J6_RFP_Question_and_Response.xls

XLS spreadsheet 155 KB Posted Mar 5, 2019

Attached to: Part A and B(A/B) Medicare Administrative Contractor (MAC), Jurisdiction 6 (J6)
Solicitation number: 75FCMC19R0002
Issued by: Department of Health and Human Services Centers for Medicare and Medicaid Services

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Written by GovTribe AI · Dec 28, 2023

This document is a request for proposal for a Medicare Administrative Contractor to provide specified health insurance benefit administration services for Medicare Parts A, B, home health and hospice in Jurisdiction 6, which includes the states of Illinois, Minnesota and Wisconsin, as well as thirteen additional states and five U.S. territories. The contractor will perform claims processing, payment services, and establish provider relationships to support healthcare services for Medicare beneficiaries in accordance with applicable laws and CMS requirements. The contract includes a base year and six one-year options, with an anticipated award date of November 29, 2019. Incumbent National Government Services, Inc. currently provides these services. Implementation cutover dates are April 12, 2020 for Parts A and home health/hospice, and May 3, 2020 for Part B. The document includes questions and answers to clarify requirements, as well as appendices on deliverables, projected workloads, facilities data, and implementation assumptions.

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J6 RFP Questions and Responses

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File	Type	Posted
75FCMC19R0002.pdf	PDF	Mar 21, 2019
75FCMC19R0002_Amendment_0001.pdf	PDF	Mar 5, 2019
J6_Amendment_0001_Updated_Attachments.zip	ZIP file	Mar 5, 2019
J6_RFP_Attachments.zip	ZIP file	Feb 1, 2019
75FCMC19R0002.pdf	PDF	Feb 1, 2019

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A. Section B-K

ID	Document	Section	Page number	Question	Answer/Action
A.1	B.6 / Schedule of Supplies/Services	B.6 / Schedule of Supplies/Services	8	Recovery audit contractor workload is listed to have an award fee; however, the award fee plan template doesn't include this as an award fee criterion. Additionally, today this is typically administered with a fixed fee due to the limited sphere of influence of a MAC in administering this workload. Would CMS confirm this is meant to reflect a fixed fee, not an award fee?	CMS confirms that RAC workload is correctly shown to have award fee. A final Award Fee Plan will be issued upon contract award.

B. Section L-M

ID	Document	Section	Page number	Question	Answer/Action
B.1	Section L Proposal Submission, Delivery, & Organization	RFP Section L.10a(2) Hand/Courier Delivery, RFP	97	With appropriate notification, please confirm offerors can deliver to 7111 Security Blvd, Baltimore (Woodlawn), Maryland. Currently this section also includes instructions for delivery to both 7111 Security Blvd and through North Gate—Dogwood Road, which is at 7500 Security Boulevard.	CMS confirms that offerors may deliver to 7111 Security Blvd., Baltimore, MD. CMS removed the sentence regarding offerors entering through the North Gate - Dogwood Road.
B.2	Section L Proposal Submission, Delivery, & Organization	RFP Section L.13.5 Volume III, Tabs D through F, Technical Approach Evaluation Factor, Proposal Instructions; Volume III Tab E, Staffing Plan, Proposal Instructions; 1. Total Staff	112 & 113	In Section 1. Total Staffing, CMS requests both FTEs and hours by labor category when describing the staffing, skill mix and productivity. Please clarify if CMS intended on requesting both FTEs and hours.	CMS removed the Hours requirement from Section 1, Total Staffing.
B.3	Cost templates J.12-J.21	L.10.g	99	We request that the Business Proposal cost templates J.12 through J.21 be excluded from the page numbering requirement.	CMS confirms that the cost templates, which are part of the Business Proposal, are excluded from the Technical Proposal page limit and page numbering requirements.
B.4	Cost templates J.12-J.21	L.14.2	121	Please confirm that for OY2-6 the hard copy should provide the Part A and B Consolidated CLIN values. For example 000XAA - Part A/B PM, 000XAB - Part A/B MIP, and 000XAC - Part A/B RAC.	CMS confirms that Attachments J.16, J.17, J.18, J.19, and J.20 for Option Years 2 through 6 (CLINs 0004- 0008) will be submitted at the CLIN Summary Level only as provided for in the cost templates. There is not a further breakout of these SLINs. No WBS breakout is requested for Option Years 2 through 6 (CLINs 0004-0008) in the cost templates.
B.5	Cost templates J.12-J.21	L.14.2	121	For the J.12 cost summary, should MCCM and MPIP be included in the Option Years or as a separate section since these projects have their own CLINs?	CMS confirms that MCCM and MPIP information is required on their respective designated Attachments J.29 and J.31. MPIP and MCCM will not be included in Attachments J.12-J.21.
B.6	Subcontract Cost	L.14.3	124	For small subcontracts (such as Iron Mountain and EDM) we request to provide Section a ("A copy of the subcontract agreement…") in electronic format and provide Section b ("Subcontract Negotiation Memorandum…") in print only.	CMS confirms that the offeror's hard copy submission should align with its electronic submission.
B.7		L.13.4.b	109	This section states, “The below table shall be used when providing a summary of the past performance information.” The example table is presented in a landscape orientation. May the offeror change the orientation of the table to portait? This change will result in data that is easier to read/review.	CMS confirms that this table is acceptable in portrait orientation versus landscape orientation.
B.8		L.13.5	111	This section states the offeror must provide a description of the approach for accomplishing the following jurisdiction specific requirements. The MAC Provider Intervention Program (MPIP) is not addressed in the SOW or other attachments. Will CMS please furnish a SOW for this work or incorporate the requirements into the jurisdiciton specific requirements of the exisiting SOW?	CMS confirms that MPIP is addressed in Attachment J.23 Government Provided Proposal Assumptions (item # 27) and Attachment J.29 MPIP cost template.
B.9		L.14.2	121	The instructions for the Cost Proposal Templates speak only to Attachments J.12 through J.21. Included with the RFP were two other templates, J.29 Medicare Healthcare Provider Intervention Program (MPIP) Cost Proposal Template and J.31 Medicare Care Choices Model (MCCM) Cost Proposal Template. Should these two templates be prepared separately as stand-alone templates for the Base Year through Option Year 6 with a respective summary for both CLIN 1000 and 1001? These are not referenced in J.12 Summary Sheet. In B.6, J.29 and J.31 are included as part of this schedule and included in the grand total. Please confirm that the amounts from J.29 and J.31 are not required to be included in J.12. Also, please provide instructions for submission of these templates (hard copy, electronic only, etc.).	CMS confirms that neither MPIP nor MCCM will be included in Attachment J.12. MPIP and MCCM will be addressed within their respective designated cost templates, Attachments J.29 and J.31. These templates shall be submitted in hard copy and electronic format for the Base Year and Option Years 1-6 (CLINs 0002-0008).
B.10		L.14.3-L.14.6	121-126	Should all applicable categories from J.29 and J.31 be included as part of each subsection in L.14.3 - L.14.6?	CMS confirms that Attachments J.29 (MPIP) and J.31 (MCCM) must be considered in context of L.14.3-L.14.6.
B.11	L.13.5, Volume III, Tab E	L.13.5	111-115	The instructions for the staffing plans only references CLINs 0001-0008. Please confirm that the staffing for CLIN 1000 and 1001 are not required to be included in the staffing plan.	CMS confirms that CLINs 1000 (MPIP) and 1001(MCCM) must be addressed in the Staffing Plan.
B.12		L.13.5 / Volume III, Tab D, Program Management	110-111	In the proposal instructions for Volume III, Tab D, Program Management, there are four major bullet points to be addressed: (1) overview of qualifications of key personnel; (2) an organizational chart; (3) a description of its quality control plan; (4) a description of the Offeror’s approach to accomplishing jurisdiction specific requirements. Under the 2nd bullet (organizational chart) there are four sub-bullets. The last of the four sub-bullets directs offerors to provide “a description of how its infrastructure, internal controls and management strategies will ensure quality and continuity of operations in fulfilling the requirements of the Contract. In particular, the Offeror shall describe its approach for internal staff, other organizational components in its corporate structure, teaming partners and subcontractors". It appears this requirement has been incorrectly formatted as a sub-bullet to the organizational chart bullet, since the requirement asks for a description that would be narrative as opposed to a visual depiction in the organizational chart. Consistent with the other "overview" and "description" bulleted items in this list of program management tab requirements, it appears this referenced requirement should be a major bullet point and responded to with narrative rather than incorporated somehow into the organizational chart. Would CMS please confirm this requirement is to be addressed in narrative form rather than in the organizational chart?	CMS has reformatted this item as a bullet instead of a sub-bullet. See the updated L.13.5 Program Management section.
B.13		L.13.5 / Volume III Tab E Staffing Plan, 1. Total Staff	112	The proposal instructions for Volume III, Tab E, Staffing Plan were changed from previous solicitations to now require hours as well as FTEs for the various sub-parts of this section. Adding additional data elements to the response makes the resulting tables more complicated and difficult for evaluators to read as each added column makes other columns narrower. For some of the tables the change will require at least two additional columns (for example, for proposed and historical hours). Because every offeror may define 1 FTE differently, it would appear hours is a more meaningful number for CMS to use to assess and compare offerors, than FTEs which are not directly comparable across offerors. Would CMS change the instructions for the staffing tables to just list hours, rather than both hours and FTEs?	CMS removed the Hours requirement from Section 1, Total Staffing.
B.14		L.17 / HHSAR 352.239-73 ELECTRONIC INFORMATION AND TECHNOLOGY ACCESSIBILITY NOTICE (DEC 2015)	129	CMS has included the standard contract clause, HHSAR 352.239-73, ELECTRONIC INFORMATION AND TECHNOLOGY ACCESSIBILITY NOTICE (DEC 2015), in SECTION L - INSTRUCTIONS, CONDITIONS AND NOTICES TO OFFERORS. In most CMS solicitations this clause has been inserted in SECTION I - CONTRACT CLAUSES. Since the Section L. Proposal Instructions will not be included in the resulting contract, should this clause be moved to Section I? If the text in Section L.17 is not moved to Section I, will CMS confirm that the text of Section L.17 applies to electronic information and technology provided pursuant to the resulting J6 contract and not to proposals submitted in response to this solicitation?	CMS confirms that this clause is in the correct location.
B.15	Attachment J.28 Product Accessibility Template

and Solicitation Number 75FCMC19R0002

A/B MAC Jurisdiction 6	L.17 / HHSAR 352.239-73 ELECTRONIC INFORMATION AND TECHNOLOGY
ACCESSIBILITY NOTICE (DEC 2015)	Attachment J.28 &
RFP p. 129-130	Please confirm that offerors are to submit a completed Attachment J.28 Product Accessibility Template only for items of electronic and information technology (EIT) provided pursuant to the resulting contract for use by federal employees and the general public (for example, a website and provider portal). Also, in which volume and tab should offerors include the completed template(s)?	CMS confirms that Attachment J.28 completion concerns Section 508 accessibility of electronic and information technology to federal employees and the general public. CMS confirms that Tab G of Volume III is the correct placement for the Product Accessibility Template, Attachment J.28. See the updated language in the L.13.1 table and M.8.
	B.16	Proposal Submission, Delivery and Organization	L.10	99	Item e. Binding and Labeling - Please confirm that in the last sentence of the paragraph that states "The original of Volumes I through V shall be marked ORIGINAL and all other copies shall be marked COPY # of 3." should state "...COPY #___ of 2" based on the information in the third column of the table on page 96 showing 1 original and 2 copies of Volumes I thru IV.	CMS confirms that the RFP has been updated to reflect COPY # _ of 2.
	B.17	L.11.3 Tab C, Completed SF33, Solicitation, Offer and Award	L.11.3	101	Section L.11.3 states, "The SF 33 and applicable solicitation amendments must be signed by an official authorized to bind the Offeror."

Will the government confirm that the correct interpretation of this requirement is that the offeror must ensure block 14 of the SF 33 is filled out to include acknowledgement of all amendments to the solicitation and that CMS is not requesting the offeror to also sign and submit the individual SF 30 amendment documents in its Volume I response?	CMS confirms that the SF 33 and applicable SF 30 solicitation amendments must be signed by an official authorized to bind the Offeror and be included in the offeror's Volume 1 response. CMS has updated L.11.3 accordingly.
	B.18	RFP and
Attachment J.03	L.11.6	101-102	Section L.11.6 states, "Attachment J.03 to this solicitation provides a template for this plan. The small business plan will cover the entire contract period of performance. The plan shall be submitted for the base period and each option period separately." The Attachment J.03 template includes a period of performance for both the base and the 4 option years. Will CMS please send a revised J.03 template that separates each option period, to be compliant with the requirements of the period of performance in the Solicitation?	CMS confirms that Offerors shall modify the template to include all option periods.
	B.19	L.11.8 Tab H, Responsibility Determination	L.11.8	102-103	Section L.11.8 Tab H, Responsibility Determination, states that: “The Government is responsible for determining that a prospective Offeror is responsible pursuant to FAR 9.104-1. Pursuant to FAR 9.104-5, generally prime contractors are responsible for determining responsibility of subcontractors. However, when it is in the Government’s interest, the Contracting Officer may directly determine a prospective subcontractor’s responsibility, applying the same standards as applied to primes. CMS will evaluate and assess the documentation provided in this proposal section, Tab H, and other available information in making a responsibility determination in evaluation as defined in M.9. Where additional responsibility information is needed, Government requests for, and an Offeror’s submission of, responsibility determination information as required by the Government are NOT exchanges as defined in FAR 15.306.”

Please confirm that the Government is requesting Determination of Responsibility information from all proposed subcontractors.	CMS confirms that in accordance with the RFP language, the subcontracting information is not being requested at this time. However, where additional responsibility information is needed, the Contracting Officer may request, and the Offeror's submission of responsibility determination information as required by the Government is NOT considered exchanges as defined in FAR 15.306.
	B.20	L.14.3, Volume IV, Tac C, Written Narrative and Other than Cost or Pricing Data	L.14.3	124	Under the Subcontract Costs section, the RFP states: “It is the responsibility of the Offeror to comply with FAR 52.244-2 – Subcontracts (OCT 2010) and 52.244-5 – Competition in Subcontracting (DEC 1996). Applicable to ALL subcontracts (all contract types), the Offeror shall submit information relevant to the considerations in FAR 44.202-2, including the following subcontract information: a. A copy of the subcontract agreement…”

Please confirm that a copy of a draft subcontract agreement is acceptable for this requirement as these subcontract agreements are not final and fully executed until contract award.	CMS confirms that a copy of the draft subcontract agreement is acceptable for this requirement.
	B.21	M.9 (g)	Contract Award Limitations	135	CMS provides a Workload Table listing each of the MAC jurisdictions and the Estimated Solicitation Release Date Range for Next Round of MAC Procurements. Please confirm that the dates provided in the table for 2019 and 2020 are accurate.	CMS confirms the 2019 and 2020 estimated solicitation release date ranges. CMS updated the 2021-2024 date ranges . The estimated date ranges are subject to change.

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C. Section J.1 SOW

ID	Document	Section	Page number	Question	Answer/Action
C.1	SOW	C.7.36 PMD Demo	155	The Statement of Work contains Section C.7.36 Payment Aggregator Power Mobility Devices Demo. The demo is not mentioned in other parts of the solicitation materials. Please confirm that the PA PMD demo should be included in the Statement of Work.	CMS confirms that the Payment Aggregator Power Mobility Devices Demonstration does not apply to this solicitation. CMS updated C.7.36 of the SOW to "Reserved" status.
C.2	SOW	C.5.11.3.4.1	109	The contractor shall operate the PS&R system in accordance with the PS&R users guide and implement any changes to the system within the required timeframe and issue PS&R reports in accordance with IOM Pub 100-06, Chapter 9 and Chapter 8, section 10.1.

The SOW states that the PS&R accumulates statistical and reimbursement data related to Medicare claims processed. It is used by the Contractor and institutional providers to accumulate key elements of the Medicare cost report. We understand that the contractors no longer operate the PS&R system or provide PS&R summary reports to providers. Can CMS clarify and update this language? CMS confirms that C.5.11.3.4.1 of the SOW remains in effect.

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D. Sections J.01-J.11

	ID	Document	Section	Page number	Question	Answer/Action
	D.1	J.02 Deliverable Schedule	C.5.11.2.3.2
Estimated Allowance for Uncollectible Accounts	17	The redlined Deliverable Schedule shows a change in due date for the Allowance Matrix from the 5th business day after month end to 4 days after the quarter end with references to Non-HIGLAS requirements. All AB MAC workloads currently use HIGLAS and submit their Allowance Matrix on the 5th business day of the month with their HIGLAS Certification package. Additionally used for non-HIGLAS workloads, IOM 100-06 Chapter 5, Section 400.14 describes the Allowance Matrix as due twice a year on April 21 and October 21, and in December 2016 this was updated via TDL-170098 to a quarterly requirement due on January 15, April 15, July 15, and October 15. The revisions to the Allowance Matrix due dates on the Deliverable Schedule do not appear to be consistent with other published CMS instructions for this report. Please clarify.	CMS confirms that the 5th business day after month end is correct for contractors on HIGLAS; the Attachment J.02 Deliverable Schedule is revised accordingly.
	D.2	J.02 Deliverable Schedule	RFP/SOW Section H.3
Annual Conflict of Interest Audit	39	The Annual COI Audit is listed in the Deliverable Schedule but not in the SOW. It is our understanding that an Annual COI Audit is not required. Please confirm.	CMS has removed the annual COI audit deliverable from the Attachment J.02 Deliverable Schedule.
	D.3	J.02 Deliverable Schedule	J.02 Deliverable Schedule lists a requirement for C.7.19	36	High Risk Fraud and Abuse Areas (HEAT Initiative). The J.01 SOW indicates ‘Reserved’ for Section C.7.19. Please confirm if there should be information within section C.7.19 of the SOW to correlate with the associated deliverable.	CMS has removed the C.7.19 HEAT deliverable from the Attachment J.02 Deliverable Schedule.

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E. Sections J.12-J.21 ID Document Section Page number Question Answer/Action

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F. Section J.22 BOE

ID	Document	Section	Page number	Question	Answer/Action
F.1	J.22 BOE	Base Year and Option Years 1-6 BCRC follow-up Workload. Lines 194, 201, and 204.		BCRC Follow Up Workload. Based on guidance obtained from TDL 190138, the volume reported for BCRC follow up is the number of times the contractor is required to contact the BCRC for a response to ECRS. Based on this direction, it appears the workload volumes identified suggest that for the first option year (800 Part A, 400 HHH, 17,822 Part B) the contractor would be required to contact the BCRC approximately 1,585 times per month ((800+400+17,822)/12 months). Please confirm that these workloads are accurate.	CMS confirms that this requirement is specific to when the MAC needs to follow-up on requests for which the MAC did not receive a timely BCRC response. Any MAC request to the BCRC, such as an ECRS request, that is beyond the 100 day response time frame on which the MAC follows up constitutes a “follow-up with the BCRC.”
F.2		Reopenings Part B Clerical Error Reopenings Processed	Row 32	The volume of C.5.9 Reopenings Part B Clerical Error Reopenings (Processed) for Base year is 1,597,129, which is 4.3% of the total Bills/Claims in C.5.8 for Part B. This number seems to be unusually high. Is this correct? If so, is there something within this jurisdiction that results in this volume of claims being reopened? (This question also applies to all Option Years)	CMS revised the Base Year and Option Year Part B clerical error reopenings workload volumes.
F.3			Instructions Tab	CMS is providing the projected number of investigated claims. The investigated claims workload is the number of initial bills/claims that require some level of development. The offeror should provide the costs associated with the investigations of these initial bills/claims on the Investigated Electronic/Paper Claims lines of the BOE. All other claims processing costs, including adjustment bills/claims, should be included on the Electronic/Paper Claims lines. Could CMS please verify that this understanding of the claims workload is accurate?	CMS is providing the projected number of investigated claims as they require further development by the MAC via telephone contact, correspondence, or automatic inquiry with physician, beneficiary, supplier, social security office, or other entities outside the MAC for missing, incorrect, or inconsistent information. All other claims processing costs, which would include, but not be limited to, suspended claims and adjustments should be included on the Electronic/Paper claims lines.
F.4		C.5.9	2	The volume of C.5.9 Reopenings Part B Clerical Error Reopenings (Processed) for Base Year is 1,597,129. Will CMS confirm this is accurate, and if so, is there something within this jurisdiction that results in this volume of claims being reopened? Note that these questions apply to all Option Years.	CMS revised the Base Year and Option Year Part B clerical error reopenings workload volumes.

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G. Section J.23 GPPA

ID	Document	Section	Page number	Question	Answer/Action
G.1	J.23.A. Table 8 Facilties by State	Table 8 - Facilities by State		The Facilities by State worksheet Table 8 does not list American Samoa. Please confirm American Samoa has no facilities.	CMS confirms that the American Samoa has no facilities.
G.2	J.23	25	12	Are the 1,167 claims included in the J.22 BOE Row 23 Part B Investigated Bills/Claims - Electronic Claims for each year? Or are we to propose this workload volume under C.7.37?	CMS confirms that the Part B investigated Bills/Claims include C.7.37. Attachment J.23 (GPPA) item 25 provides the anticipated C.7.37 annual workload volume.
G.3	J.23	2.a Table 1 - Implementation Cutover Dates	2	Implementation Cutover Dates in the table all say 12/1/2019, which is the contract effective date and not the segment cutover dates. Will CMS confirm that the cutover dates in the table should be Part A and HH&H 4/12/2020 and Part B 5/3/2020, as shown in the timeline graphic and in Table 2 in section 2.c?

Outgoing Contractor State(s) & U.S. Territories Claim Type Virtual Data Center Implementation Cutover Date National Government Services, Inc. Illinois, Minnesota, Wisconsin A HP 12/1/2019 National Government Services, Inc. Alaska, Arizona, California, Hawaii, Idaho, Michigan, Minnesota, Nevada, New Jersey, New York, Oregon, Wisconsin and Washington, American Samoa, Guam, Northern Mariana Islands, Puerto Rico, and the U.S. Virgin Islands

HHH

HP 12/1/2019

National Government Services, Inc. Illinois, Minnesota, Wisconsin B HP 12/1/2019 CMS confirms that the correct dates for Table 1 are 4/12/2020 for Part A and HHH and 5/3/2020 for Part B. CMS revised Table 1 accordingly.

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H. Other tbd ID Document Section Page number Question Answer/Action

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File details come from the government source that posted it. Updated Dec 28, 2023.