Questions_and_Responses.pdf

75FCMC18R0016

Amendment 3

QUESTION RESPONSE

Does restriction on NQIIC awardees' ability to contract with or be affiliated with health care providers apply to situations only where the NQIIC is being paid by the health care provider?

CMS is unsure of the intent of this question; contracts and affiliations are different.

If there is an affiliation where there is ownership, then there may be a conflict, which would be reviewed on a case by case basis.

If the question is whether awardees can partner with healthcare providers, then that may be allowable and necessary depending on the task order.

NQIIC Awardees cannot be affiliated with or contract with a healthcare provider (only applies to QIN-QIO task orders based on statute) -please clarify.

1. What constitutes an "affiliation" with a healthcare provider?

2. Would a health insurer have an affiliation?

3. Would having employees who work part time at healthcare providers count?

Correct. This only applies to specific task orders such as the anticipated first task order for QIN-QIOs. The restriction would not apply to anticipated task orders for Hospital Improvement or Clinician Focused work. There could also be other future task orders specific to QIN-QIOs.

A parent company or subsidiary or any entity with financial/ownership interest.

Not if the insurer is providing employee benefits/administration. But if the offeror has a financial interest in the insurer, then yes – that is an affiliation.

This is a personal COI which should be resolved by the offeror’s compliance officer through mitigation. This would have to be reviewed on a case by case basis depending on their role to confirm they aren’t a major decision maker who could shift the direction of the QI initiatives.

4. What constitutes a "contract with" a healthcare provider? For example, would selling a product at a hospital constitute a contract?

5. Does this requirement apply to primes or subcontractors as well?

It depends on the product. For example, selling computers to providers is not the type CMS is concerned with. But a contract to provide administrative or similar services might be problematic, depending on the services.

Yes, both

Will task orders be predictable enough that NQIICs can retain staff during transitions between task orders?

Task orders will allow for the full spectrum of quality improvement (QI) work.

Therefore, staffing and the retention may vary per task order.

Will NQIICs have the opportunity to propose topic areas for task orders or will all topic areas be decided by CMS?

There may be the opportunity for special project task orders where NQIICs will have the opportunity to propose topic areas.

What are the differences between the NQIIC support contractor and the Strategic Innovation Engine (SIE) listed on page 52?

The National Support Contract (NSC) provides support to the NQIIC awardees across the various Task Orders. This contractor engages with the community on an on-going basis.

The SIE takes what we are seeing across the network and brings it to CMS for us to strategically review and work to integrate in a manner that may influence the broader work moving forward over the long run. Analyses from the SIE could lead to small scale testing projects, called strategic innovation projects, or SIPs.

Is there a proposed timeline for task orders to be announced? How much notice can NQIICs expect from the time a task order is announced to the award and the start of work?

Other than the mention of the QIN-QIO and the Clinician based task orders to be issued shortly after award, there is no additional information at this time for the timeline of future task orders. The typical turnaround of a task order award from the announcement of that task order is 6 months, however this time may vary.

If the NQIIC is not awarded any task orders, does the NQIIC have to produce reports or documentation on internal operations to CMS on a regular or on-demand basis?

No. Deliverables will be required at the task order level

The draft RFP states that past performance evaluations shall be prepared at least annually. Is this required even if the NQIIC has not Task Order in effect?

No, this applies on a task order basis. If the NQIIC has no Task Order in effect, past performance evaluations would not apply.

Can CMS please confirm that subcontractors can submit their Attachment J.8 Contractor Business Ethics, Conflicts Of Interest and Compliance Program Requirements, past performance table as a sealed package directly to CMS, and provide their Prime Contractor with a sanitized version?

Many companies consider information included therein, such as specific contract information, financial interest/relationship information, lawsuits, etc. to be confidential. CMS has consistently allowed this approach under recent RFPs.

Yes, although not all of this information is required for the IDIQ, CMS will always allow subcontractors to submit their proposal information directly.

This applies to the task orders as well.

Are Subcontractors required to complete J.12b detailing their direct and indirect rates and cost build? If so, can subcontractors required to submit “a complete cost proposal in the same format as the contractor’s cost proposal” submit their cost proposal with proprietary and confidential information as a sealed package to

CMS?

Yes, this information is required for the sample task order and may be submitted directly to CMS.

Section L.14 C; Can the Government please confirm that the Past Performance of an Offeror's/Subcontractor's parent, subsidiary, or affiliate, which would contribute to the performance of the awarded contract, can be used as a Past Performance citation?

Yes

Recent GAO rulings that define the Offeror to include parent, subsidiaries, and affiliates, allow the use of their relevant experience as long as they are proposed to perform work under the awarded contract. CMS has consistently allowed their use in other recent RFPs.

Section I.1; Can the Government please confirm that the solicitation is administratively or otherwise exempt from the requirements of the Service Contract Act?

The Service Contract Act applies to this requirement. Wage determinations will be applied at the task order level.

Volume I (Phase 1) NQIIC Contractor Capability, p. 138; Reach & Recruitment. The offeror will describe:

• Its strategy previously used to reach a broad spectrum of healthcare providers, beneficiaries, and/or local communities to improve healthcare quality. If an Offeror/Subcontractor works in a program with providers that either is mandatory to participate in or a government agency performs the recruitment, such as a Medicaid Agency, but the Offeror/Subcontractor performs the quality improvement activities as well as measuring the outcomes, can this be counted for this task?

This is not the intent of this section. The intent is to demonstrate your experience for gaining commitments from these entities to commit to working on improvement in healthcare quality.

Volume I (Phase 1) NQIIC Contractor Capability, p. 138; Reach & Recruitment. The offeror will describe:

• Its strategy previously used to reach a broad spectrum of healthcare providers, beneficiaries, and/or local communities to improve healthcare

Yes quality. If an Offeror/Subcontractor offers and provides technical assistance to all providers in a setting such as nursing homes across the country, can this fulfill the requirement of reach and recruitment?

Section L.14.B, Page 144, Table 2 The offeror has performed work as a subcontractor in a CMS quality program, but the subcontractor performed work equal to the prime contractor and shares equal responsibility for the outcomes based on a formal, written agreement between the two organizations. Should the offeror prorate the outcomes when reporting in this table or should the offeror report the total outcomes for the project in the table?

Your proposal should be accountable for the work that you achieved as a subcontractor, not the entire outcome achieved by the prime contractor.

Can CMS provide more detail on how NQIICs will be evaluated? Will there be one set of standardized metrics for all contractors on the same task orders, or will NQIICs be expected to define the metrics they will be evaluated on?

The intent is for CMS to define the measures, however the contractors may be asked to define their measures. This will be determined at task order level.

Section H.20, The draft RFP states that DHHS has determined that all non-profit businesses are defined as large businesses for reporting purposes? How does that determination impact the subcontracting plan requirements on page 26 and the definitions on page 116?

A subcontracting plan is required by non-profit organizations.

Must we submit signed SF-30s with our proposal? If yes, in which volume? Vol III Business?

Yes and Volume III – Business

Can you confirm that the only required documents for Subcontractors are “C? Business Proposal Forms and Support Information and Schedules.”?

Confirmed