J.32 Systems of Records.docx

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Attached to
Part A/B Medicare Administrative Contractor, Jurisdiction E
Solicitation number
75FCMC19R0023
Issued by

About this file

This document contains a federal contract opportunity solicitation for Medicare administrative services. The Centers for Medicare and Medicaid Services intends to award a contract to provide specified health insurance benefit administration services including Medicare claims processing and payment services for Jurisdiction E, which covers the states of California, Hawaii and Nevada as well as the U.S. territories of American Samoa, Guam and Northern Mariana Islands. Key dates include a anticipated solicitation release of September 4, 2019, a proposal due date of November 4, 2019 and an anticipated award date of August 4, 2020. The contractor will perform numerous functions to support healthcare services for Medicare beneficiaries, including claims-related activities and establishing relationships with providers. The contract is expected to have a one year base period and six one-year option periods. Award will be made based on the best overall value to the government considering cost and technical factors.

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75FCMC19R0023_Amendment_2.pdf PDF
Amendment_2,_Attachment_1_-_RFP_Question_Responses.xlsx XLSX spreadsheet
JE_Amendment_1_CLEAN_Attachments_UPDATED.zip ZIP file
Amendment_1,_Attachment_1_REDLINE_Backpages.pdf PDF
JE_Amendment_1_REDLINED_Attachments_UPDATED.zip ZIP file
JE_RFP_Questions_and_Responses_Amendment_1.xlsx XLSX spreadsheet
75FCMC19R0023_Amendment_1.pdf PDF
J.23 Government Provided Proposal Assumptions —
J.39 CLIN 0006 Cost Proposal Template - Option Year 2 —
J.1.G AB MAC Performance Requirements Summary.docx DOCX document
J.22 Basis of Estimate.xlsx XLSX spreadsheet
J.42 CLIN 0009 Cost Proposal Template - Option Year 3 —
J.34 CLIN 0001 Cost Proposal Template - Implementation.xlsx XLSX spreadsheet
J.1 Statement of Work —
J.40 CLIN 0007 Cost Proposal Template - Option Year 2 —
J.28 Product Accessibility Template.docx DOCX document
J.1.C Fee-For-Service Shared System Base Functions.docx DOCX document
J.5 Government Systems Provided For Use.docx DOCX document
J.46 CLIN 0013 Cost Proposal Template - Option Year 5 —
J.37 CLIN 0004 Cost Proposal Template - Option Year 1 —
J.45 CLIN 0012 Cost Proposal Template - Option Year 5 —
J.49 CLIN 0016 Cost Proposal Template - Outgoing Contractor Workload Transition Activities.xlsx XLSX spreadsheet
J.10 Contractor Business Ethics COI and Compliance Program Requirements.docx DOCX document
J.1.A List of Key Definitions.docx DOCX document
J.23.A Government Provided Proposal Assumptions Audit and Reimbursement Tables.xlsx XLSX spreadsheet
J.33 Cost Template Summary Sheet.xlsx XLSX spreadsheet
J.23.B Government Provided Proposal Assumptions CSR-Handled Telephone Inquiries Tables.docx DOCX document
75FCMC19R0023.pdf PDF
J.11 Personal Conflicts of Interest Financial Disclosure.docx DOCX document
J.2 Deliverable Schedule.docx DOCX document
J.1.D Cash Collections Worksheet For HIGLAS Users.xlsx XLSX spreadsheet
J.44 CLIN 0011 Cost Proposal Template - Option Year 4 —
J.24 Attestations.docx DOCX document
J.47 CLIN 0014 Cost Proposal Template - Option Year 6 —
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J.35 CLIN 0002 Cost Proposal Template - Base Year —
J.48 CLIN 0015 Cost Proposal Template - Option Year 6 —
J.7 AB MAC Award Fee Plan and Self Assessment Template.docx DOCX document
J.25 Past Performance Questionnaire.docx DOCX document
J.4 HHS Contracting Guide for Contract of Government Property.docx DOCX document
J.41 CLIN 0008 Cost Proposal Template - Option Year 3 —
J.43 CLIN 0010 Cost Proposal Template - Option Year 4 —
J.9 Non-Disclosure Statement.docx DOCX document
J.1.B List of Key Acronyms.docx DOCX document
J.36 CLIN 0003 Cost Proposal Template - Base Year —
J.38 CLIN 0005 Cost Proposal Template - Option Year 1 —
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J.6 Contractor Furnished Property.docx DOCX document
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Text version

Attachment J.32 Systems of Records

RFP# 75FCMC19R0023

SYSTEMS OF RECORDS

The Privacy Act of 1974, Public Law 93-579, and the Regulations and General Instructions issued by the Secretary pursuant thereto, are applicable to this contract, and to all subcontractors thereunder to the extent that the design, development, operation or maintenance of a system of records as defined in the Privacy Act is involved. The following systems of records will be applicable to this contract and made available to the Contractor:

System
System Record Number
Common Working File (CWF)
09-70-0526
Intern and Resident Information System (IRIS)
09-70-0524
Provider Enrollment Chain and Ownership System (PECOS)
09-70-0532
Fiscal Intermediary Shared System (FISS)
09-70-0503
Medicare Multi-Carrier Claims System (MCS)
09-70-0501
Medicare Appeals System (MAS)
09-70-0566
Individuals Authorized Access to CMS Computer Services (IACS)
09-70-0538
Medicare Integrated Data Repository (IDR)
09-70-0571

January 10, 2019 Page 1 of 1

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