Attachment_J.3-D_TO_0002_Proposal_Instructions_and_Eval_Criteria_BFCC_Case_Review.docx

Attachment J.3-D TO 0002

PROPOSAL PREPARATION INSTRUCTIONS

General Instructions for Task Order 0002 - Beneficiary Protection: Case Review Services

Multiple Task Order awards are anticipated. Not receiving a Task Order award does not preclude the offeror from receiving an IDIQ award.

A. The Offeror’s proposal submission shall consist of:

Volume IIIA – Technical Proposal Volume IIIB – Business Proposal Volume IIIC – Business Ethics, Conflict of Interest and Compliance Proposal

Each of the parts shall be separate and complete so that the evaluations are independent of each other. The technical proposal must not contain reference to price/cost; however, resource information such as data concerning labor hours and categories, subcontracts, etc., may be contained in the technical proposal so that Offeror’s understanding of the scope of the work may be evaluated.

B. Question Submission:

All communication and questions concerning this Task Order Request for Proposal (TORP) shall be submitted electronically via e-mail to BFCC2019@cms.hhs.gov no later than TBD. Questions submitted to any other e-mail address, by telephone or verbally will not be honored.

CMS will answer relevant questions by amendment to this solicitation, with copies of both the questions and answers being supplied to all prospective Offerors via FedBizOpps at www.fbo.gov, without reference as to the originating source.

Offerors shall submit any questions they may have via e-mail in the form of an electronic file attachment in Microsoft Excel format utilizing the question template, Attachment J.14. The subject line of the e-mail shall specify “BFCC Task Order 0002 questions.”

Submission of Questions shall include at a minimum: Company Name, Address, Point of Contact and Phone Number for questions submitted.

As soon as an Offeror is aware of any problems or ambiguities in interpreting the specifications, terms and conditions, instructions or evaluation criteria of this solicitation, the Contracting Office shall be notified.

C. Intent to Submit a Proposal Submission:

Offerors that intend to submit a proposal in response to this TORP are requested to submit a Notice of Intent to Submit a Proposal. The notice shall be submitted via e-mail with the subject title “BFCC Intent to Submit for Task Order 0002” to BFCC2019@cms.hhs.gov by TBD. Please be advised that an intent to submit a proposal is not binding on the Offeror and is for planning/scheduling purposes only. In addition, an Offeror that submits a negative intent or does not submit an intent is not precluded from submitting a proposal.

D. Proposal Submission:

1. Proposals shall be submitted via e-mail to BFCC2019@cms.hhs.gov no later than TBD.

Each proposal submission shall be submitted via e-mail separately, i.e. the TO 0002 submission shall be submitted with the subject “BFCC Proposal for TO 0002”.

Offerors are responsible for submitting proposals, so that they are received by the time specified. Based upon the size of the electronic submissions, Offerors are advised that the Agency often holds transfer of large documents to after core work hours, so as not to disrupt the normal flow of business. Therefore, it is recommended that Offerors account for possible delay and provide additional transmission time.

2. Specifications for electronic submissions:

a. All files shall be compatible with Microsoft Office 2010 or later versions or PDF.

b. Each file shall be printable to 8.5”x11” paper and be readable without requiring formatting adjustments. Type font shall be Times New Roman. Type size shall not be less than 12 point. Margins shall be no less than 1". Graphs and tables shall be no less than 10 point font. All pages shall be numbered.

c. CMS requires separate attachments for each volume. Volumes IIIA, IIIB, IIIC should each be considered separate volumes and submitted as separate attachments. Excel spreadsheets shall be included in the PDF file as well as submitted separately.

d. Each PDF shall be organized using a Table of Contents to clearly identify all sections. Each PDF must contain Bookmarks corresponding to each item in the Table of Contents.

e. Each PDF name shall be labeled with the offeror’s corporate name (or initials), volume number, solicitation number and Task Order (TO) number.

f. Based upon size of potential proposals, Offerors may find it necessary to submit multiple emails. Each email must indicate the solicitation number and total number of emails being submitted. For example, “BFCC TO 0002 Email 1 of 3”.

g. Excel spreadsheets must allow full functionality and editing. No cells shall be locked.

h. Volumes/sections may have a specified page limit. Any pages beyond the stated page limit will not be considered.

i. Volumes/sections that do not have a specified page limit are expected to be carefully prepared to be clear and concise.

j. Each of the volumes shall be separate and complete so that the evaluations are independent of each other. The technical proposal must not contain reference to price/cost; however, resource information such as data concerning labor hours and categories, subcontracts, etc., may be contained in the technical proposal so that Offeror’s understanding of the scope of the work may be evaluated.

3. Cover Letter/Page. Each volume shall include a cover page that includes the following information:

a. Solicitation number, Task Order number, and Volume number

b. Offeror’s legal name and address

c. Name, phone number and e-mail address of primary contact

d. DUNS Number

e. Business Size

f. Confirmation that Offeror is registered as a Small Business in SAM under the applicable NAICS Code

g. Proposed Total Cost (for Business Proposal only)

h. Assumptions, if applicable

Case Review Proposal Instructions

This will be a multiple award task order. This task order will cover all ten regions of the country as follows:

* Hawaii includes the Pacific Territories of American Samoa, Guam and the Commonwealth of the Northern Mariana Islands.

Offerors may bid a minimum of 1 and a maximum of 5 regions. CMS intends to award no more than 4 regions to any one contractor as to not overburden any one contractor but reserves the right to award more than 4. If no proposals are received for a particular area or if at any point during the evaluation process, it becomes apparent that there are no viable proposals for a particular area, CMS reserves the right to post an amendment to the solicitation and provide an opportunity for offerors to submit a proposal and compete for that area.

E. Technical Proposal Instructions (Volume IIIA)

Technical Proposal Format

· Table of Contents (not included in page limit)

· Technical Approach and Understanding (approximately 25 pages)

· Management Plan (approximately 18 pages)

· Key and Other Recommended Personnel and Staffing Plan (approximately 17 pages)

· Past Performance (not included in page limit)

· 508 Compliance (not included in page limit)

· Appendix (not included in page limit)

Volume IIIA shall be no more than sixty (60) single-spaced pages.

1. Table of Contents (Not included in page limit)

Offerors shall include a Table of Contents that identifies and clearly labels the various proposal sections.

2. QIO Eligibility

Offeror’s must provide evidence of meeting QIO eligibility requirements specified Section C.2.1 of the IDIQ SOW.

3. Technical Approach and Understanding

Proposals which merely offer to conduct the work in accordance with or to meet the Government’s requirements as set forth in the TO Statement of Work (SOW) will not be eligible for award. The Offeror shall make a clear and concise presentation of the technical approach chosen for the proposed TO. This approach should demonstrate an understanding of all aspects of the requirement. The proposal must explain the proposed technical approach in conjunction with the project objectives, the tasks to be performed, and the expected outcomes (and/or deliverables). The Offeror shall provide clear and appropriate detail in the proposal to indicate an in depth technical understanding of, and capability for, performing all aspects of the SOW. The offeror shall make a clear and concise presentation of their technical understanding and approach to conduct case review and related services as defined below. Proposals shall include a justifiable work plan and contract phase in/phase out transition plan.

Topics to be addressed include the following:

· Strategy for conducting review for all case types

· When conducting case reviews, addressing the following areas:

· Adhere to identified time frames; and

· Handling reviews over multiple states

· Managing fluctuations in review volume including action plan to address surge capacity, handling of potential backlog, having additional resources in place, and plan to avoid contractor “burnout”

· Provide strategy to effectively and efficiently perform case review and related services which includes analytics (i.e. case review tracking and trending activities), data-driven improvements, innovation, and collaboration efforts.

· Provide strategy to recruit, secure, and maintain a broad spectrum of local physicians

· Provide detailed strategy to build and maintain relationships with stakeholders including but not limited to healthcare providers, practitioners, Medicare beneficiaries and their representatives, and national experts to contribute to BFCC-related initiatives as it relates to case review activities.

· Provide strategy for Medicare beneficiaries and their representatives to identify and contact the offeror to file appeals and quality of care complaints.

· Explain how the contractor will structure and maintain a public web site to serve the needs of BFCC-QIOs and any other aspects of the BFCC community including CMS, providers, Medicare beneficiaries and their representatives, and other stakeholders as it relates to case review activities.

· Provide approaches to adequately comply with regulations and requirements for case reviews.

· Identification of potential barriers and mitigation strategies pertaining to case review services and how the offeror will use innovative ways to be effective, including cost containment.

· Demonstrate an approach that provides a patient centered, positive experience for callers and those with quality of care complaints or concerns, appeals of denials of hospital admissions, discharge and service terminations.

If the Offeror proposes subcontractors for this effort, the proposal shall describe the subcontracting approach, including the subcontractor’s past performance and experience in performing activities of similar size and scope, personnel proposed to be used for this effort, availability of proposed personnel, and initiatives taken to identify any potential integrity issues with the subcontractor. The Offeror also must show the ability to effectively manage and monitor subcontractors to include consideration for cost efficiency and cost effectiveness of having numerous subcontractors.

4. Management Plan

The Offeror shall describe how it will organize and manage the project, how tasks will be prioritized, sequenced, organized into time frames, and the management control and coordination tools (including appropriate technology) that will be used to assure the timely and successful conduct of the proposed TO. The plan should also address the process to handle tasks that may occur simultaneously and tasks that will need to occur in parallel for optimal efficient use of resources. It should include: resource allocations, milestone measures by task, hours committed to a “key” or “other recommended” person by task; and a designation of what tasks will be performed by the prime, by a subcontractor, or by a consultant. The plan should also describe the lines of communication among all of the responsible partners.

a. Individual TO needs will dictate specific management, quality assurance and staffing plans, but the Offeror shall describe a reasonable approach to spanning all settings of care and domains of care, taking into consideration that individual TO needs will dictate specific management, quality assurance and staffing plans.

b. A Contract Start-Up Plan that complies with all start-up requirements and allows for efficient, effective implementation of Case Review Services by May 8, 2019.

c. Explain how the offeror applies its Comprehensive Contract Management Plan to case review and related services to ensure that performance, deliverables, data management and reporting aligns to the contract.

d. Explain how the offeror applies its Internal Quality Improvement Program (IQIP) (at the IDIQ level) to case review and related services to ensure that performance, deliverables, data management and reporting aligns to the contract, regulatory requirements, and the quality control process is proven and effective.

e. A Continuity of Operations Plan (COOP), contingency planning for extended loss of service, identification of risks, and mitigation strategies.

f. A comprehensive work plan for Case Review Services which demonstrates the ability to maintain a local presence in each state across the proposed BFCC-QIO area.

g. Discuss how Offeror proposes to provide an efficient and effective proposal to maintain communications and coordination with Government representatives to assure maximum effectiveness and minimum interference with Agency operations.

h. Discuss in appropriate detail all lines of authority and communication for the proposed organization.

i. Address the method to be employed for obtaining labor for additional work.

j. Clearly identify and discuss the extent to which work will be accomplished by subcontractor, consultant and/or teaming arrangement. Work to be performed by the subcontractor, consultant and/or teaming arrangement shall include a detailed rationale.

5. Key and Other Recommended Personnel and Staffing Plan

Key and Other Recommended Personnel

The Offeror should identify its proposed key and other recommended personnel to be utilized under the TO. Identify the positions that will be assigned to manage performance and supervise the work under this TO. Provide information that will identify each position’s general qualifications and recent experience with similar projects or contracts. The Offeror shall include educational background, professional experience, and special qualifications and certifications directly related to the TO. Offeror shall state if the key personnel is an employee of the prime, an employee of a proposed subcontractor, or a consultant; and how they will be integrated organizationally, their proposed responsibilities, and the percentage of time dedicated to the TO. The offeror shall identify and provide resumes for all key personnel. Resumes shall identify technical qualifications, education and experience having relevance to the BFCC Case Review requirements. The offeror will be evaluated on the degree to which it demonstrates the immediate availability of key personnel. CMS may contact other sources to verify the accuracy of resume contents. Each resume shall contain, at a minimum, the following information:

· Name and position

· Educational background, including academic degrees and the year conferred.

· Technical training, including program year completions

· Years of applicable experience

· Citizenship

· Immediate availability

· History of applicable employment experience and the technical qualifications relevant to the BFCC requirements and labor categories.

· History of other experience and professional accomplishments that the offeror may wish to present to demonstrate the qualifications of the proposed candidate.

Key Personnel shall include, but not necessarily be limited to:

· Medical Director (Clinical MD) (1 FTE)

· Project Coordinator (1 FTE)

· Case/Claims Review Lead (1 FTE)

For Key Personnel, the Offeror shall define the responsibilities, qualifications and prior experience in relation to the duties listed. The Offeror shall indicate roles fulfilled by Key Personnel. The offeror shall provide information on manpower to support project management needs, key personnel experience with public reporting.

Letters of Commitment: CMS will evaluate Letters of Commitment submitted for Key Personnel and assess the degree to which each proposed candidate has committed to fulfilling the proposed position immediately after award including both current employees and staff not currently employed.

Other Recommended Personnel may include, but not necessarily limited to:

· Quality Improvement (QI) Coordinator (1 FTE)

· Data Analyst (1 FTE) For key personnel and recommended personnel:

· Describe role, functions and duties with respect to the TO;

· Describe relevant training and experience;

· Specify percent of time in FTEs to be allocated to this project;

· Provide (in appendix) a current resume indicating relevant specific experience and education. Resumes shall be a maximum of two (2) pages each and will not count against the written proposal page limit.

All Key and Other Recommended Personnel must demonstrate the requirements outlined in Section 2.1 of the SOW.

The Offeror shall provide the appropriate level of staff with expertise and credentials to support the needs of CMS and the greatest level of quality performance will be provided under the contract.

NOTE: Key Personnel will be listed in the TO award and cannot be changed unless prior approval is obtained from the Contracting Officer; other recommended personnel are staff essential to the successful completion of the SOW and are not listed in the award.

Staffing Plan/Skill Mix

The offeror shall submit a staffing plan that demonstrates its ability to provide qualified personnel in sufficient numbers for ensuring its proposed team, including subcontractors (if proposed), has the skills to meet the requirements stated in the BFCC Case Review task order. The offeror shall provide a proposed labor mix that demonstrates an accurate and effective understanding of the technical requirements of the SOW. The offeror shall provide a summary of the roles and responsibilities of each labor category with the associated FTEs, including subcontractor labor categories, if proposed. In addition, the offeror is required to submit a staffing chart for the proposed plan for each case type. Labor hours and FTEs are required to be specified. Do not include labor rates and indirect rates in this section.

CMS will evaluate the offeror’s proposed personnel to be engaged in accomplishing the requirements. The evaluation will include the types of personnel (skill mix) proposed by the offeror, educational background, professional experience, and special qualifications that directly relate to the requirements. This includes any key personnel, staff, and subcontractors proposed by the offeror to ensure that the proposed labor mix accurately reflects the offeror’s technical approach.

The proposal shall demonstrate:

· Offeror’s approach to assemble a team with the appropriate skills to meet the requirements; including but not limited to review experience, coding experience, customer service experience.

· Offeror’s proposed labor mix and number of staff accurately reflects the offeror’s technical approach.

· Offeror’s proposal presents and describes its rationale and method for staffing the contract that can be accomplished.

· Offeror’s ability to assemble a team that will cover the proposed BFCC-QIO Region(s).

6. Past Performance (Not included in page limit)

The offeror shall describe in detail relevant contracts it has performed in the past five (5) years that demonstrate experience in completing requirements similar or related in size scope and complexity to the BFCC Case Review and related services. Provide examples of successful implementation of similar requirements. At a minimum, offeror shall furnish the following information for each contract cited:

· A brief description of the work. Include any additional information that will further describe the activities performed and demonstrate the relationship of such experience to the requirements of this task order. Specifically, the offeror shall provide a brief explanation of how the work it is performing or has performed relates to the requirements of the BFCC Case Review task order. The explanation must include a correlation between the experience and the work under the BFCC Case Review task order requirements.

· The type of contract;

· The total dollar value of contract;

· The period of performance;

· For each example identify issues that occurred and how those issues were addressed and the benefits and risks of each approach; and

· For each example identify the outcomes, impact, and return on investment (as applicable).

a. Definitions:

Relevant – Relevant past performance information is described in FAR 42.1501, General. For the purposes of this solicitation, ‘relevant’ is also past performance information which is similar in size, scope and complexity to this contract.

Significant Subcontractor – A subcontractor performing major or critical aspects of the requirements relevant to the prospective contract. If a subcontractor is performing 25% or more of the work, they are considered Significant.

b. Instructions

Offeror shall provide the general background experience and qualifications of the Offeror’s organization. The Offeror shall demonstrate relevant capabilities that it can bring to this project and any other advantages it offers based upon its experience. The Offeror shall demonstrate satisfactory performance on current and completed contracts within the last five (5) years. This is not a request for a complete listing of contracts. All contracts included as past performance must be related and relevant to the SOW in size and scope. Offerors shall submit information as part of their proposal for both the Offeror and proposed significant subcontractors.

The relevant past performance information shall be supplied in a list format along with a brief summary of the relevance the contract has to the SOW. The contracts, subcontracts and task/purchase orders may be with CMS, other federal government agencies, state agencies, local government and/or commercial firms for the same or similar services required by this solicitation. The list of directly related projects/contracts shall cover at least the last 6 months, but not more than the most recent 5 years.

When providing Contractor Performance Assessment Reporting System (CPARS)/ Past Performance Information Retrieval System (PPIRS) information:

· Provide the contract number, order number and the period of performance so that a CPARS/PPIRS record may be located.

When providing non-CPARS/PPIRS information, the Offeror shall provide the following:

· Name of Contracting Activity

· Contract Number and Task Order Number, if applicable

· Contract Type

· Period of Performance

· Total Contract Value

· Brief Contract Description

· Contracting Officer/Contact Person, Address and Telephone

· Program Manager and Telephone

· Key Project Staff

· Information on Problems Encountered and Offeror's Corrective Action (if applicable)

· The Offeror shall identify the methods and outcomes of its evaluation of proposed subcontractors.

The below table should be used when providing a list of the past performance information:

Customer/ Agency Contract No./ Order No.

CMS utilizes CPARS and PPIRS for recording and storing all CMS Contractor performance evaluations. CMS will access CPARS and PPIRS for all relevant CMS performance history, if available; however, the Offeror must identify for CMS in its written proposal which CPARS evaluations are being referenced for this solicitation. CMS may also search on-line databases such as Dun and Bradstreet.

Offerors are reminded that they are responsible for ensuring that accurate information is provided with the reference material, including up-to-date telephone numbers and points of contact.

A joint venture having no past performance history itself may provide references based on the constituent companies. In addition, Offerors having no organizational past performance record may provide references for proposed “key personnel.”

Past Performance information will be used for both the responsibility determination and as an evaluation factor when determining best value to the Government.

The Government is not required to contact all references provided by the Offeror. Also, references other than those identified by the Offeror may be contacted by the Government to obtain additional information that will be used to evaluate the Offeror’s past performance.

The Offeror shall demonstrate a history of high quality services, timeliness of performance, and effective budgeting and financial management to assure best value to the Government.

Limit the number of past performance references to six (6) for the prime Offeror and three (3) for each significant subcontractor.

7. 508 Compliance (not included in page limit)

In accordance with the terms of the Provision HHSAR 352.239-73, the Government is seeking to determine Offeror’s ability to adequately address Section 508 accessibility standards. Complete the Voluntary Product Accessibility Template (VPAT) (Attachment J.15) for all relevant sections to this requirement.

8. Appendix (Not included in page limit)

Include all items listed within the solicitation that should be included in the Appendix, i.e. resumes, letters of commitment, milestone chart, etc. Do not include marketing material or superfluous materials.

F. Business Proposal Instructions (Volume IIIB)

In order to adequately establish the reasonableness and realism of the proposed cost or price, the Offeror shall support their total cost or price with a functional Microsoft Excel spreadsheet breakdown of costs by SOW task/chapter. The Offeror’s initial proposal shall contain the Offeror’s best terms from a cost/price standpoint.

The business proposal should be prepared for the period of performance identified herein. The business proposal must include supporting narrative documenting how the proposed costs were calculated, including underlying assumptions, rationale, and pricing data.

Note: In Section J, Attachment J.3-H, CMS is providing an estimated Level of Effort by case type to perform the work under the SOW. This is an estimate only and shall not be construed to represent a level of effort that Offerors must utilize. Any deviations from the estimate provided by CMS, should be explained as part of the assumptions included in the cover letter.

The Offeror shall submit the following information in its business proposal:

1. Table of Contents

Offerors shall include a Table of Contents that identifies and clearly labels the various proposal sections.

2. Contract Form and Representation and Certifications

The SF33 and the Representations and Certifications contained in Section K must be executed by an official authorized to bind the Offeror and provided by the Prime Contractor and subcontractors. Offeror’s shall include a statement indicating its’ Representations and Certifications are updated and current in the System for Award Management (SAM), as required in FAR 4.12. The web site for SAM is www.SAM.gov.

3. Task Order 0002 Business Proposal Forms and Support Information and Schedules

Offerors shall propose costs for Task Order 0002 Technical Response using the business proposal form provided by CMS. The SOW and SOD are provided in Attachments J.3-A and J.3-B. The Task Order 0002 Technical Response SOW cost proposal should be based on a five-year period of performance and shall be priced utilizing a Cost-Plus-Fixed-Fee contract type. The Offeror shall use business proposal spreadsheets in accordance with Attachment J.3-E and J.3-F for this task order.

Offerors are informed that the Government will conduct a cost realism and cost reasonableness analysis. (Note: There are no page limitations for the business proposals.) Offerors need to provide a PDF version of the complete business proposal. Offerors must submit sufficient detailed narrative rationale and supporting documentation to justify the proposed cost. The Government reserves the right to request additional cost and pricing information, as necessary, to determine that the Offeror’s proposed costs are realistic and reasonable.

The cost estimate shall describe an estimated annual total dollar amount for direct labor, the types of labor categories estimated to be required, the total number of direct labor hours required, the annual total indirect costs (fringe, G&A, etc.), subcontractor direct labor amounts, and subcontractor indirect costs, in accordance with Attachments J.3-E and J.3-F.

4. Subcontract and Consulting Agreements

a. A statement as to the adequacy of the subcontractor’s accounting system, with supporting documentation. Include what agency made the determination of adequacy, and provide supporting documentation of the determination. If a subcontractor does not have an adequate accounting system, the subcontractor will be unable to be awarded cost reimbursement subcontracts until their accounting system is deemed adequate.

b. If the subcontractor is required to submit a disclosure statement has this been done and has the submitted disclosure statement been reviewed for adequacy and compliance? Please identify the agency that made the determination and copy of the adequacy and compliance determination.

c. Provide a statement as to whether the proposed subcontractor is on the List of Parties Excluded from Federal Procurement and Non-procurement Programs.

d. Extent to which adequate price competition was obtained, or justification for its absence.

e. Identification of the type of subcontract to be used (e.g. Time & Materials, Firm-Fixed- Price)

f. Certificate of Current Cost or Pricing Data; not required for IDIQ award

g. The Offeror shall furnish information concerning the need for such consultant services, copy of the consultant agreement, a description as to how the consultant was selected and the reasonableness of the fees to be paid.

5. Other Administrative Data

a. Statement of Proposal Validity: The offeror must stipulate that their proposal is predicated upon all the terms and conditions of this TORP. In addition, it must contain a statement to the effect that it is firm for a period of at least 270 days from the date of receipt by the Government.

b. CAS Disclosure Statement: In order to assure that a firm properly discloses its accounting practices when required by Government cost accounting standards (CAS) and that the disclosed practices comply with CAS requirements, Offerors shall submit a CAS Disclosure Statement in accordance with FAR Part 30.202 as part of their business proposal unless a CAS exemption applies (Please also see Section K Representations and Certifications). If your CAS Disclosure Statement has previously been considered adequate, please indicate this by providing the following information: Approving agency, Point of Contact and phone number, and the date of the determination. When cost accounting practices are changed to comply with a new CAS, the offeror must provide the revised Disclosure Statement. A CAS-covered contract may not be award until a determination is made that a required Disclosure Statement is adequate.

c. Acceptable or Adequate Accounting and Estimating System: Offerors shall have an acceptable or adequate accounting system that is in compliance with applicable Contract Cost Principles of FAR Part 31 as well as FAR Appendix A, Cost Accounting Standards (CAS), in order to be considered for award of cost type task orders. The Offeror’s accounting system must be determined adequate or acceptable by no later than the proposal submission deadline of the cost-plus-fixed-fee task order that it intends to propose on, using one of the following methods: (1) offeror has passed a federal Government (such as the Defense Contract Audit Agency) performed pre-award accounting system review (2) offeror has a federal Government provided audit determination that its accounting systems is adequate or (3) the offeror has a federal Government Contracting Officer determination that its accounting system is adequate. If applicable, offerors shall provide a copy of the federal government audit and/or letter of approval from the cognizant Federal agency (See FAR 42.003), which deems the Offeror’s accounting system acceptable or adequate. Offerors shall also state if their practices used in estimating costs are consistent with their cost accounting practices used in accumulating, segregating and reporting costs.

i. In the event that the Contractor does not have a Government acceptable/adequate accounting system and/or has never had a Government cost reimbursement contract, the following information is required:

1) A Provisional Indirect Rate Submission subject to audit verification immediately after award. The package shall be prepared in accordance with (b) below. It should include all schedule detail and explanation for the basis and rational of the indirect rates proposed. Approved rates by a Cognizant Federal Government Agency are required in order to be awarded a cost reimbursement type contract.

2) The schedule and detail prescribed in the Publication DCAAP 7641.90 dated January 2005, titled “Information for Contractors” published by the Defense Contract Audit Agency. This publication is only a guide and the specific Contractor’s situation must be used in preparing the Provisional Rate Package.

3) Provide information that describes the basis and relationships of the proposed indirect expense rates including overhead, general and administrative, material and fringe benefits amounts, if applicable. (Source: DCAAP 7641.90)

d. Responsible Prospective Contractor Submission

i. The Offeror shall submit a Responsible Prospective Contractor Plan (Plan) that assists the contracting officer when determining whether prospective contractors are responsible in accordance with FAR 9.1.

ii. This information shall be submitted in no more than a five (5) page Executive Summary.

iii. The Offeror’s Plan shall provide the Government with information that demonstrates its ability to perform as a responsible business entity with an organizational infrastructure, resources and ability to meet the terms and conditions of this contract.

iv. While an Offeror may provide information in this section regarding corporate commitment to this solicitation, the plan shall not contradict its Conflict of Interest (COI) submittal as applicable to this procurement.

v. Consistent with FAR 9.104-1, the Plan must demonstrate that the Offeror:

(a) Have adequate financial resources to perform the contract, or the ability to obtain them (see 9.104-3(a)). Offeror’s proposal must indicate whether they have the necessary financial capacity, working capital, and other resources to perform the contract without assistance from any outside source (If not, indicate the amount required and the anticipated source). Include a copy of Offeror’s audited financial statements for the past 2 fiscal years. If an audited financial statement is not available, provide the most recent revised, compiled or internally prepare financial statement. Offeror’s that are newly formed shall submit the financial statements of the “parent” company(ies).

(b) Be able to comply with the required or proposed delivery or performance schedule, taking into consideration all existing commercial and governmental business commitments;

(c) Have a satisfactory performance record (see 9.104-3(b) and Subpart 42.15). A prospective contractor shall not be determined responsible or nonresponsible solely on the basis of a lack of relevant performance history, except as provided in 9.104-2;

(d) Have a satisfactory record of integrity and business ethics (for example, see Subpart 42.15);

(e) Have the necessary organization, experience, accounting and operational controls, and technical skills, or the ability to obtain them (including, as appropriate, such elements as production control procedures, property control systems, quality assurance measures, and safety programs applicable to materials to be produced or services to be performed by the prospective contractor and subcontractors). (See 9.104-3 (a).)

(f) Have the necessary production, construction, and technical equipment and facilities, or the ability to obtain them (see 9.104-3(a)); and

(g) Be otherwise qualified and eligible to receive an award under applicable laws and regulations (see also inverted domestic corporation prohibition at 9.108).

G. Business Ethics, Conflict of Interest and Compliance Proposal Instructions (Volume IIIC) (No Page Limit)

For this TO, Offerors must provide any additional information that differs from the IDIQ Business Ethics, Conflict of Interest and Compliance Proposal already submitted as part of the IDIQ solicitation. If nothing needs to be updated or changed, simply state that and refer back to the IDIQ submission.

In accordance with FAR 9.5, the Government must ensure that an Offeror and its proposed Subcontractor(s) is/are free of all Organizational/Personal Conflict of Interest (hereinafter collectively or individually referred to as COI). The Business Ethics, Conflicts of Interest and Compliance information is so material to the award of this contract that a proposal failing to provide the requirements identified in Attachment J.4, Contractor Business Ethics, Conflicts Of Interest and Compliance Program Requirements, may be ineligible for award.

The Offeror and Subcontractor(s) shall submit Volume IIIC. Attachment J.4 Contractor Business Ethics, Conflicts of Interest and Compliance Program Requirements and Attachment J.5, Contractor Personal Conflicts of Interest Financial Disclosure Template, contain the proposal submission requirements for Volume IIIC.

The Offeror/Subcontractor(s) must provide adequate substantive detail in order for the Government to conduct an independent analysis of the provided information. Where the Offeror/Subcontractor(s) indicates that no COI exists for a given contract, then for each indication, the Offeror/ Subcontractor(s) shall provide rationale and facts in support of said indication.

H. Task Order Type

The Government intends to award a Cost-Plus-Fixed-Fee (CPFF) type TO for this effort. However, the Government reserves the right to award any other type of pricing arrangement.

I. Period of Performance

The period of performance for this TO has a transition period of ninety (90) days, and a base period of fifty seven (57) months from date of contract award. The anticipated start date is February 2019.

EVALUATION CRITERIA

The evaluation procedures for review of TOs under the BFCC IDIQ shall be in accordance with FAR Part 15. CMS reserves the right to award based upon initial proposals. The Government will be assessing the proposals by using adjectival ratings.

Award will be made to the Offeror whose proposal offers the best overall value to the Government. This will be determined by a trade-off technique that allows the Government to consider award to other than the lowest cost Offeror or other than the highest technically rated Offeror. It permits tradeoffs among cost and non-cost evaluation factors.

Offerors are advised that primary consideration will be given to the technical quality of the proposals in the evaluation process. All evaluation factors other than cost or price, when combined, are significantly more important to cost or price. The non-cost evaluation factors are listed below in descending order of importance.

· Technical Approach and Understanding

· Management Plan

· Key and Other Recommended Personnel and Staffing Plan

· Past Performance

· 508 Compliance

As the degree of technical equality increases between proposals, cost/price will become more important.

The following criteria will be used in the evaluation of the technical portion of the proposal.

A. Technical Proposal Evaluation

The following technical evaluation criteria will be applied to the technical evaluation of each proposal. The Government will evaluate the factors listed below based on the Offeror’s written Technical Proposal.

1. Technical Approach and Understanding

The Offeror shall make a clear and concise presentation of the technical approach chosen for the proposed TO. This approach should demonstrate an understanding of all aspects of the requirement. The Offeror should provide sufficient detail in the proposal to indicate a technical understanding of, and capability for, performing all aspects of the SOW. Evaluation will include whether or not the offeror has a justifiable technical approach and contract phase in/phase out transition plan. Offerors will be evaluated based on their technical approach to areas contained in the SOW including the extent to which the Offeror provides evidence of:

· A clear strategy for conducting review for all case types

· When conducting case reviews, addressing the following areas:

· Adhere to identified time frames;

· Handling reviews over multiple states.

· Demonstrated plan to manage fluctuations in review volume including action plan to address surge capacity, handling of potential backlog, having additional resources in place, and plan to avoid contractor “burnout”

· Strategy to effectively and efficiently perform case review and related services which includes analytics (i.e. case review tracking and trending activities), data-driven improvements, innovation, and collaboration efforts.

· Strategy to recruit, secure, and maintain a broad spectrum of local physicians

· Detailed strategy to build and maintain relationships with stakeholders including but not limited to healthcare providers, practitioners, Medicare beneficiaries and their representatives, and national experts to contribute to BFCC-related initiatives as it relates to case review activities.

· Strategy for Medicare beneficiaries and their representatives to identify and contact the offeror to file appeals and quality of care complaints.

· Explanation of how the contractor will structure and maintain a public web site to serve the needs of BFCC-QIOs and any other aspects of the BFCC community including CMS, providers, Medicare beneficiaries and their representatives, and other stakeholders as it relates to case review activities.

· Approaches to adequately comply with regulations and requirements for case reviews.

· Identification of potential barriers and mitigation strategies pertaining to case review services and how the offeror will use innovative ways to be effective, including cost containment.

· Demonstration of an approach that provides a patient centered, positive experience for callers and those with quality of care complaints or concerns, appeals of denials of hospital admissions, discharge and service terminations.

2. Management Plan

CMS will evaluate the Offeror’s capability to execute the project effectively, including access to requisite resources including staff, expert consultants, computers and technical equipment. CMS will review the work plan for specificity, nature of the responsibility, and authorities of key personnel and the extent to which the plan is comprehensive, specific and feasible. CMS will evaluate the extent to which the offeror’s proposed Comprehensive Task Order Management Plan, staffing plan including evaluation of key personnel qualifications and expertise, support staff’s relevant experience, qualifications and accomplishments, and the anticipated level of effort for all positions aligns with SOW requirements and the offeror’s proposed approach. The evaluation will assess the Offeror’s understanding of the TO requirements and ability to demonstrate that the Offeror has a plan for completing these requirements in a timely and high quality manner as proposed in the work plan.

Other criteria relative to the Comprehensive Task Order Management Plan and project timeline include:

· Specific management, quality assurance and staffing plans and an approach to spanning all settings of care and domains of care, taking into consideration that individual TO needs will dictate specific management, quality assurance and staffing plans.

· A Contract Start-Up Plan that complies with all start-up requirements and allows for efficient, effective implementation of Case Review Services by May 8, 2019.

· Explanation of how the offeror applies its Comprehensive Contract Management Plan to case review and related services to ensure that performance, deliverables, data management and reporting aligns to the contract.

· Explanation of how the offeror applies its Internal Quality Improvement Program (IQIP) (at the IDIQ level) to case review and related services to ensure that performance, deliverables, data management and reporting aligns to the contract, regulatory requirements, and the quality control process is proven and effective.

· A Continuity of Operations Plan (COOP), contingency planning for extended loss of service, identification of risks, and mitigation strategies.

· A comprehensive work plan for Case Review Services which demonstrates the ability to maintain a local presence in each state across the proposed BFCC-QIO area.

· Efficient and effective proposal to maintain communications and coordination with Government representatives to assure maximum effectiveness and minimum interference with Agency operations.

· Discussion of lines of authority and communication for the proposed organization.

· Address the method to be employed for obtaining labor for additional work.

· Clearly identify and discuss the extent to which work will be accomplished by subcontractor, consultant and/or teaming arrangement. Work to be performed by the subcontractor, consultant and/or teaming arrangement shall include a detailed rationale.

3. Key and Other Recommended Personnel and Staffing Plan

The evaluation of personnel shall consider key personnel and other recommended personnel who are competent and experienced in the skills required in the SOW. The caliber of key personnel shall be based upon the individual’s past performance on similar efforts, academic qualifications, and relevant training. This evaluation shall also consider any proposed subcontractor and their experiences.

The evaluation will assess the proposed key and other recommended personnel’s relevant experience and qualifications for conducting the work described in the TO SOW, including their expertise, education, experience, qualifications and training. The following will be evaluated.

· Project team resumes/curricula vitae, per key staff member or consultant: Does the Offeror have the appropriate level of staff to support CMS’ needs?

· If so, are the personnel appropriately credentialed to provide the greatest level of quality performance under this contract?

· Is the Offeror familiar with CMS quality programs and their implementations?

· Does the Offeror provide sufficient manpower to support project management needs?

· Do the key personnel have experience with healthcare quality improvement as well as expertise in a broad spectrum of issues-

· Project management and evaluation;

· Analyzing and summarizing large data sets;

· Medicare case/claims review and case/claims validation;

· Training and education;

· Providing technical assistance defined in this task order;

· Preparing and managing website content and related materials

· Development and maintenance of timelines and key project management milestones

The Staffing Plan will be evaluated based on Offeror’s ability to provide qualified personnel in sufficient numbers for ensuring its proposed team, including subcontractors (if proposed), has the skills to meet the requirements stated in the BFCC Case Review SOW.

4. Past Performance

The Offeror will be evaluated on its past performance history. The Government’s evaluation will be a subjective assessment based on the past performance information obtained. The evaluation of past performance will be based on the Offeror’s demonstrated ability, under contracts of a similar nature, scope, and complexity, to successfully meet the requirements of the TO SOW. The CMS will also search on-line databases such as Duns and Bradstreet and PPIRS.

CMS may utilize information contained in CPARS or otherwise obtained from sources inside or outside of CMS. An Offeror that states it has no past performance history will neither be favorably nor unfavorably rated in regards to past performance.

Specifically, the Government will be evaluating the Offeror’s experience and quality of performance as it relates to the following:

· The proposal will be reviewed with respect to the Offeror’s experience and actual performance on work similar to that required under this TO.

· The Offeror will demonstrate a history of high quality services, timeliness of performance, and effective budgeting and financial management to assure best value to the Government.

5. 508 Compliance

This criterion will be evaluated as adequate or inadequate.

The Government is seeking to determine Offeror’s ability to adequately address Section 508 accessibility standards.

Offerors will be evaluated on:

a. The presence and adequacy of a completed Voluntary Product Accessibility Template (VPAT) document;

b. The Offeror’s ability to demonstrate compliance with the established EIT accessibility standards.

B. Business Proposal Evaluation

CMS will evaluate the Business Proposal to assess CMS' level of confidence in the Offeror's ability to deliver efficient, risk free performance at a fair and reasonable cost. The business proposal evaluation will consist of a cost realism analysis and cost analysis. In accordance with FAR 15.404-1(c), CMS will conduct a cost analysis which will consist of review and evaluation of separate cost elements of each Offeror’s proposal to determine the reasonableness of the proposed costs.