J.22 Basis of Estimate.xlsx
XLSX spreadsheet 351 KB Posted
- Solicitation number
- 75FCMC19R0023
About this file
This document provides details regarding a forthcoming request for proposal for Medicare Administrative Contractor services in Jurisdiction E. The Centers for Medicare and Medicaid Services intends to issue an RFP to obtain a contractor to provide specified health insurance benefit administration services including Medicare claims processing and payment for California, Hawaii, Nevada, American Samoa, Guam, and Northern Mariana Islands. The contractor will perform claims-related activities, establish provider relationships, and ensure financial integrity of the Medicare Fee-For-Service Program in accordance with applicable laws and CMS requirements. The anticipated RFP release date is September 4, 2019, with a proposal due date of November 4, 2019 and anticipated award date of August 4, 2020. Award will be made based on best overall value considering cost and technical factors.
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Instructions
| Attachment J.22 | BASIS OF ESTIMATE |
| RFP # 75FCMC19R0023 | September 4, 2019 |
| BASIS OF ESTIMATE INSTRUCTIONS | |
| PURPOSE: The purpose of the Basis of Estimate (BOE) is to assist the Centers for Medicare & Medicaid Services (CMS) in its evaluation of the Offeror’s technical and business proposals. Specifically, the BOE and other relevant historical data available to CMS will be used as a baseline tool for measuring and understanding how the Offeror proposes to perform the Statement of Work (SOW) requirements in contrast to how the Offeror has historically performed similar Medicare Administrative Contractor (MAC) work. Variances between an Offeror’s proposed and historical productivity rates, total number of hours and skill mix will be examined. If these variances are not fully explained or supported in the proposal, the variances may result in a technical finding and/or a cost realism adjustment pursuant to Federal Acquisition Regulation (FAR) 15.404-1(d). |
INSTRUCTION: The Offeror shall complete the BOE for the Base Year and Option Years 1 through 6. A tab is provided for each option period. In order to assist the Offeror in completing this BOE, CMS has provided instructions for populating the template. In addition, CMS has provided a sample calculation for the Offeror under the Example Tab.
NOTE: The Offeror shall submit the TOTAL proposed staffing (inclusive of existing staff, direct labor, inter-organizational transfers, subcontracts, etc., as applicable) to perform the work from implementation through contract end. The Offeror shall use the BOE format provided, inclusive of any formulas or formatting. The Offeror is instructed to copy-paste additional rows, as necessary, including any formulas and formatting from a similar row.
NOTE: At its option, if applicable conditions are met, the Offeror may abbreviate its BOE submission for Option Year (OY) 3 through OY6 (Contract Line Item Numbers (CLINs) 0005 through 0008) to the extent permitted by Request for Proposal (RFP) L.12.2.
Column A, Row 4 The Offeror will fill in its company name on each worksheet in the space provided next to "OFFEROR NAME".
| Column A, | ||
| SOW WBS Crosswalk | PURPOSE: The purpose of this column is to enable CMS to sort on proposed labor by function to allow for direct crosswalks that map between the BOE and the Offeror's CLIN templates and Technical Proposal. |
INSTRUCTION: The Offeror shall identify the Work Breakdown Structure (WBS) at the level necessary to provide clear and relevant distinctions for the associated hours by labor category. WBS levels are counted starting with “C,” so, for example C.5.11.3 is the fourth level of the WBS for that function. The pre-populated SOW WBS Crosswalk numbers provided in Column A are intended as a guide. The Offeror should update these numbers to the appropriate level as indicated below and can update these numbers if needed.
| Please note the further breakout required for the following areas: |
| * Claims Processing (C.5.8) - the Offeror shall propose hours at (at least) the fourth level of the WBS (in cases where the fourth level is not available, the third level). |
| * Redeterminations (C.5.10) - the Offeror shall propose hours at (at least) the fourth level of the WBS (in cases where the fourth level is not available, the third level). |
| * Audit and Reimbursement (C.5.11.3) - the Offeror shall propose hours at the fifth level of the WBS, except for the specific codes identified, which shall be proposed at the sixth level of the WBS: C.5.11.3.2.1, C.5.11.3.2.2, C.5.11.3.2.3, C.5.11.3.2.4, C.5.11.3.2.5, C.5.11.3.2.6, C.5.11.3.2.7, C.5.11.3.2.8, C.5.11.3.3.1, and C.5.11.3.3.3. |
| * Medical Review (C.5.12) - the Offeror shall propose hours at these specified WBS: C.5.12.1.6, C.5.12.2.2, C.5.12.2.3, C.5.12.2.4, C.5.12.2.5, C.5.12.2.6, C.5.12.2.7, C.5.12.2.8, C.5.12.2.10, C.5.12.2.11, C.5.12.2.12, C.5.12.2.13, C.5.12.2.14, C.5.12.2.16, and C.5.12.2.18. |
| For all other Medical Review direct labor hours, the Offeror shall identify the WBS level necessary to provide clear and relevant distinction for the associated hours by labor category. |
| * For Home Health and Hospice (HH&H) workloads, the Offeror shall propose Full Time Equivalents (FTEs) and productivity separately from the Part A workloads. However, the Offeror shall use the same WBS codes identified for the Part A workloads. For example, Part A claims and HH&H claims would both be proposed under C.5.8 for this BOE as well as in the Offeror’s business proposal CLIN templates. |
| Column B, | |||
| SLIN Crosswalk | PURPOSE: The purpose of this column is to enable the Government to sort on proposed labor by Sub-contract Line Item Number (SLIN) and allow for crosswalks that map between the BOE and the Offeror's CLIN templates and Technical Proposal. | ||
| INSTRUCTION: The Offeror shall identify the SLIN for the associated workload category. |
| Column C, | |||
| Workload Category | PURPOSE: The purpose of this column is to identify the overall workload performed or supported by the proposed level of effort. | ||
| INSTRUCTION: The Offeror shall use the workload category names provided. When copy-pasting additional rows into a section, the Offeror will ensure this column contains the appropriate workload category for the labor described in the rest of the row. (See Example tab.) |
| Column D, | |||
| Workload Subcategory | PURPOSE: The purpose of this column is to identify the driver of the proposed level of effort for the workload. CMS defines labor in two ways - "productive" and "non-productive." CMS defines "productive" labor as that labor that is solely dependent on workload volume; as workload volume increases, productive labor hours increase at a proportionate rate. Conversely, CMS defines "non-productive" labor as labor that is not solely driven by workload volume. Rather, "non-productive" labor may be fixed labor with no ties to workload fluctuations, or it may be labor that increases based on other factors, such as manager hours that are based on management to staff ratios. | ||
| INSTRUCTION: The Offeror shall use the workload subcategory names provided by CMS to identify the driver for a given productive labor category. In the event that workload does not drive the proposed level of effort for a given labor category, the Offeror shall classify its non-productive labor categories with the label "Non-Workload Estimating Factor" and group these rows at the end of the respective workload category section. (See Example tab.) | |||
| NOTE: There is a blank “Non-Workload Estimating Factor” row available at the end of each workload category section to be used (or delete) as necessary to capture the "non-productive" labor categories that support a workload. |
| PROPOSAL | |||
| Column E, | |||
| RFP Workload | PURPOSE: The purpose of this column is to ensure the Offeror uses the Government's workload assumptions when estimating the proposed level of effort. | ||
| INSTRUCTION: The Government has pre-populated this column with the Government's workload assumptions. The Offeror shall NOT change the RFP workloads in this column. The Offeror shall leave this column blank for any row(s) relating to “Non-Workload Estimating Factor” (a non-productive labor category). | |||
| NOTE: Some RFP Workloads are reported as "—", specifically Recovery Audit workloads. While the Offeror should not delete these rows, the Offeror does not need to enter any resources for these "—" workloads. The Recovery Audit Contractor (RAC)-related Appeals/Qualified Independent Contractor (QIC)/Administrative Law Judge (ALJ) workloads (SOW WBS C.5.26) are not segregated and are included in the Appeals workloads (SOW WBS C.5.10). | |||
| NOTE: Some RFP Workloads are "N/A," specifically the HH+H rows, as JE is not an HH+H A/B MAC. While the Offeror should not delete these rows, the Offeror does not need to enter any resources for these "N/A" workloads. |
| Column F, | |||
| Total Proposed/Derived Workload | PURPOSE: The purpose of this column is to understand the few instances in which the Offeror is proposing a workload or deriving a workload that differs from the RFP workload. For most workload subcategories, the total proposed workload will mirror the RFP workload, given that workload assumptions are mandatory for bidding purposes, with the exception of Medical Review. However, certain workloads, namely Provider Telephone Inquiries, are potentially impacted by various processes that allow for automation or self-service, thus potentially reducing the workload to be processed by the productive labor categories. This column should display the Offerors proposed workload. The technical proposal should explain the rationale for the use of the proposed workload number, e.g. automation or self-service activity. | ||
| INSTRUCTION: For most workload subcategories the Offeror will not change the mandatory RFP workloads already provided in this column. (If the Offeror does change a mandatory RFP workload in this column, it MUST also provide an explanation in Column N.) For Provider Telephone Inquiries, Provider Outreach and Education, and Local Coverage Determinations, the Offeror shall identify its proposed workloads based on the RFP volumes and disclose its other assumptions (in Column N). Please see below for further detail on how to complete the total proposed workloads for these four identified workload categories. The Offeror shall leave this column blank for a row relating to “Non-Workload Estimating Factor” (a non-productive labor category). |
Claims Processing
CMS is no longer providing Paper and Electronic claim counts separately. Paper and Electronic Bills and Claims are combined. Rows have been added for Part A Bills - Electronic & Paper, Part A Investigated Bills - Electronic & Paper, Part A Suspended Bills - Electronic & Paper, Part B Claims - Electronic & Paper, Part B Investigated Claims - Electronic & Paper, and Part B Suspended Claims - Electronic & Paper.
CMS has changed the Column F instruction as it relates to Part A and Part B claims. Rows have been added to the BOE to provide the number of suspended claims (that are not investigated) and the number of investigated claims for both Part A and Part B.
In claims processing the majority of claims are processed through the standard system, with only a percentage of claims suspending for manual review. Suspended claims are claims that are not auto-adjudicated and that have been moved to a suspended status location during the course of processing the claim, either per CMS direction related to shared system fixes or for the MAC to further develop the claim (i.e., manually resolve edits and/or supply missing/incorrect information). Investigated claims are suspended claims that require further development by the MAC. Investigated claims require contact during the month by telephone, correspondence, or automatic inquiry with physician, beneficiary, supplier, social security office, or other entities outside the MAC for missing, incorrect, or inconsistent information.
Offerors shall provide the level of effort for the claims workload program area in its entirety, inclusive of the level of effort to identify and process suspended and investigated claims, on the Electronic/Paper Claims lines, Rows 8, 9, 16, 17, 24 and 25. Additionally, Offerors shall also provide the total level of effort on their historic baseline contracts to perform the entire Claims function, including investigated claims, suspended claims and any non-workload estimating factors. Please note that if an Offeror's total proposed level of effort for the entire claims function differs significantly from its historic baseline, the Offeror must explain the difference in the Basis of Estimate column. The level of effort to process suspended claims shall be separated out and reported on Rows 13, 14, 21, 22, 29 and 30. The level of effort to process investigated claims shall be separated out and reported on Rows 11, 12, 19, 20, 27 and 28. NOTE: The Offeror shall not change the mandatory RFP workloads provided. (If the Offeror does change a mandatory RFP workload, it MUST also provide an explanation in Column N.)
| Provider Telephone Inquiries |
| CMS has formulated estimates for the volume of provider telephone inquiries that will need to be answered by a person (a Customer Service Representative, or CSR), and has provided these agency estimates in Column F. The Offeror will complete the BOE, and formulate its technical and business proposal, using the CMS-provided estimates for CSR-handled telephone inquiries. |
If the Offeror adjusts (overwrites) the CMS-provided CSR-handled telephone inquiry workloads, whether based on an assertion regarding the positive impact of its self-service technology solution(s) or some other basis, the Offeror MUST provide an explanation in Column N. Moreover, all Offerors MUST complete the table required by the RFP instructions at L.13.5, Tab F, F.3; in that table (Attachment J.23.B, Government Provided Proposal Assumptions CSR-Handled Telephone Inquiries Tables), all Offerors adjusting (overwriting) the CMS-provided estimates for CSR-handled telephone inquiries MUST furnish additional, historical baseline contract CSR performance data as required by such RFP instructions.
| Web Portal Inquiries |
| CMS has removed the Provider Inquiries Part A and Part B Web Portal Inquiries workload subcategory. Additional rows have been added to the BOE to provide the number of Web Portal Inquiries - Transactions Received and Web Portal Inquiries - Transactions Returned, as defined below. Offerors have been provided the workload numbers for Part A and Part B Web Portal Inquiries - Transactions Received and Web Portal Inquiries - Transactions Returned for proposal purposes. The Offeror shall apply their own local experience to determine and propose to the portion of web portal inquiries transactions that require some level manual intervention. |
| WEB PORTAL INQUIRIES - TRANSACTIONS RECEIVED: The total of queries performed through the portal, regardless of whether the query finds a matching record. This excludes activities related to login, registration, revocation, new access requests, and re-certifications. |
| WEB PORTAL INQUIRIES - TRANSACTIONS RETURNED: The total of queries performed through the portal that find a matching record. This excludes activities related to login, registration, revocation, new access requests, and re-certifications. |
| Provider Outreach and Education Activities (PM and MIP Provider Customer Service Workloads) |
| The Offeror shall enter the types and number of provider outreach and education activities in this column. See below for more information on the assumptions to be used for these proposed workloads. |
The Offeror shall use the jurisdiction-specific provider populations shown in BOE tabs "Facilities by Type" and "Facilities by State" to determine the workload appropriate for each type of provider outreach and education activity. There are no minimum requirements for this function, so the Offeror must develop its own strategy for how it can best service the provider population.
Provider Reimbursement & Audit
The Provider Specific File (PSF) workload sub-category should reflect the estimated number of hours associated with updating the PSF.
The Offeror shall use the jurisdiction-specific provider populations shown in BOE tab "Facilities by Type" to estimate the numbers of hours associated with updating the PSF.
| Local Coverage Determinations |
| The Local Coverage Determinations (LCD) workload categories were moved out of the Medical Review area and the SOW reference was updated to C.5.6. CMS has provided LCD workloads in the Basis of Estimate, Offerors are directed to use the provided workloads. NOTE: The Offeror shall not change the mandatory RFP workloads provided. (If the Offeror does change a mandatory RFP workload, it MUST also provide an explanation in Column N.) |
| Medical Review |
| CMS has provided Medical Review workloads in the Basis of Estimate, Offerors are directed to use the provided workloads to support its MR Strategy. (Please see instructions for column A for more detail on the WBS breakout required for Medical Review.) NOTE: The Offeror shall not change the mandatory RFP workloads provided. (If the Offeror does change a mandatory RFP workload, it MUST also provide an explanation in Column N.) |
| Column G, | |||
| Position/Labor Category (Proposed) | PURPOSE: The purpose of this column is to disclose the labor categories that will perform or support a given workload subcategory. (This includes both productive and non-productive labor categories.) The Government may consider this information in determining the reasonableness of the Offeror's proposed labor (skill) mix. | ||
| INSTRUCTION: For each workload subcategory, the Offeror shall identify all the labor categories required to perform the functional requirements of the statement of work. Each labor category shall be displayed using a separate row. This may require the Offeror to insert additional rows. The Offeror shall copy and paste all formulas and formatting into each inserted row. In the event that the Offeror wishes to display separate productivities for the same labor category to process the same workload subcategory, the Offeror shall display all productivities sequentially in the BOE. For example, if the Offeror has a Claims Analyst position that processes claims in State A and State B, the Offeror may display separate productivities by State for the Claims Analyst in the BOE. However, if the Offeror displays separate productivities, the Offeror shall display those productivities and associated hours on sequential rows. Similarly, if the Offeror wants to display separate productivities for a single labor category based on varying difficulty in a workload subcategory, the Offeror shall ensure that those productivities are also listed sequentially in the BOE. |
POSITION DESCRIPTIONS: For each labor category identified in the BOE the Offeror shall also complete the Position Description tab of this template to describe the specific job tasks, qualifications, and experience for each proposed labor category. The instructions for completing the position descriptions are found at the end of this Instructions tab.
| Column H, | |||
| % Workload Processed by Labor Category (Proposed) | PURPOSE: The purpose of this column is to explain to CMS the percentage of the workload to be processed by each specific labor category. This is especially useful in understanding how a particular workload is allocated across more than one productive labor category, where applicable. For example, the Offeror may use Claims Analysts I and II to process claims that suspend for manual review. Claims Analyst I may handle the easier claims, while Claims Analyst II may handle the more difficult claims. Therefore, using this example, each labor category would not process 100% of the suspended claims, but a subset specific to their tasks (e.g., 75% of claims go to Claims Analyst I and 25% go to Claims Analyst II). | ||
| INSTRUCTION: For each workload category the Offeror shall identify the percentage of the annual workload to be processed by each specific labor category. The Offeror shall only identify a percentage in this column if the Offeror defines that position as "productive." The Offeror shall leave this column blank for a row relating to “Non-Workload Estimating Factor” (a non-productive labor category). |
| Column I, | |||
| Workload Distribution (Proposed) | PURPOSE: The purpose of this column is to explain to CMS the distribution of workload across more than one productive labor category. | ||
| INSTRUCTION: The Offeror shall NOT alter the contents of this column, as these cells will auto-populate once data is entered in the previous column. The Offeror shall leave this column blank for a row relating to “Non-Workload Estimating Factor” (a non-productive labor category). |
| Column J, | |||
| Annual Productive Hours (Proposed) | PURPOSE: The purpose of this column is to explain to CMS the proposed annual productive hours used to calculate the FTEs for the respective labor category. | ||
| INSTRUCTION: The Offeror shall provide the proposed annual productive hours for each labor category identified. |
| Column K, | |||
| Hourly Production per FTE (Proposed) | PURPOSE: The purpose of this column is to identify the proposed productivity driving the hours for the productive labor category. CMS may verify the Offeror's proposed productivity against its history and its proposed approach discussed in the Offeror's technical proposal. | ||
| INSTRUCTION: For any productive labor category identified, the Offeror shall provide the workload that can be accomplished by one (1) FTE in one (1) hour. The Offeror shall leave this column blank for a row relating to “Non-Workload Estimating Factor” (a non-productive labor category). |
| Column L, | |||
| Total Hours (Proposed) | PURPOSE: The purpose of this column is to identify the proposed hours for a specific labor category to perform or support a given workload subcategory. CMS may verify total hours proposed with the Offeror's history, as well as its business and technical proposal to ensure consistency. | ||
| INSTRUCTION: For productive labor categories the Offeror shall NOT alter the contents of this column, as these cells will auto-populate once data is entered in previous columns. For a row relating to “Non-Workload Estimating Factor” (a non-productive labor category), the Offeror shall enter the total hours proposed for the labor category to support the workload. The Offeror should ensure the total hours proposed for a workload category crosswalk to the Offeror's history shown in the BOE, as well as historic data available in CMS Analysis, Reporting, and Tracking system (ART) for both productive and non-productive labor categories. The Offeror shall describe and provide rationale for any variances in Column N. |
| Column M, | |||
| Total FTEs (Proposed) | PURPOSE: The purpose of this column is to identify the total proposed FTEs for a specific labor category to perform or support a given workload subcategory so that the Government can crosswalk the rationale for the proposed FTEs to the FTEs identified in the Offeror's technical approach. | ||
| INSTRUCTION: The Offeror shall NOT alter the contents of this column, as these cells will auto-populate once data is entered in previous columns. The Offeror shall ensure the total FTEs shown for a workload category crosswalk to the Offeror's CLIN Templates and Technical Proposal. |
| BASIS OF ESTIMATE | |||
| Column N, | |||
| Basis of Estimate | PURPOSE: The purpose of this column is to provide a summary, narrative explanation to CMS to support the proposal elements in light of the Offeror’s history, including the proposed/derived workload, the proposed hours and productivity, and the proposed labor (skill) mix. | ||
| INSTRUCTION: The Offeror shall provide a summary, narrative explanation in this column to ensure CMS has adequate understanding of the Offeror’s proposal in light of the Offeror’s own history. The Offeror may also provide additional narrative in support of this summary in Volume II, Tab C, Offeror Proposal Assumptions. If additional narrative is provided in the Offeror Proposal Assumptions, the Offeror shall include a page reference to the additional narrative within the summary in this Column N. |
The Offeror shall use historic data as its baseline for the effort proposed on this contract. (An Offeror without historic MAC workloads should indicate the basis for the proposal, whether through similar historic workloads or through other assumptions used.) Therefore, the Offeror shall disclose the following information in Column N as it relates to the Offeror’s history:
| 1. WORKLOAD - WORKLOAD DISTRIBUTION – PRODUCTIVITY – HOURS. The Offeror shall specify the basis of its proposed/derived workload, workload distribution, hours, and productivity for each labor category identified; such as using its historic experience and/or process improvement proposed for this contract, with a focus on any variances from its history for these proposed elements. | |||
| Impacts and Changes to Level of Effort: The Offeror shall describe any impacts on or changes to its historic level of effort that resulted in changes to its proposed level of effort. Impacts may include, but are not limited to the following: | |||
| a) Proposed technical solutions for the contract such as a process improvement, | |||
| b Improvements implemented during the 12-month period used to derive the historic data, | |||
| c) One-time occurrences/temporary requirements that occurred during the 12-month historic timeframe, but are not part of this contract, and/or | |||
| d) Trends in performance (actual and/or anticipated). | |||
| This section also explains why variances exist between an Offeror's proposal and its history, such as the elimination of historic labor categories, as well as any variances between the history shown in the BOE and the historic data available to CMS, such as from the Contractor Management Information System (CMIS) and CMS ART. | |||
| 2. SOURCE. The Offeror shall identify the contract name and the system from which the historic data was derived. The Offeror shall also identify the time period used. | |||
| Time period. The Offeror shall use a minimum of 12 months of historic hours and production data as the baseline for this contract (i.e., Offeror’s most recent performance). If the Offeror chooses to use a productivity baseline period of less than 12 months’ duration, the Offeror shall provide detailed rationale to support the use of the shorter baseline period for its proposed productivity metrics. Moreover, when electing a shorter baseline period, the Offeror shall still provide its historic month-by-month hours and production performance for the full 12 consecutive months’ time span, highlighting the months actually used by the Offeror for the basis of estimate. This is to ensure that CMS may view the proposed limited historic baseline in the context of a full 12 consecutive months’ worth of performance. The Offeror should place this additional data in Volume II, Tab C, Offeror Proposal Assumptions. | |||
| 3. PROVIDER TELEPHONE INQUIRIES: For the provider telephone inquiry workload, the Offeror shall provide the basis for the Offeror's proposed CSR-handled telephone inquiries workload volume; if the Offeror proposes to adjust (overwrite) the CMS-provided CSR-handled telephone inquiry workloads in Column F, the Offeror's explanation for doing so much be clear and complete. In addition, the Offeror will provide the additional required data in Volume III, Tab F of its proposal as required by RFP L.13.5. The Offeror shall also provide in Volume II, Tab C, Offeror Proposal Assumptions, the following historical data points for the BOE 12-month historic baseline period, including the following: | |||
| 1. Interactive Voice Response (IVR) Handle Rate (as reported in the Provider Inquiries Evaluation System) - separate for Part A, HH&H (if available/applicable), and Part B, reported as a percentage | |||
| 2. Customer Service Representative (CSR) Calls Handled - separate for Part A and Part B, reported in number of calls (not as percentages) | |||
| 3. Web-Portal Utilization Rate – separate for Part A, HH&H (if available/applicable), and Part B, reported as the percentage of inquiries handled to completion through the Offeror’s web portal | |||
| HISTORY - BASELINE | |||
| Column O, | |||
| Historic Workload | An Offeror shall repeat (copy/paste) its 12-month history baseline data from the Base Year (CLIN 0002) into the tabs for all of the Option Years (CLINs 0003-0008). | ||
| PURPOSE: The purpose of this column is to demonstrate workload differences between the proposed workload and the Offeror's historic workload (12 month baseline) so CMS can understand potential impacts of the history on the level of effort proposed. CMS may verify the Offeror's stated historic workloads against historic data available to CMS. | |||
| INSTRUCTION: The Offeror shall identify the historic workload (12 month baseline) for the respective labor subcategory that impacted its proposed productivity and level of effort. The Offeror shall leave this column blank for a row relating to “Non-Workload Estimating Factor” (a non-productive labor category). | |||
| Column P, | |||
| % Workload Processed by Labor Category (Historic) | PURPOSE: The purpose of this column is to explain to CMS the percentage of the workload that was processed by each specific labor category. This is especially useful in understanding how a particular workload subcategory was allocated historically across multiple productive labor categories, where applicable. For example, the Offeror may have used Claims Analysts I and II to process claims that suspended for manual review. Claims Analyst I may have handled the easier claims, while Claims Analyst II may have handled the more difficult claims. Therefore, in this example each labor category would not have processed 100% of the claims, but a subset specific to their tasks (e.g., 75% of claims went to Claims Analyst I and 25% went to Claims Analyst II). | ||
| INSTRUCTION: For each workload category the Offeror shall identify the percentage of the historic workload (12-month baseline) that was processed by the respective labor category, where applicable. The Offeror shall only identify a percentage in this column if the Offeror defined that position as "productive." The Offeror shall leave this column blank for a row relating to “Non-Workload Estimating Factor” (a non-productive labor category). | |||
| Column Q, | |||
| Workload Distribution (Historic) | PURPOSE: The purpose of this column is to understand the distribution of historic workload (12-month baseline) across more than one productive labor category. | ||
| INSTRUCTION: The Offeror shall NOT alter the contents of this column, as these cells will auto-populate once data is entered in the previous column. The Offeror shall leave this column blank for a row relating to “Non-Workload Estimating Factor” (a non-productive labor category). | |||
| Column R, | |||
| Annual Productive Hours (Historic) | PURPOSE: The purpose of this column is to understand the historic annual productive hours used to calculate the FTEs for the specific labor category. | ||
| INSTRUCTION: The Offeror shall provide the historic annual productive hours (12-month baseline) for each position identified. | |||
| Column S, | |||
| Hourly Production per FTE (Historic) | PURPOSE: The purpose of this column is to identify the historic productivity (12-month baseline) driving hours for the productive labor category so that CMS can make relevant comparisons between the Offeror's history and its proposal. | ||
| INSTRUCTION: For any "productive" labor category identified the Offeror shall provide the historic workload that was completed by one (1) FTE in one (1) hour using this column. The Offeror shall leave this column blank for a row relating to “Non-Workload Estimating Factor” (a non-productive labor category). |
| Column T, | ||
| Total Hours (Historic) | PURPOSE: The purpose of this column is to identify the historic hours (12-month baseline) for a specific labor category to perform or support a given workload subcategory. CMS may verify the Offeror's stated historic total hours against data available in CMS ART. |
INSTRUCTION: The Offeror shall identify the total historic labor hours for the respective labor category to perform the associated workload. The Offeror shall ensure the total hours shown for a workload category or subcategory align with the hours charged historically in CMS ART. The Offeror shall explain in Column N any variances between the total historic hours shown and historic data available in CMS ART and/or other data available to CMS.
| Column U, | ||
| Total FTEs (Historic) | PURPOSE: The purpose of this column is to identify the total historic FTEs for a specific labor category to perform or support a given workload subcategory so that CMS can make relevant comparisons and to clearly understand how an Offeror's proposed technical approach may lead to FTE counts that differ from an Offeror's historic experience. |
INSTRUCTION: The Offeror shall NOT alter the contents of this column, as these cells will auto-populate when all other columns are completed.
| Column V, | ||
| Item Number | PURPOSE: The purpose of this column is to provide an item number for each row to facilitate sorting of data. |
INSTRUCTION: The pre-populated numbers in this column are intended as a guide. Upon completion of the entire tab the Offeror shall overwrite the pre-populated numbers and enter sequential numbers in this column, top to bottom for each row.
| POSITION DESCRIPTION INSTRUCTIONS |
| The instructions below are specific to the Position Descriptions tab found after the Option Year 6 tab. |
| PURPOSE: The purpose of the position description tab is two-fold. First, this tab provides the Government with the necessary information to assess the reasonableness of the proposed labor (skill) mix to accomplish the SOW requirements. Second, this tab explains to the Government changes in the types of labor an Offeror historically used to process the work as compared to the types of labor proposed to do the work, which assists the Government in validating historic level of effort. |
| INSTRUCTION: For each labor category identified in the BOE, the Offeror and/or subcontractor(s) shall provide a description of the activities performed and the minimum required education and/or experience requirements. The Offeror shall provide a description of activities performed specific to each SOW WBS line item. When the same labor category is identified for multiple SOW WBS line items (e.g., Analyst I is proposed for C.5.3, C.5.8, and C.5.10), the Offeror shall provide a separate line/row for each SOW WBS item performed by the labor category. The Offeror shall submit this information (as prescribed in the Position Description tab) as part of its Basis of Estimate. |
| The Offeror shall also clarify any changes to its proposed labor categories (mix of staff) from its history (the 12-month period of historic data the Offeror used to determine level of effort and productivity). Reasons for differences may include, but are not limited to: |
| a) Elimination of category based on proposed approach |
| b) Elimination of category based on solution implemented in current operations within the 12-month timeframe |
| c) Consolidation of associated activities within another labor category |
| d) Revision to labor category name |
The Offeror shall capture any changes in labor mix using Columns E and F of the Position Descriptions tab only when there is a change in labor category. The Offeror shall use Column E to capture the name/classification of the history labor category and use Column F to provide a summary rationale for the change between the Offeror's proposed labor category name/classification and the Offeror's history. If the Offeror has eliminated a historic labor category, the Offeror shall identify this labor category in Column E, provide a rationale for the elimination in Column F, and identify the function it was eliminated from in Column C. The Offeror should also identify page references to its Proposal where additional narrative exists explaining the change.
BASIS OF ESTIMATE
Example
| Attachment J.22 | BASIS OF ESTIMATE |
| RFP # 75FCMC19R0023 | September 4, 2019 |
| OFFEROR NAME: | ||||||||||||||||||||||
| A/B Medicare Administrative Contractor (MAC) Basis of Estimate - Base Year | DO NOT ALTER THE CONTENTS OF THE SHADED CELLS IN COLUMNS E, F, I, L, M, Q AND U. (THESE CELLS WILL AUTO-POPULATE WHEN VALUES ARE ENTERED INTO ADJACENT CELLS.) SEE INSTRUCTIONS TAB FOR MORE INFORMATION ON THESE COLUMNS. | |||||||||||||||||||||
| PROPOSAL | HISTORY/BASELINE | |||||||||||||||||||||
| Statement of Work (SOW) Work Breakdown Structure (WBS) Crosswalk | Sub-contract Line Item Number (SLIN) Crosswalk | Workload Category | Workload Subcategory | RFP Workload | Total Proposed/Derived Workload | Position/ Labor Category (Proposed) | % Workload Processed with Direct Labor (Proposed) | Workload Distribution (Proposed) | Annual Productive Hours (Proposed) | Hourly Productivity per FTE (Proposed) | Total Hours (Proposed) | Total FTEs (Proposed) | BASIS OF ESTIMATE | Historic Workload | % Workload Processed with Direct Labor (Historic) | Workload Distribution (Historic) | Annual Productive Hours (Historic) | Hourly Productivity per FTE (Historic) | Total Hours (Historic) | Total FTEs (Historic) | Item Number | |
| C.5.10.1 | Sub-contract Line Item Number (SLIN) AA | Appeals Part A | Part A Redeterminations (Claims Cleared) | 2,025 | 2,025 | Appeals Coordinator | 100% | 2,025 | 788 | 6 | 337.5 | 0.43 | HOURS: Some historical hours are related to XYZ special project | |||||||||
| SOURCE: JX AB MAC contract, Centers for Medicare & Medicaid Services (CMS) Analysis, Reporting, and Tracking (ART) - July 2013 through June 2014. | 4,239 | 5.00% | 212 | 788 | 5 | 59.19 | 0.08 | |||||||||||||||
| C.5.10.1 | SLIN AA | Appeals Part A | Part A Redeterminations (Claims Cleared) | 2,025 | 2,025 | Appeals Analyst I | 100% | 2,025 | 788 | 5 | 405 | 0.51 | HOURS: Some historical hours are related to XYZ special project | |||||||||
| SOURCE: JX AB MAC contract, CMS ART - July 2013 through June 2014. | 4,239 | 5.00% | 212 | 788 | 5 | 140.13 | 0.18 | |||||||||||||||
| C.5.10.1 | SLIN AA | Appeals Part A | Part A Redeterminations (Claims Cleared) | 2,025 | 1,863 | Appeals Analyst II | 100% | 1,863 | 788 | 1 | 1,863.00 | 2.36 | PROPOSED WORKLOAD: 92% of the workload requires clinical decision. |
PRODUCTIVITY: Productivity is based on JX staffing and proposed innovation ABC which reduces effort by X%. See Volume II, Tab A, Section 3.2.1, page 15 and Volume III, Tab F, Page 49.
| SOURCE: JX AB MAC contract, CMS ART - July 2013 through June 2014. | 1,275 | 92.00% | 1,173 | 788 | 0.5 | 5,786.23 | 7.34 | |||
| C.5.10.1 | SLIN AA | Appeals Part A | Non-Workload Estimating Factor | Medical Reviewer III | 788 | 1,163.13 | 1 |
SOURCE: JX AB MAC contract, CMS ART - July 2013 through June 2014.
| 788 | 3,157.07 | 1.7 | ||||||
| C.5.10.1 | SLIN AA | Appeals Part A | Non-Workload Estimating Factor | Certified Professional Coder | 788 | 601.23 | 0.75 |
SOURCE: JX AB MAC contract, CMS ART - July 2013 through June 2014.
| 788 | 1,282.63 | 0.69 | |||||||
| C.5.10.1 | SLIN AA | Appeals Part A | Non-Workload Estimating Factor | Clerk | 788 | 559.82 | 0.5 | ||
| SOURCE: JX AB MAC contract, CMS ART - July 2013 through June 2014. | 788 | 2,132.65 | 1.15 | ||||||
| C.5.10.1 | SLIN AA | Appeals Part A | Non-Workload Estimating Factor | Training Coordinator | 788 | 1,163.13 | 1 |
SOURCE: JX AB MAC contract, CMS ART - July 2013 through June 2014.
788 3,102.00 1.67
BASIS OF ESTIMATE
BASIS OF ESTIMATE
Page &P
Page &P of &N
Base Year
| Attachment J.22 | BASIS OF ESTIMATE |
| RFP # 75FCMC19R0023 | September 4, 2019 |
| OFFEROR NAME: | ||||||||||||||||||||||
| A/B Medicare Administrative Contractor (MAC) Basis of Estimate - Base Year | DO NOT ALTER THE CONTENTS OF THE SHADED CELLS IN COLUMNS E, F, I, L, M, Q AND U. (THESE CELLS WILL AUTO-POPULATE WHEN VALUES ARE ENTERED INTO ADJACENT CELLS.) SEE INSTRUCTIONS TAB FOR MORE INFORMATION ON THESE COLUMNS. | |||||||||||||||||||||
| NOTE: The estimated base period used to calculate the workloads below are as follows: Part A workload is 8 months; Part B is 6 months. | PROPOSAL | HISTORY/BASELINE | ||||||||||||||||||||
| Statement of Work (SOW) Work Breakdown Structure (WBS) Crosswalk | Sub-contract Line Item Number (SLIN) Crosswalk | Workload Category | Workload Subcategory | RFP Workload | Total Proposed/Derived Workload | Position/ Labor Category (Proposed) | % Workload Processed with Direct Labor (Proposed) | Workload Distribution (Proposed) | Annual Productive Hours (Proposed) | Hourly Productivity per FTE (Proposed) | Total Hours (Proposed) | Total FTEs (Proposed) | BASIS OF ESTIMATE | Historic Workload | % Workload Processed with Direct Labor (Historic) | Workload Distribution (Historic) | Annual Productive Hours (Historic) | Hourly Productivity per FTE (Historic) | Total Hours (Historic) | Total FTEs (Historic) | Item Number | |
| C.5.8 | Bills/Claims Part A | Bills - Electronic & Paper | 9,867,844 | 9,867,844 | 0 | 0 | 1 | |||||||||||||||
| C.5.8 | Bills/Claims Part A | Non-Workload Estimating Factor | 3 | |||||||||||||||||||
| C.5.8 | Bills/Claims Part A | Investigated Bills - Electronic & Paper | 19,341 | 19,341 | 0 | 0 | 4 | |||||||||||||||
| C.5.8 | Bills/Claims Part A | Suspended Bills - Electronic & Paper (do not include Investigated Bills) | 136,544 | 136,544 | 0 | 0 | 6 | |||||||||||||||
| C.5.8 | Bills/Claims Part A | Non-Workload Estimating Factor | 8 | |||||||||||||||||||
| C.5.8 | Bills/Claims Home Health & Hospice (HH&H) (if applicable) | Bills - Electronic & Paper | N/A | N/A | 0 | 9 | ||||||||||||||||
| C.5.8 | Bills/Claims HH&H (if applicable) | Non-Workload Estimating Factor | 11 | |||||||||||||||||||
| C.5.8 | Bills/Claims HH&H (if applicable) | Investigated Bills - Electronic & Paper | N/A | N/A | 0 | 12 | ||||||||||||||||
| C.5.8 | Bills/Claims HH&H (if applicable) | Suspended Bills - Electronic & Paper (do not include Investigated Bills) | N/A | N/A | 0 | 14 | ||||||||||||||||
| C.5.8 | Bills/Claims HH&H (if applicable) | Non-Workload Estimating Factor | 16 | |||||||||||||||||||
| C.5.8 | Bills/Claims Part B | Claims - Electronic & Paper | 48,064,503 | 48,064,503 | 0 | 0 | 17 | |||||||||||||||
| C.5.8 | Bills/Claims Part B | Non-Workload Estimating Factor | 19 | |||||||||||||||||||
| C.5.8 | Bills/Claims Part B | Investigated Claims - Electronic & Paper | 34,710 | 34,710 | 0 | 0 | 20 | |||||||||||||||
| C.5.8 | Bills/Claims Part B | Suspended Claims - Electronic & Paper (do not include Investigated Bills) | 1,393,752 | 1,393,752 | 0 | 0 | 22 | |||||||||||||||
| C.5.8 | Bills/Claims Part B | Non-Workload Estimating Factor | 24 | |||||||||||||||||||
| C.5.9 | Reopenings Part A | Clerical Error Reopenings (Processed) | 2,422 | 2,422 | 0 | 0 | 25 | |||||||||||||||
| C.5.9 | Reopenings Part A | Non-Clerical Error Reopenings (Processed) | 53 | 53 | 0 | 0 | 26 | |||||||||||||||
| C.5.9 | Reopenings Part A | Non-Workload Estimating Factor | 27 | |||||||||||||||||||
| C.5.9 | Reopenings HH&H (if applicable) | Clerical Error Reopenings (Processed) | N/A | N/A | 0 | 28 | ||||||||||||||||
| C.5.9 | Reopenings HH&H (if applicable) | Non-Clerical Error Reopenings (Processed) | N/A | N/A | 0 | 29 | ||||||||||||||||
| C.5.9 | Reopenings HH&H (if applicable) | Non-Workload Estimating Factor | 30 | |||||||||||||||||||
| C.5.9 | Reopenings Part B | Clerical Error Reopenings (Processed) | 283,489 | 283,489 | 0 | 0 | 31 | |||||||||||||||
| C.5.9 | Reopenings Part B | Non-Clerical Error Reopenings (Processed) | 9,374 | 9,374 | 0 | 0 | 32 | |||||||||||||||
| C.5.9 | Reopenings Part B | Non-Workload Estimating Factor | 33 | |||||||||||||||||||
| C.5.10 | Appeals Part A | Part A Redeterminations (Claims Cleared) Note: This includes Recovery Audit Contractor (RAC) Redeterminations (Claims Cleared) (Part A) | 1,613 | 1,613 | 0 | 0 | 34 | |||||||||||||||
| C.5.10 | Appeals Part A | Part B of A Redeterminations (Claims Cleared) Note: This includes RAC Redeterminations (Claims Cleared) (Part B of A) | 11,377 | 11,377 | 0 | 0 | 35 | |||||||||||||||
| C.5.10 | Appeals Part A | Qualified Independent Contractor (QIC) Requests Supported (Case Files Forwarded) (Part A & Part B of A) | ||||||||||||||||||||
| Note: This includes RAC QIC Case File Requests (Part A & Part B of A) | 43 | 43 | 0 | 0 | 36 | |||||||||||||||||
| C.5.10 | Appeals Part A | Effectuations of Redeterminations (Claims) (Part A & Part B of A) | 7,327 | 7,327 | 0 | 0 | 37 | |||||||||||||||
| C.5.10 | Appeals Part A | Effectuations of Part A QIC Decisions (Claims) (Part A & Part B of A) Note: This includes RAC QIC Effectuations (Part A & Part B of A) | 1,169 | 1,169 | 0 | 0 | 38 | |||||||||||||||
| C.5.10 | Appeals Part A | Effectuations of Part A Administrative Law Judge (ALJ) Decisions (Claims) (Part A & Part B of A) | ||||||||||||||||||||
| Note: This includes RAC ALJ Effectuations (Part A & Part B of A) | 739 | 739 | 0 | 0 | 39 | |||||||||||||||||
| C.5.10 | Appeals Part A | Non-Workload Estimating Factor | 40 | |||||||||||||||||||
| C.5.10 | Appeals HH&H (if applicable) | HH&H Redeterminations (Claims Cleared) Note: This includes RAC Redeterminations (Claims Cleared) (HH&H) | N/A | N/A | 0 | 41 | ||||||||||||||||
| C.5.10 | Appeals HH&H (if applicable) | QIC Requests Supported (Case Files Forwarded) Note: This includes RAC QIC Case File Requests (HH&H) | N/A | N/A | 0 | 42 | ||||||||||||||||
| C.5.10 | Appeals HH&H (if applicable) | Effectuations of Redeterminations (Claims) | N/A | N/A | 0 | 43 | ||||||||||||||||
| C.5.10 | Appeals HH&H (if applicable) | Effectuations of HH&H QIC Decisions (Claims) Note: This includes RAC QIC Effectuations (HH&H) | N/A | N/A | 0 | 44 | ||||||||||||||||
| C.5.10 | Appeals HH&H (if applicable) | Effectuations of HH&H ALJ Decisions (Claims) Note: This includes RAC ALJ Effectuations (HH&H) | N/A | N/A | 0 | 45 | ||||||||||||||||
| C.5.10 | Appeals HH&H (if applicable) | Non-Workload Estimating Factor | 46 | |||||||||||||||||||
| C.5.10 | Appeals Part B | Part B Redeterminations (Claims Cleared) Note: This includes RAC Redeterminations (Claims Cleared) (Part B) | 74,915 | 74,915 | 0 | 0 | 47 | |||||||||||||||
| C.5.10 | Appeals Part B | QIC Requests Supported (Case Files Forwarded) (Part B) Note: This includes RAC QIC Case File Requests (Part B) | 4,156 | 4,156 | 0 | 0 | 48 | |||||||||||||||
| C.5.10 | Appeals Part B | Effectuations of Redeterminations (Claims) (Part B) | 31,177 | 31,177 | 0 | 0 | 49 | |||||||||||||||
| C.5.10 | Appeals Part B | Effectuations of Part B QIC Decisions (Claims) (Part B) Note: This includes RAC QIC Effectuations (Part B) | 4,886 | 4,886 | 0 | 0 | 50 | |||||||||||||||
| C.5.10 | Appeals Part B | Effectuations of Part B ALJ Decisions (Claims) (Part B) Note: This includes RAC ALJ Effectuations (Part B) | 259 | 259 | 0 | 0 | 51 | |||||||||||||||
| C.5.10 | Appeals Part B | Non-Workload Estimating Factor | 52 | |||||||||||||||||||
| C.5.26 | Adjustments to Recovery Auditor (RA) Part A (Claims) - SLIN 000X AC | Automated and Complex Adjustments | 2,488 | 2,488 | 0 | 0 | 53 | |||||||||||||||
| C.5.26 | Adjustments to RA Part A (Claims) - SLIN 000X AC | RAC Redeterminations (Claims Cleared) (Part A and Part B of A) Note: The RAC workload is not reflected on this line as it is included in the workload that is provided above in Part A and Part B of A Redeterminations. | — | — | 0 | 54 | ||||||||||||||||
| C.5.26 | Adjustments to RA Part A (Claims) - SLIN 000X AC | RAC QIC Case File Requests Note: The RAC workload is not reflected on this line as it is included in the workload that is provided above in Part A QIC Requests Supported. | — | — | 0 | 55 | ||||||||||||||||
| C.5.26 | Adjustments to RA Part A (Claims) - SLIN 000X AC | RAC QIC/ALJ Effectuations Note: The RAC workload is not reflected on this line as it is included in the workload that is provided above in Effectuations of Part A QIC Decisions & Effectuations of Part A ALJ Decisions. | — | — | 0 | 56 | ||||||||||||||||
| C.5.26 | Adjustments to RA Part A (Claims) - SLIN 000X AC | Non-Workload Estimating Factor | 57 | |||||||||||||||||||
| C.5.26 | Adjustments to RA HH&H (Claims) - SLIN 000X AC (if applicable) | Automated and Complex Adjustments | N/A | N/A | 0 | 58 | ||||||||||||||||
| C.5.26 | Adjustments to RA HH&H (Claims) - SLIN 000X AC (if applicable) | RAC Redeterminations (Claims Cleared) Note: The RAC workload is not reflected on this line as it is included in the workload that is provided above in HH&H Redeterminations. | — | — | 0 | 59 | ||||||||||||||||
| C.5.26 | Adjustments to RA HH&H (Claims) - SLIN 000X AC (if applicable) | RAC QIC Case File Requests Note: The RAC workload is not reflected on this line as it is included in the workload that is provided above in HH&H QIC Requests Supported. | — | — | 0 | 60 | ||||||||||||||||
| C.5.26 | Adjustments to RA HH&H (Claims) - SLIN 000X AC (if applicable) | RAC QIC/ALJ Effectuations Note: The RAC workload is not reflected on this line as it is included in the workload that is provided above in Effectuations of HH&H QIC Decisions & Effectuations of HH&H ALJ Decisions. | — | — | 0 | 61 | ||||||||||||||||
| C.5.26 | Adjustments to RA HH&H (Claims) - SLIN 000X AC (if applicable) | Non-Workload Estimating Factor | 62 | |||||||||||||||||||
| C.5.26 | Adjustments to RA Part B (Claims) - SLIN 000X AC | Automated and Complex Adjustments | 4,846 | 4,846 | 0 | 0 | 63 | |||||||||||||||
| C.5.26 | Adjustments to RA Part B (Claims) - SLIN 000X AC | RAC Redeterminations (Claims Cleared) (Part A and Part B of A) Note: The RAC workload is not reflected on this line as it is included in the workload that is provided above in Part B Redeterminations. | — | — | 0 | 64 | ||||||||||||||||
| C.5.26 | Adjustments to RA Part B (Claims) - SLIN 000X AC | RAC QIC Case File Requests Note: The RAC workload is not reflected on this line as it is included in the workload that is provided above in Part B QIC Requests Supported. | — | — | 0 | 65 | ||||||||||||||||
| C.5.26 | Adjustments to RA Part B (Claims) - SLIN 000X AC | RAC QIC/ALJ Effectuations Note: The RAC workload is not reflected on this line as it is included in the workload that is provided above in Effectuations of Part B QIC Decisions & Effectuations of Part B ALJ Decisions. | — | — | 0 | 66 | ||||||||||||||||
| C.5.26 | Adjustments to RA HH&H (Claims) - SLIN 000X AC (if applicable) | Non-Workload Estimating Factor | 67 | |||||||||||||||||||
| C.5.4.5 | Program Management (PM) Beneficiary Inquiries Part A & Part B | Complex Beneficiary Inquiry Responses | 2,322 | 2,322 | 0 | 0 | 68 | |||||||||||||||
| C.5.4.5 | PM Beneficiary Inquiries Part A | Complex 2nd Level Screenings (Receipts) | 264 | 264 | 0 | 0 | 69 | |||||||||||||||
| C.5.4.5 | PM Beneficiary Inquiries Part A | Non-Workload Estimating Factor | 70 | |||||||||||||||||||
| C.5.4.5 | PM Beneficiary Inquiries HH&H (if applicable) | Complex Beneficiary Inquiry Responses | N/A | N/A | 0 | 71 | ||||||||||||||||
| C.5.4.5 | PM Beneficiary Inquiries HH&H (if applicable) | Complex 2nd Level Screenings (Receipts) | N/A | N/A | 0 | 72 | ||||||||||||||||
| C.5.4.5 | PM Beneficiary Inquiries HH&H (if applicable) | Non-Workload Estimating Factor | 73 | |||||||||||||||||||
| C.5.4.5 | PM Beneficiary Inquiries Part B | Complex 2nd Level Screenings (Receipts) | 1,300 | 1,300 | 0 | 0 | 74 | |||||||||||||||
| C.5.4.5 | PM Beneficiary Inquiries Part B | Non-Workload Estimating Factor | 75 | |||||||||||||||||||
| C.5.23.10 | Freedom of Information Act (FOIA) requests | |||||||||||||||||||||
| (Includes requests for Duplicate Medicare Summary Notices (MSNs) and Remittance Advice (RA) requests) | FOIA requests (this is for Part A, HH&H, and Part B) | 743 | 743 | 0 | 0 | 76 | ||||||||||||||||
| C.5.5 | Participating Physicians (PAR) Part B | Enrollment Packages Mailed to Providers | ||||||||||||||||||||
| Note: See Assumptions for more detail on this requirement. | 20,959 | 20,959 | 0 | 0 | 77 | |||||||||||||||||
| C.5.5 | Participating Physicians (PAR) Part B | PAR Enrollments | ||||||||||||||||||||
| Note: See Assumptions for more detail on this requirement. | 99 | 99 | 0 | 0 | 78 | |||||||||||||||||
| C.5.5 | Participating Physicians (PAR) Part B | PAR Withdrawals | ||||||||||||||||||||
| Note: See Assumptions for more detail on this requirement. | 5 | 5 | 0 | 0 | 79 | |||||||||||||||||
| C.5.5 | Participating Physicians (PAR) Part B | Limiting Charge Reports, Violations, and Complaints Processed | ||||||||||||||||||||
| Note: See Assumptions for more detail on this requirement. | 1 | 1 | 0 | 0 | 80 |
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