnel requirements for the IDIQ.

120 RFP, Section L.14.D 147 1) What does personnel labor mix mean in this context? Please be specific.

2) Are we to provide FTEs? For what period of time? For which staff (e.g., key TO, essential/all TO, key IDIQ?)

The offeror shall describe its plan to manage contract operations, which includes the proposed labor to manage the requirements of the SOW.

FTEs are not required.

121 RFP, Section L.15.C 148 Are subcontractors agreement and consultants letter of intent required at the IDIQ level?

122 RFP, Section M.3.A 154 This section states “…move forward to Phase II as ‘Acceptable/Unacceptable' basis.”

Please be advised that proposals submitted in response to this solicitation will first be reviewed to determine viability

Other sections state that only Phase I will be evaluated as acceptable/not acceptable. Please clarify.

on an “Acceptable/Unacceptable” basis in order to move forward to Phase II.

123 NQIIC_2018_DRAFT_RFP_

4-18-2018, Section B - Corporate Experience - Table 2

144 -

Must all offerors…