Solicitation 75FCMC19R0041.pdf

75FCMC19R0041

SOLICITATION, OFFER AND AWARD

4. TYPE OF SOLICITATION2. CONTRACT NUMBER 3. SOLICITATION NUMBER

7. ISSUED BY CODE 8. ADDRESS OFFER TO (If other than Item 7)

ORDER UNDER DPAS (15 CFR 700)

6. REQUISITION/PURCHASE NUMBER

NOTE: In sealed bid solicitations "offer" and "offeror" mean "bid" and "bidder".

NEGOTIATED (RFP)

SEALED BID (IFB)

5. DATE ISSUED

1. THIS CONTRACT IS A RATED RATING PAGE OF PAGES

1 148

C. E-MAIL ADDRESS

EXT.NUMBERAREA CODE

B. TELEPHONE (NO COLLECT CALLS)A. NAME

10. FOR

INFORMATION

CALL:

CAUTION: LATE Submissions, Modifications, and Withdrawals: See Section L, Provision No. 52.214-7 or 52.215-1. All offers are subject to all terms and conditions contained in this solicitation.

(Date)(Hour) local timeuntildepository located in copies for furnishing the supplies or services in the Schedule will be received at the place specified in Item 8, or if hand carried, in the

SOLICITATION

9. Sealed offers in original and

PART IV - REPRESENTATIONS AND INSTRUCTIONS

OTHER STATEMENTS OF OFFERORS

EVALUATION FACTORS FOR AWARD

INSTRS., CONDS., AND NOTICES TO OFFERORS

REPRESENTATIONS, CERTIFICATIONS AND

LIST OF ATTACHMENTS

CONTRACT CLAUSES

PART III - LIST OF DOCUMENTS, EXHIBITS AND OTHER ATTACH.

I

J

K

L

M SPECIAL CONTRACT REQUIREMENTS

CONTRACT ADMINISTRATION DATA

DELIVERIES OR PERFORMANCE

INSPECTION AND ACCEPTANCE

PACKAGING AND MARKING

DESCRIPTION/SPECS./WORK STATEMENT

SUPPLIES OR SERVICES AND PRICES/COSTS

SOLICITATION/CONTRACT FORM

PART II - CONTRACT CLAUSESPART I - THE SCHEDULE

H

G

F

E

D

C

B

A

SEC. DESCRIPTION PAGE(S) (X) DESCRIPTION SEC. (X)

11. TABLE OF CONTENTS

18. OFFER DATE17. SIGNATURE

SUCH ADDRESS IN SCHEDULE.

IS DIFFERENT FROM ABOVE - ENTER

15C. CHECK IF REMITTANCE ADDRESS

EXT.NUMBERAREA CODE

15B. TELEPHONE NUMBER

(Type or print)AND

ADDRESS

OF

OFFEROR

CODE FACILITY

16. NAME AND TITLE OF PERSON AUTHORIZED TO SIGN OFFER15A. NAME

DATEAMENDMENT NO.DATEAMENDMENT NO.

and related documents numbered and dated):

amendments to the SOLICITATION for offerors

(The offeror acknowledges receipt of

14. ACKNOWLEDGEMENT OF AMENDMENTS

CALENDAR DAYS (%)30 CALENDAR DAYS (%)20 CALENDAR DAYS (%)10 CALENDAR DAYS (%)

(See Section I, Clause No. 52.232.8)

13. DISCOUNT FOR PROMPT PAYMENT

designated point(s), within the time specified in the schedule.

by the offeror) from the date for receipt of offers specified above, to furnish any or all items upon which prices are offered at the price set opposite each item, delivered at the

NOTE: Item 12 does not apply if the solicitation includes the provisions at 52.214-16, Minimum Bid Acceptance Period.

OFFER (Must be fully completed by offeror)

IMPORTANT - Award will be made on this Form, or on Standard Form 26, or by other authorized official written notice.

28. AWARD DATE

(Signature of Contracting Officer)

27. UNITED STATES OF AMERICA

25. PAYMENT WILL BE MADE BY

26. NAME OF CONTRACTING OFFICER (Type or print)

CODE 24. ADMINISTERED BY (If other than Item 7)

ITEM

(4 copies unless otherwise specified)

23. SUBMIT INVOICES TO ADDRESS SHOWN IN

41 U.S.C. 253 (c) ( 10 U.S.C. 2304 (c) (

22. AUTHORITY FOR USING OTHER THAN FULL AND OPEN COMPETITION:

21. ACCOUNTING AND APPROPRIATION20. AMOUNT19. ACCEPTED AS TO ITEMS NUMBERED

AWARD (To be completed by government)

CODE

01/14/2020 X

MSCG - DFSC

CMS,OAGM,MSCG,DFSC

7500 SECURITY BLVD., MS: B3-30-03

BALTIMORE MD 21244-1850

1100 ES 03/16/2020

Karen Epps 410 karen.epps@cms.hhs.gov

786-8680

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X

X

X

X

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X

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PAGE(S)

Jeannine Bohlen

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition is unusable

STANDARD FORM 33 (Rev. 9-97)

Prescribed by GSA - FAR (48 CFR) 53.214(c)

12. In compliance with the above, the undersigned agrees, if this offer is accepted within _____0_________ calendar days (60 calendar days unless a different period is inserted

Solicitation Number 75FCMC19R0041 DME MAC Jurisdiction C

TABLE OF CONTENTS

SECTION B - SUPPLIES OR SERVICES AND PRICES/COSTS

B.1 BRIEF DESCRIPTION OF SERVICES

B.2 CONTRACT TYPE

B.3 AWARD FEE

B.4 ESTABLISHED COST AND AWARD FEE

B.5 TASK DIRECTIVES

B.6 SCHEDULE OF SUPPLIES/SERVICES

SECTION C - DESCRIPTION/SPECIFICATIONS/WORK STATEMENT

C.1 STATEMENT OF WORK

SECTION D - PACKAGING AND MARKING

D.1 PACKAGING AND MARKING

SECTION E - INSPECTION AND ACCEPTANCE

E.1 FAR 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

E.2 APPROVALS BY THE CONTRACTING OFFICER REPRESENTATIVE

E.3 INSPECTION OF SERVICES – COST-REIMBURSEMENT

SECTION F - DELIVERIES OR PERFORMANCE

F.1 FAR 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

F.2 PERIOD OF PERFORMANCE (JAN 2014)

F.3 DELIVERABLES

SECTION G - CONTRACT ADMINISTRATION DATA

G.1 ACCOUNTING AND APPROPRIATION DATA

G.2 PAYMENT, SELECTED ITEMS OF COST REIMBURSEMENT CONTRACTS ...19

G.3 DISSEMINATION, PUBLICATION & DISTRIBUTION OF INFORMATION

G.4 SUBCONTRACTING REPORTING

G.5 SUBCONTRACTING PROGRAM

G.6 SUBCONTRACT CONSENT

G.7 SERVICE OF CONSULTANTS/ SUBCONTRACTORS

G.8 GOVERNMENT REPRESENTATIVES AND RESPONSIBLITIES (JUL 2016)

G.9 CONTRACT PROPERTY ADMINISTRATION

G.10 GOVERNMENT FURNISHED PROPERTY

G.11 CONTRACTOR FURNISHED PROPERTY

G.12 PAYMENTS – VOUCHERS - COST REIMBURSEMENT CONTRACTS (SEPT

2018)

G.13 SEPARATION OF MEDICARE INTEGRITY PROGRAM AND PROGRAM

MANAGEMENT FUNDING

G.14 SEPARATION OF TRUST FUND EXPENDITURES/ACCOUNTING FROM

ADMINISTRATIVE EXPENDITURES/ACCOUNTING

G.15 COMPLEMENTARY CREDITS

G.16 CORRESPONDENCE PROCEDURES

G.17 DATA TO BE DELIVERED

G.18 AWARD FEE EVALUATION PLAN

G.19 INDIRECT COST RATES (SEP 2014)

G.20 USE OF GOVERNMENT DATA (REPORTS/FILES/COMPUTER TAPES OR

DISCS)

G.21 INCORPORATION OF REPRESENTATIONS AND CERTIFICATIONS

G.22 CONTRACTOR PAST PERFORMANCE EVALUATION(S) (OCT 2014)

G.23 CONTRACTOR WORK PERFORMED OUTSIDE THE UNITED STATES AND

ITS TERRITORIES (APR 2016)

SECTION H - SPECIAL CONTRACT REQUIREMENTS

H.1 BUSINESS ETHICS, CONFLICT OF INTEREST AND COMPLIANCE (APR

2017)

H.2 HHSAR 352.237-75 KEY PERSONNEL (DEC 2015)

H.3 APPROVAL OF CONTRACT ACQUIRED INFORMATION TECHNOLOGY

(IT)

H.4 HIPAA BUSINESS ASSOCIATE CLAUSE (OCT 2014)

H.5 WAGE DETERMINATION

H.6 INDEMNIFICATION

H.7 DISCLOSURE OF INFORMATION

H.8 PARTICIPATION IN DEMONSTRATIONS

H.9 SEPARATION OF CERTIFICATION AND DISBURSEMENT

RESPONSIBILITIES

H.10 SURETY BONDS

H.11 LIABILITY FOR MEDICARE BENEFIT PAYMENTS – CERTIFYING

OFFICER

H.12 LIABILITY FOR MEDICARE BENEFIT PAYMENTS – DISBURSING

OFFICER

H.13 LIABILITY FOR MEDICARE BENEFIT PAYMENTS – MEDICARE

ADMINISTRATIVE CONTRACTOR

H.14 LIABILITY FOR UNCOLLECTED OVERPAYMENTS

H.15 MEDICARE RECORDS RETENTION

H.16 SECURITY INCIDENT AND REPORTABLE EVENT REPORTING

H.17 CMS SECURITY CLAUSE (APR 2016)

H.18 PRIVACY ACT ‘SYSTEMS NOTICE’

H.19 PUBLICITY

H.20 CMS INFORMATION SECURITY (APR 2013)

H.21 REPORTING CHANGES IN CONTRACTOR TEAM ARRANGEMENTS, AND

ACQUISITIONS/DIVESTITURES

H.22 OPEN GOVERNMENT PROACTIVE PREDISCLOSURE NOTIFICATION (OCT

2013)

H.23 CONTRACT RENEWAL

H.24 HHSAR 352.239-74 ELECTRONIC INFORMATION AND TECHNOLOGY

ACCESSIBILITY (DEC 2015)

H.25 SECTION 508-ACCESSIBILITY OF INFORMATION AND COMMUNICATIONS

TECHNOLOGY (SEP 2019)

H.26 LIMITATION OF FUNDS

SECTION I - CONTRACT CLAUSES

I.1 FAR 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

I.2 U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES ACQUISITION

REGULATIONS (HHSAR) CLAUSES INCORPORATED BY REFERENCE

I.3 FAR 52.204-21 BASIC SAFEGUARDING OF COVERED CONTRATOR

INFORMATION SYSTEMS (JUN 2016)

I.4 FAR 52.215-19 NOTIFICATION OF OWNERSHIP CHANGES (OCT 1997)

I.5 FAR 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR

2000)

I.6 FAR 52.222-2 PAYMENT FOR OVERTIME PREMIUMS (JUL 1990)

I.7 FAR 52.222-35 EQUAL OPPORTUNITY FOR VETERANS (OCT 2015)

I.8 FAR 52.222-36 EQUAL OPPORTUNITY FOR WORKERS WITH DISABILITIES

(JUL 2014)

I.9 FAR 52.222-42 STATEMENT OF EQUIVALENT RATES FOR FEDERAL HIRES

(MAY 2014)

I.10 FAR 52.252-4 ALTERATIONS IN CONTRACT (APR 1984)

I.11 HHSAR 352.224-71 CONFIDENTIAL INFORMATION (DEC 2015)

SECTION J - LIST OF ATTACHMENTS

SECTION K - REPRESENTATIONS, CERTIFICATIONS, AND OTHER STATEMENTS OF

OFFERORS OR QUOTERS

K.1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE

K.2 TO BE COMPLETED BY THE OFFEROR: [THE REPRESENTATIONS AND

CERTIFICATIONS MUST BE EXECUTED BY AN INDIVIDUAL AUTHORIZED

TO BIND THE OFFEROR]

K.3 FAR 52.204-8 ANNUAL REPRESENTATIONS AND CERTIFICATIONS (OCT

2018)

K.4 FAR 52.204-20 PREDECESSOR OF OFFEROR (JUL 2016)

K.5 FAR 52.209-5 CERTIFICATION REGARDING RESPONSIBILITYMATTERS

(OCT 2015)

K.6 FAR 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS

(OCT 2018)

K.7 FAR 52.209-11 REPRESENTATION BY CORPORATION REGARDING

DELINQUENT TAX LIABILITY OR A FELONY CONVICTION UNDER ANY

FEDERAL LAW (FEB 2016)

K.8 FAR 52.215-6 PLACE OF PERFORMANCE (OCT 1997)

K.9 FAR 52.219-1 SMALL BUSINESS PROGRAM REPRESENTATIONS (OCT

2014)

K.10 FAR 52.222-22 PREVIOUS CONTRACTS AND COMPLIANCE REPORTS (FEB

1999)

K.11 FAR 52.222-25 AFFIRMATIVE ACTION COMPLIANCE (APR 1984)

K.12 FAR 52.225-20 PROHIBITION ON CONDUCTING RESTRICTED BUSINESS

OPERATIONS IN SUDAN CERTIFICATION (AUG 2009)

K.13 FAR 52.230-1 COST ACCOUNTING STANDARDS NOTICES AND

CERTIFICATION (OCT 2015)

K.14 FAR 52.230-7 PROPOSAL DISCLOSURE – COST ACCOUNTING PRACTICE

CHANGES (APR 2005)

SECTION L - INSTRUCTIONS, CONDITIONS AND NOTICES TO OFFERORS

L.1 INTRODUCTION

L.2 FAR 52.252-1SOLICITATION PROVISIONS INCORPORATED BY REFERENCE

(FEB 1998)

L.3 U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES ACQUISITION

REGULATIONS (HHSAR) PROVISIONS INCORPORATED BY REFERENCE .106

L.4 FAR 52.216-1 TYPE OF CONTRACT (APR 1984)

L.5 FAR 52.233-2 SERVICE OF PROTEST (SEP 2006)

L.6 ALTERATIONS IN SOLICITATION 52.252-3 (APR 1984)

L.7 HHSAR 352.232-70 INCREMENTAL FUNDING (DEC 2015)

L.8 INTENT TO SUBMIT A PROPOSAL

L.9 SOLICITATION QUESTIONS

L.10 COMMUNICATIONS PRIOR TO CONTRACT AWARD

L.11 SUBMISSION, DELIVERY, ORGANIZATION AND GENERAL

INSTRUCTIONS

L.12 VOLUME I, ADMINISTRATIVE REQUIREMENTS AND RESPONSIBILITY

DETERMINATION PROPOSAL INSTRUCTIONS

L.13 VOLUME II, PROPOSAL ASSUMPTIONS INSTRUCTIONS

L.14 VOLUME III, TECHNICAL PROPOSAL INSTRUCTIONS

L.15 VOLUME IV, BUSINESS PROPOSAL INSTRUCTIONS

L.16 VOLUME V, BUSINESS ETHICS, CONFLICTS OF INTEREST AND

COMPLIANCE PROPOSAL INSTRUCTIONS (OCT 2015)

SECTION M - EVALUATION FACTORS FOR AWARD

M.1 FAR 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE

(FEB 1998)

M.2 BEST VALUE CONTINUUM

M.3 TECHNICAL EVALUATION FACTORS (NON-COST/PRICE FACTORS)

M.4 BUSINESS PROPOSAL EVALUATION CRITERIA (COST/PRICE FACTOR)

M.5 BUSINESS ETHICS, CONFLICTS OF INTEREST AND COMPLIANCE

EVALUATION

M.6 REVIEW OF ATTESTATIONS

M.7 RESPONSIBILITY DETERMINATION

M.8 508 COMPLIANCE AND VOLUNTARY PRODUCT ACCESSIBILITY

TEMPLATE (VPAT) (SECTION 508)

M.9 POTENTIAL EXCLUSION OF SOURCES (FAR 6.202)

SECTION B - SUPPLIES OR SERVICES AND PRICES/COSTS

B.1 BRIEF DESCRIPTION OF SERVICES

The purpose of this contract is to obtain a Durable Medical Equipment (DME) Medicare Administrative Contractor (hereinafter referred to as “the contractor” or “MAC” or “DME MAC”) to provide specified health insurance benefit administration services, including Medicare claims processing and payment services, in support of the “traditional” Medicare program (also known as the Medicare fee-for-service or FFS, program) for Jurisdiction C. Jurisdiction C includes the following states and territories: Alabama, Arkansas, Colorado, Florida, Georgia, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, Puerto Rico, South Carolina, Tennessee, Texas, U.S. Virgin Islands, Virginia and West Virginia.

B.2 CONTRACT TYPE

The Centers for Medicare & Medicaid Services (CMS) anticipates awarding a Cost Reimbursement type contract. In accordance with FAR 16.102 (b) Policies, “Contracts negotiated under Part 15 may be of any type or combination of types that will promote the Government’s interest, except as restricted in this part (see 10 U.S.C. 2306(a) and 41 U.S.C.

254(a))”. The primary pricing arrangement is anticipated to be Cost-Plus-Award-Fee (CPAF).

B.3 AWARD FEE

The amount of award fee the Contractor earns, if any, will be based upon an evaluation by the Government of the contractor’s performance in accordance with the Performance Evaluation Award Fee Plan (Attachment J.7). The CMS Fee Determination Official (FDO) will determine the amount of award fee earned by the contractor for the evaluation period. The determination of the amount of the award fee for the evaluation period is a unilateral decision made solely at the discretion of the FDO. Upon receiving written notification from the FDO of the amount of award fee earned for the evaluation period, the Contractor may submit an invoice for the earned award fee. The Government may unilaterally change the Performance Evaluation Award Fee Plan at any time. However, any revisions to the evaluation factors in the Performance Evaluation Award Fee Plan shall be presented to the Contractor prior to the evaluation period in which it will be used.

The award fee evaluations will be performed on an annual basis with the actual evaluation beginning in the month immediately following the evaluation period. The award fee available for each period shall be a portion of the total award fee pool available for the entire contract period (see Section G.18).

*Note: A sample Performance Evaluation Award Fee Plan (Attachment J.7) is provided. The final Performance Evaluation Award Fee Plan will be provided at time of contract award.

B.4 ESTABLISHED COST AND AWARD FEE

The estimated cost of this contract is detailed in the chart below.

Estimated Cost Base Fee

Maximum Available

Award Fee Fixed Fee Total Estimated

CPAF

TBD TBD TBD TBD TBD

B.5 TASK DIRECTIVES

The Contracting Officer may use individual Task Directives with specifically defined scopes and schedules to direct the contractor to perform special projects. Task Directives may also be issued to request a special administrative or user support services project. This mechanism will be used on a project-by-project basis and will be incorporated into the contract through the Changes clause (FAR 52.243-2 Alternate 1).

Task Directives issued under this contract may be fixed price or cost reimbursement. The contractor is required to establish separate cost accounts for each Task Directive issued and to segregate those costs in their vouchers.

B.6 SCHEDULE OF SUPPLIES/SERVICES

For Incremental Funding Table, per HHSAR 332.703-72, refer to Section H.26, Limitation of Funds.

CONTRACT LINE

ITEM NUMBER

ESTIMATED

COST

BASE

FEE

AWARD

FEE

FIXED

FEE

TOTAL

ESTIMATED

CPAF

EST.

COMP*

TOTAL

CPAF

NET

COMP

CREDITS

CLIN 0001*** –IMPLEMENTATION

Date: TBD

TOTAL CLIN 0001 –

IMPLEMENTATION TBD TBD TBD TBD TBD TBD TBD

ESTIMATED

COST

BASE

FEE

AWARD

FEE

FIXED

FEE

TOTAL

ESTIMATED

CPAF

EST.

COMP*

TOTAL

CPAF

NET

COMP

CREDITS

CLIN 0002** – DME MAC SERVICES

BASE YEAR OPERATIONS

Date: TBD

0002AA

Program Management TBD TBD TBD TBD TBD TBD TBD

0002AB

Medicare Integrity Program

TBD TBD TBD TBD TBD TBD TBD

0002AC

Recovery Audit Contractor

TBD TBD TBD TBD TBD TBD TBD

TOTAL CLIN 0002 –

DME MAC SERVICES

BASE YEAR

OPERATIONS

ESTIMATED

COST

BASE

FEE

AWARD

FEE

FIXED

FEE

TOTAL

ESTIMATED

CPAF

EST.

COMP*

TOTAL

CPAF

NET

COMP

CREDITS

CLIN 0003** – DME MAC SERVICES

OPTION YEAR 1 OPERATIONS

0003AA

0003AB

Medicare Integrity Program

TBD TBD TBD TBD TBD TBD TBD

0003AC

Recovery Audit Contractor

TBD TBD TBD TBD TBD TBD TBD

TOTAL CLIN 0003 –

DME MAC SERVICES

OPTION YEAR 1

ESTIMATED

COST

BASE

FEE

AWARD

FEE

FIXED

FEE

TOTAL

ESTIMATED

CPAF

EST.

COMP*

TOTAL

CPAF

NET

COMP

CREDITS

CLIN 0004** – DME MAC SERVICES

OPTION YEAR 2 OPERATIONS

0004AA Part A

0004AB Part A Medicare Integrity Program

TBD TBD TBD TBD TBD TBD TBD

0004AC Part B Recovery Audit Contractor

TBD TBD TBD TBD TBD TBD TBD

TOTAL CLIN 0004 –

DME MAC SERVICES

OPTION YEAR 2

ESTIMATED

COST

BASE

FEE

AWARD

FEE

FIXED

FEE

TOTAL

ESTIMATED

CPAF

EST.

COMP*

TOTAL

CPAF

NET

COMP

CREDITS

CLIN 0005** – DME MAC SERVICES

OPTION YEAR 3 OPERATIONS

0005AA

0005AB

Medicare Integrity Program

TBD TBD TBD TBD TBD TBD TBD

0005AC

Recovery Audit Contractor

TBD TBD TBD TBD TBD TBD TBD

TOTAL CLIN 0005 –

DME MAC SERVICES

OPTION YEAR 3

ESTIMATED

COST

BASE

FEE

AWARD

FEE

FIXED

FEE

TOTAL

ESTIMATED

CPAF

EST.

COMP*

TOTAL

CPAF

NET

COMP

CREDITS

CLIN 0006** – DME MAC SERVICES

OPTION YEAR 4 OPERATIONS

0006AA

0006AB

Medicare Integrity Program

TBD TBD TBD TBD TBD TBD TBD

0006AC

Recovery Audit Contractor

TBD TBD TBD TBD TBD TBD TBD

TOTAL CLIN 0006 –

DME MAC SERVICES

OPTION YEAR 4

ESTIMATED

COST

BASE

FEE

AWARD

FEE

FIXED

FEE

TOTAL

ESTIMATED

CPAF

EST.

COMP*

TOTAL

CPAF

NET

COMP

CREDITS

CLIN 0007** – DME MAC SERVICES

OPTION YEAR 5 OPERATIONS

0007AA

0007AB

Medicare Integrity Program

0007AC

Recovery Audit Contractor

TBD TBD TBD TBD TBD TBD TBD

TOTAL CLIN 0007 –

DME MAC SERVICES

OPTION YEAR 5

ESTIMATED

COST

BASE

FEE

AWARD

FEE

FIXED

FEE

TOTAL

ESTIMATED

CPAF

EST.

COMP*

TOTAL

CPAF

NET

COMP

CREDITS

CLIN 0008** – DME MAC SERVICES

OPTION YEAR 6 OPERATIONS

0008AA

0008AB

Medicare Integrity Program

TBD TBD TBD TBD TBD TBD TBD

0008AC

Recovery Audit Contactor

TBD TBD TBD TBD TBD TBD TBD

TOTAL CLIN 0008 –

DME MAC SERVICES

OPTION YEAR 6

ESTIMATED

COST

BASE

FEE

AWARD

FEE

FIXED

FEE

TOTAL

ESTIMATED

CPAF

EST.

COMP*

TOTAL

CPAF

NET

COMP

CREDITS

CLIN 0009 - CLOSE

OUT TBD TBD TBD TBD TBD TBD TBD

ESTIMATED

COST

BASE

FEE

AWARD

FEE

FIXED

FEE

TOTAL

ESTIMATED

CPAF

EST.

COMP*

TOTAL

CPAF

NET

COMP

CREDITS

CLIN 0010*** – MPIP BASE YEAR

Date: TBD

TOTAL CLIN 00010 –

MPIP BASE YEAR TBD TBD TBD TBD TBD TBD TBD

ESTIMATED

COST

BASE

FEE

AWARD

FEE

FIXED

FEE

TOTAL

ESTIMATED

CPAF

EST.

COMP*

TOTAL

CPAF

NET

COMP

CREDITS

CLIN 0011*** – MPIP OPTION YEAR 1

Date: TBD

TOTAL CLIN 0011 –

MPIP OPTION YEAR

ESTIMATED

COST

BASE

FEE

AWARD

FEE

FIXED

FEE

TOTAL

ESTIMATED

CPAF

EST.

COMP*

TOTAL

CPAF

NET

COMP

CREDITS

CLIN 00012*** – MPIP OPTION YEAR

TOTAL CLIN 00012 –

MPIP OPTION YEAR

ESTIMATED

COST

BASE

FEE

AWARD

FEE

FIXED

FEE

TOTAL

ESTIMATED

CPAF

EST.

COMP*

TOTAL

CPAF

NET

COMP

CREDITS

CLIN 00013*** – MPIP OPTION YEAR

TOTAL CLIN 00013 –

ESTIMATED

COST

BASE

FEE

AWARD

FEE

FIXED

FEE

TOTAL

ESTIMATED

CPAF

EST.

COMP*

TOTAL

CPAF

NET

COMP

CREDITS

CLIN 00014*** – MPIP OPTION YEAR

TOTAL CLIN 00014 –

ESTIMATED

COST

BASE

FEE

AWARD

FEE

FIXED

FEE

TOTAL

ESTIMATED

CPAF

EST.

COMP*

TOTAL

CPAF

NET

COMP

CREDITS

CLIN 00015*** – MPIP OPTION YEAR

TOTAL CLIN 00015 –

ESTIMATED

COST

BASE

FEE

AWARD

FEE

FIXED

FEE

TOTAL

ESTIMATED

CPAF

EST.

COMP*

TOTAL

CPAF

NET

COMP

CREDITS

CLIN 00016*** – MPIP OPTION YEAR

TOTAL CLIN 00016 –

TOTAL DME MAC

JURISDICTION C TBD TBD TBD TBD TBD TBD TBD

*Refer to section G.15, Complementary Credits.

**Cost Plus Award Fee (CPAF) SLIN ***Cost Plus Fixed Fee (CPFF) SLIN. CPFF line items are Term.

(END OF SECTION B)

SECTION C - DESCRIPTION/SPECIFICATIONS/WORK STATEMENT

C.1 STATEMENT OF WORK

The Statement of Work (SOW) is provided in Section J as Attachment J.1 and shall be made a part of the contract. The SOW takes precedence over the Internet Only Manuals and Paper-Based Manuals unless otherwise specified.

(END OF SECTION C)

SECTION D - PACKAGING AND MARKING

D.1 PACKAGING AND MARKING

All deliverables required pursuant to the terms of the contract must be shipped and marked in accordance with Section F.3 Deliverables and any other requirements as set forth in Attachment J.2.

(END OF SECTION D)

SECTION E - INSPECTION AND ACCEPTANCE

E.1 FAR 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this address:

https://www.acquisition.gov/far/

Federal Acquisition Regulation (FAR) Clauses:

52.246-5 INSPECTION OF SERVICES – COST REIMBURSEMENT (APR 1984)

E.2 APPROVALS BY THE CONTRACTING OFFICER REPRESENTATIVE

All services or supplies to be delivered to the Contracting Officer Representative (COR) will be deemed to have been accepted 30 calendar days after date of delivery, except as otherwise specified in this contract, if written approval or disapproval has not been provided within such period. The COR's approval or revision to the services or supplies delivered shall be within the general scope of work stated in the contract.

E.3 INSPECTION OF SERVICES – COST-REIMBURSEMENT

(a) All work included in this contract is subject to inspection and final acceptance by the

Contracting Officer or the duly authorized representative of the Government.

(b) The Government's COR is a duly authorized representative of the Government and is responsible for inspection and acceptance of all items required to be delivered by this contract.

(c) Inspection and acceptance of the Contractor's performance shall be in accordance with

FAR Clause 52.246-5, Inspection of Services-Cost Reimbursement.

(END OF SECTION E)

SECTION F - DELIVERIES OR PERFORMANCE

F.1 FAR 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this address:

Federal Acquisition Regulation (FAR) Clauses:

52.242-15 STOP WORK ORDER (AUG 1989) ALTERNATE I (APR 1984)

F.2 PERIOD OF PERFORMANCE (JAN 2014)

The period of performance for completion of all work included in this contract shall be from the effective date of contract award through 12 months, plus six (6) one (1) year options as follows:

CLIN DESCRIPTION PERIOD OF PERFORMANCE

0001 Implementation 5 months from date of contract award 0002 Base Period Operations 7 months from cut-over date 0003 Option Year 1 Operations 12 months from exercise of option* 0004 Option Year 2 Operations 12 months from exercise of option* 0005 Option Year 3 Operations 12 months from exercise of option* 0006 Option Year 4 Operations 12 months from exercise of option* 0007 Option Year 5 Operations 12 months from exercise of option* 0008 Option Year 6 Operations 12 months from exercise of option* 0009 Transition Activities Not to exceed 6 months from exercise of option** 0010 Base Period MPIP 7 months from cut-over 0011 Option Year 1 MPIP 12 months from exercise of option 0012 Option Year 2 MPIP 12 months from exercise of option 0013 Option Year 3 MPIP 12 months from exercise of option 0014 Option Year 4 MPIP 12 months from exercise of option 0015 Option Year 5 MPIP 12 months from exercise of option 0016 Option Year 6 MPIP 12 months from exercise of option

*Operations CLINs (Base Year through OY6) include SLINs for Program Management (PM), Medicare Integrity Program (MIP), Recovery Audit Contract (RAC).

**This option may be exercised approximately 6 months prior to the expiration of the current year of performance.

Note: The option periods delineated above are subject to the FAR option clauses incorporated in Section I of the contract.

F.3 DELIVERABLES

(a) The Deliverable Schedule is provided under Section J as Attachment J.2 and shall be made a part of this contract.

(b) The Contractor shall submit all required deliverables and reports in accordance with the attached schedule. Reports submitted under the contract shall reference and cite the contract number and identify CMS as the sponsoring agency.

(c) Except for deliverables containing Protected Health Information (PHI), deliverables shall be submitted to the Centers for Medicare & Medicaid Services Analysis Reporting and Tracking (CMS ART) system. Deliverables containing PHI, as defined in the Health Insurance Portability and Accountability Act (HIPAA), cannot be submitted in CMS ART and shall be submitted electronically using the Deliverable electronic mailbox. For deliverables containing PHI, the email shall include the deliverable title and reference number (if applicable) in the subject line. The contractor will copy the Contracting Officer’s Representative (COR) and Contract Specialist (CS) on all electronic and/or written correspondence. Once the deliverable is received, the Contractor will receive an automatic reply confirmation.

(a) For the PHI deliverables, if unable to send electronically, the contractor is to send a notice to the JC MAC Deliverable electronic mailbox (CMS JC_MAC_Deliverables@cms.hhs.gov) stating the deliverable is being mailed in hardcopy, with an expected delivery date. The contractor will mail the hardcopy of the deliverable (excluding implementation deliverables) to the COR.

(b) Hardcopy Implementation deliverables should be sent to the JC Implementation Lead.

Refer to JSM Number 10337 for further instructions.

(c) Satisfactory performance under the contract shall be deemed to occur upon delivery and acceptance by the Contracting Officer, or the duly authorized representative, of the items in the attached Deliverable Schedule (Attachment J.2). Reports submitted under the contract shall reference and cite the contract number and identify CMS as the sponsoring agency:

The following abbreviations apply to Attachment J.2:

IAW In accordance with NLT Not later than COB Close of business E Electronic copy (e-mail or diskette) H Hard copy CP Cover page COR Contracting Officer’s Representative CS Contract Specialist

Note: Additional deliverables may be assigned as part of the project planning process. Individual projects may be released on a flow basis, as necessary by the direction of the Contracting Officer.

Addressees:

• CONTRACTING OFFICER’S REPRESENTATIVE (COR): Please refer to Section G.8, Government Representatives and Responsibilities

• CONTRACTING OFFICER (CO): Please refer to Section G.8, Government

Representatives and Responsibilities

• CONTRACT SPECIALIST (CS): Please refer to Section G.8, Government Representatives and Responsibilities

For the PHI Deliverables, the mailbox address is as follows:

Deliverables email: JC_MAC_Deliverables@cms.hhs.gov

All electronic files shall be submitted in a format that is compatible with Microsoft Office PC-based software. As this requirement is subject to change, the contractor shall be able to adapt to any new CMS standard in order to submit deliverables. Unless specifically denoted as “workday(s),” all timeframes are in calendar days, calendar weeks, calendar months, etc. after the effective date of the contract.

(END OF SECTION F)

mailto:JC_MAC_Deliverables@cms.hhs.gov

SECTION G - CONTRACT ADMINISTRATION DATA

G.1 ACCOUNTING AND APPROPRIATION DATA

CLIN/SLIN Requisition

Number Accounting

Commitment Number Object Class Appropriation CAN Amount

G.2 PAYMENT, SELECTED ITEMS OF COST REIMBURSEMENT CONTRACTS

(a) Travel Costs (Including Foreign Travel)

The Contractor shall be reimbursed for travel costs in accordance with FAR 31.205-46 Travel Costs.

(b) Per Diem

Expenses for subsistence and lodging shall be reimbursed to the Contractor only to the extent where overnight stay is necessary for performance under this contract. Incurred costs shall be considered to be reasonable and allowable only to the extent that they do not exceed, on a daily basis, the maximum per diem rates in effect at the time of travel as set forth in the Federal Travel Regulations in accordance with FAR 31.205-46(2).

(c) Cost of Materials

The cost of materials furnished or used under this contract shall be reimbursed in accordance with FAR 52.216-7 Allowable Cost and Payment, Reimbursing costs for cost reimbursement contracts. Expendable material costs for items such as office supplies, report paper, etc., and tools of the trade shall be priced in accordance with the Contractor’s approved accounting practices or standards, as applicable. The Contractor shall be required to support all material costs claimed.

(d) Relocation Costs

In accordance with FAR 31.205-35, Relocation costs, either direct charged or included in the contractor's indirect cost pools, associated with an individual not completing a term of service equal to one (1) year working under this contract shall be an unallowable cost under this contract.

G.3 DISSEMINATION, PUBLICATION & DISTRIBUTION OF INFORMATION

(a) Data and information either provided to the Contractor, or to any subcontractor or generated by activities under this contract or derived from research or studies supported by this contract, shall be used only for the purposes of the contract. It shall not be duplicated, used or disclosed for any purpose other than the fulfillment of the requirements set forth in this contract. This restriction does not limit the contractor's right to use data or information obtained from a non- restrictive source. Any questions concerning "privileged information" shall be referred to the Contracting Officer.

(b) Some data or information may require special consideration with regard to the timing of its disclosure so that preliminary findings which could create erroneous conclusions are not stipulated. Some data or information, which relate to policy matters under consideration by the Government, may also require special consideration with regard to the timing of its disclosure so that the open and vigorous debate within the government of possible policy options is not damaged.

(c) Any questions about use or release of the data or information or handling of material under this contract shall be referred to the Contracting Officer who must render a written determination. The Contracting Officer's determinations will reflect the results of internal coordination with appropriate program and legal officials.

(d) Written advance notice of at least forty-five (45) days shall be provided to the

Contracting Officer of the Contractor's desire to release findings of studies or research or data or information described above. If the Contractor disagrees with the Contracting Officer's determination, and if this disagreement cannot be settled by the Contractor and the Contracting Officer in a mutually satisfactory manner, then the issue will be settled pursuant to the FAR 52.233.1 Disputes.

(e) Any presentation of any report, statistical or analytical material based, on information obtained from this contract shall be subject to review by the COR before dissemination, publication, or distribution. Presentation includes, but is not limited to, papers, articles, professional publications, speeches, testimony or interviews with public print or broadcast media. This does not apply to information that is requested pursuant to the Federal Freedom of Information Act (FOIA).

(f) The COR review shall cover accuracy, content, manner of presentation of the information, and also the protection of the privacy of individuals. If the review finds that the Privacy Act is or may be violated, the release/use of the presentation shall be denied until the offending material is removed or until the Contracting Officer makes a formal determination, in writing, that the privacy of individuals is not being violated.

(g) If the review shows that the accuracy, content, or manner of presentation is not correct or is inappropriate in the light of the purpose of the project, the COR shall immediately inform the Contractor, in writing, of the nature of the problem. If the Contractor disagrees, the COR may insist that the presentation contain, in a manner of equal importance, materials, which show the government's problem with the presentation.

(h) The Contractor agrees to acknowledge support by CMS whenever reports of projects funded, in whole or in part, by this contract are published in any medium. The Contractor shall include in any publication resulting from work under this contract, an acknowledgment substantially, as follows:

"The analyses upon which this publication is based were performed under Contract Number , entitled, DME MAC Jurisdiction C.”

Sponsored by the Centers for Medicare & Medicaid Services, U.S. Department of Health & Human Services."

Any deviation from the above legend shall be approved, in writing, by the Contracting

G.4 SUBCONTRACTING REPORTING

The Contractor shall report all subcontract awards to small, small disadvantaged, women-owned, HUBZones, veteran-owned and service-disabled veteran-owned small business concerns. The reports shall be prepared using the electronic Subcontracting Reporting System (eSRS) via the internet at Electronic Subcontracting Reporting System Site (https://www.esrs.gov/).The Individual Subcontracting Report (ISR), formerly SF 294, and the Summary Subcontracting Report (SSR), formerly SF 295, shall be submitted as detailed in the chart below.

Reporting Period Report Due Due Date Oct 1 – Mar 31 ISR Apr 30 Apr 1 – Sept 30 ISR Oct 30 Oct 1 – Sept 30 SSR Oct 30 Contract Completion OF 312 (If required) 30 days after completion

G.5 SUBCONTRACTING PROGRAM

Contractors are to submit Small Business Subcontracting Plans per FAR 52.219-9, Small Business Subcontracting Plan. In accordance with FAR 19.704, Subcontracting Plan Requirements, the subcontracting plan submitted shall be approved by the CO and incorporated as Attachment J.3 of this contract and made a part hereof.

The plan shall cover the entire contract period of performance and the Contractor shall strive to achieve the HHS small business utilization goals outlined in Attachment J.3 when developing its small business subcontracting plan.

The contractor hereby agrees to implement the conditions of the subcontracting plan submitted and approved by the Contracting Officer for this contract.

G.6 SUBCONTRACT CONSENT

(a) To facilitate the review of a proposed subcontract by the COR and the Contracting

Officer, the Contractor shall submit the information required by FAR Clause 52.244-2, Subcontracts and FAR 52.244-5 to the Contracting Officer. The Contracting Officer shall review the request for subcontract approval and the COR's recommendation and advise the Contractor of his/her decision to consent or object to the proposed subcontract, in writing.

https://www.esrs.gov/

(b) Consent is hereby given to issue the following subcontract(s):

(To be completed at time of award, if applicable)

G.7 SERVICE OF CONSULTANTS/ SUBCONTRACTORS

(a) For the purposes of this contract, consultants are considered subcontractors. The

Contractor shall follow the procedures established in FAR Clause 52.244-2, Subcontracts.

(b) The Contractor shall be reimbursed at the rates(s) set forth below for services provided by consultants in connection with this contract:

Name Rate Per Hour Number of Hours Total Cost Not to Exceed

TBD TBD TBD

(To be completed at time of award, if applicable)

G.8 GOVERNMENT REPRESENTATIVES AND RESPONSIBLITIES (JUL 2016)

Following are the Government Representatives and their respective roles and responsibilities related to this contract:

a. Contracting Officer

As defined in Federal Acquisition Regulation (FAR) 2.101, Definitions, and in accordance with FAR 1.602-1, Authority, “Contracting officers have authority to enter into, administer, and/or terminate contracts and make related determinations and findings.” There is no other authorized representative or any other Administrative Contracting Officer assigned to this contract to carry out a Contracting Officer’s duties, except for technical direction assigned to the Contracting Officer’s Representative, if applicable.

The Contracting Officer is:

Centers for Medicare & Medicaid Services Office of Acquisition & Grants Management Medicare Support Contracts Group Division of Fee-for-Service Contracts ATTN: Jeannine Bohlen 7500 Security Blvd. Mail-stop: B3-30-03 Baltimore, MD 21244-1850

Phone: 410-786-2864 Email Address: jeannine.bohlen@cms.hhs.gov mailto::%20jeannine.bohlen@cms.hhs.gov

b. Contract Specialist

Notwithstanding any of the other provisions of this Contract, the Contract Specialist will assist the Contracting Officer with his/her responsibilities as defined in the FAR.

The Contract Specialist is:

Office of Acquisition & Grants Management Medicare Support Contracts Group Division of Fee-for-Service Contracts ATTN: Karen Epps 7500 Security Blvd. Mail-stop: B3-30-03 Baltimore, MD 21244-1850

Phone: 410-786-8680 Email Address: karen.epps@cms.hhs.gov

c. Contracting Officer’s Representative

The Contracting Officer’s Representative (COR), as defined in FAR 2.101, Definitions, is:

TBD

Division of TBD

ATTN: TBD

7500 Security Blvd.

Mail-stop: TBD Baltimore, MD 21244-1850

Phone: 410-786-XXXX Email Address: TBD

In accordance with FAR 1.602-2(d), Responsibilities, the COR’s delegated responsibilities are identified in the Contracting Officer’s appointment memorandum, a copy of which will be furnished to the contractor.

In the event a technical direction is issued, it must be within the general scope of the work stated in the contract. The term "technical direction" is defined to include, without limitation, the following:

(1) Directions to the Contractor which direct the contract effort, shift work emphasis between work areas or tasks, require pursuit of certain lines of inquiry, fill in details or otherwise serve to accomplish the contractual technical requirements as identified in the Statement of Work or Performance Work Statement; or mailto::%20karen.epps@cms.hhs.gov

(2) Provision of information to the Contractor, which assists in the interpretation of drawings, specifications, or technical portions of the work description.

The COR does not have the authority to:

1. Make changes to contract terms and conditions;

2. Direct the contractor to perform work or make deliveries not specifically required under the contract;

3. Waive or relax the Government’s rights with regard to the Contractor’s compliance with the specifications, price, delivery or any other terms or conditions of the contract;

4. Make any commitments or approve any actions that would create any financial obligation on the part of the Government; or

5. Issue direction that constitutes a “change” as defined in:

FAR 52.243-1, Changes – Fixed Price;

FAR 52.243-2, Changes – Cost Reimbursement;

FAR 52.243-3, Changes – Time and Material and Labor Hour;

FAR 52.243-4, Changes; or, FAR 52.243-5, Changes and Changed Conditions.

All technical direction shall be issued in writing by the COR or, if issued verbally, shall be confirmed in writing by the COR within five (5) business days after issuance.

The Contractor shall proceed promptly with the performance of technical direction duly issued by the COR within the scope of his/her authority.

If, in the opinion of the Contractor, any instruction or direction issued by a Government representative constitutes a change to the contract or constitutes a “Change Order” as defined in FAR 2.101, Definitions, the Contractor shall follow the instructions identified in FAR 52.243-7 Notification of Changes.

G.9 CONTRACT PROPERTY ADMINISTRATION

(a) Contractor agrees to furnish information regarding Government Property to the Contract

Property Administrator in the manner and to the extent required by the Contract Property Administrator, his duly designated successors, and in accordance with FAR Part 45 – GOVERNMENT PROPERTY and Appendix Q of the U.S. Department of Health & Human Services (HHS) Contracting Guide for Contract of Government Property, (April 2009) which is provided as Attachment J.4 to this solicitation.

(b) The Contractor is responsible for an annual physical inventory accounting for all government property under this contract. The inventory must be conducted by September 30th and the Standard Form 1428 Inventory Schedule, (or other form designated by the Contract Property Administrator), submitted by October 31st of each year.

(c) The inventory report shall include all items acquired, furnished, rented or leased under the contract. Employees who conduct the inventories should not be the same individuals who maintain the property records. The contractor must complete an HHS-342, Report of Survey, for any Government Furnished Equipment/Government Furnished Property inventory damages or shortages upon the direction of the Contract Property Administrator. Following the physical inventory, the Contractor shall prepare an inventory report and submit the report to the CMS Contract Property Administrator at the following address:

Office of Operations Management, Administrative Services Group Division of Printing, Mail, and Logistics Attn: TBD 7500 Security Boulevard, M/S SL-13-12 Baltimore, Maryland 21244-1850

(410) 786-XXXX

AND

Email the Contract Specialist (Refer to Section G.8 for contact information).

(d) Commercially leased software is subject to these reporting requirements.

(e) The Contractor shall submit a consolidated report of all accountable government property under this contract, including subcontractor inventory information.

(f) The final inventory report shall indicate that all items required for continued contract performance are acceptable and free from contamination. Property that is no longer usable or required shall be reported and disposition requested from the Contract Property Administrator at least 60 days prior to contract expiration. The final inventory report shall be submitted upon the date of contract expiration.

G.10 GOVERNMENT FURNISHED PROPERTY

Pursuant to FAR Part 45 – Government Property and FAR Clause 52.245-1, Government Property, of this contract, the Government will furnish for performance of the work required herein a list of accessible government systems, which is provided under Attachment J.5 and is hereby made part of this contract.

G.11 CONTRACTOR FURNISHED PROPERTY

A list of Contractor Furnished Property is incorporated as Attachment J.6 (To be completed at time of award).

G.12 PAYMENTS – VOUCHERS - COST REIMBURSEMENT CONTRACTS (SEPT

2018)

a. GENERAL: The Contractor may submit to the Government a voucher or Standard

Form 1034, Public Voucher for Purchases and Services Other Than Personal, for payment in accordance with the instructions below.

b. BANKING CHANGES: The contractor shall notify CMS’ Division of Accounting

Operations of all banking and address changes made in SAM via the following email address: CCRChanges@cms.hhs.gov.

c. CONTENT OF VOUCHER: FAR 32.905 Payment Documentation and Process, provides the required content for a proper voucher. In addition to the requirements of FAR 32.905, the following items shall also be included on the voucher to be considered proper:

• Contract/Subcontract Line Item Number (i.e. CLIN/SLIN as applicable)

• Contractor’s DUNS Number

• Period of performance or delivery date of goods or services provided

d. VOUCHER SUBMISSION: Vouchers shall be submitted via email in electronic format as follows:

To…: InvoiceSubmission@cms.hhs.gov Cc…: Please “Cc…” your respective Contract Specialist (CS) and Contracting

Officer’s Representative (COR) as follows:

• Contract Specialist – Refer to Section G.8 for contact information; and

• COR – Refer to Section G.8 for contact information

Subject Line: The email subject line shall contain the following information:

Contract Number, Task/Delivery Order Number (if applicable), Voucher Number, and Notification of Final Invoice (if applicable).

PLEASE DO NOT INCLUDE ANY ADDITIONAL INFORMATION IN

THE SUBJECT LINE, as doing so may delay internal processing of your invoice for payment.

Attachments: Voucher attachments shall be submitted in .pdf format. Only one voucher shall be attached per email. The first page of the attachment shall be the invoice, followed by any supporting documents as applicable.

e. PAYMENTS: The Government shall make interim payments on all vouchers

(subject to later audit) in accordance with the following clauses, as applicable:

mailto:CCRChanges@cms.hhs.gov https://www.acquisition.gov/sites/default/files/current/far/html/Subpart%2032_9.html#wp1032997 https://www.acquisition.gov/sites/default/files/current/far/html/Subpart%2032_9.html#wp1032997 mailto:InvoiceSubmission@cms.hhs.gov

• FAR 52.232-33 Payments by Electronic Funds Transfer – System for Award Management,

• FAR 52.216-7, Allowable Cost & Payment, and

• FAR 52.232-7, Payments under Time-and-Materials and Labor-Hour Contracts

Payment shall be made upon acceptance by the Contracting Officer’s Representative (COR) of the required supplies/services in accordance with the applicable FAR Inspection and Acceptance clause and the Contracting Officer’s approval.

Reimbursement for vouchers submitted under this contract shall be made no later than 30 calendar days after receipt of an acceptable voucher from the Contractor requested at the paying office designated above. CMS will make every effort to accelerate payments to small businesses and prime contractors with small business subcontractors.

f. INTEREST ON OVERDUE PAYMENT: The Prompt Payment Act, Public Law

97- 177 (96 Stat.85.31 U.S.C. 1801) is applicable to payments under this contract and requires the payment of interest on payments made more than 30 calendar days after receipt of a proper voucher by the Division of Accounting Operations.

Determinations of interest due will be made in accordance with the provisions of the Prompt Payment Act and 5 CFR 1315.

G.13 SEPARATION OF MEDICARE INTEGRITY PROGRAM AND PROGRAM

MANAGEMENT FUNDING

Funding for Medicare Integrity Program activities under Section 1893 of the Social Security Act is derived from a different source than funding for the other functions (called “Program Management functions”) which the Contractor performs pursuant to the authority of Section 1874A of the Social Security Act. Therefore, separate accounts shall be designated for Medicare Integrity Program activities and the Program Management functions which the Contractor performs pursuant to the authority of Section 1874A. The Contractor shall separately account for costs incurred to perform Medicare Integrity Program activities and its Program Management functions under this contract. In no event shall the Contractor apply funding which is designated for Medicare Integrity Program activities to costs incurred in performing its Program Management functions authorized by Section 1874A; similarly, the Contractor shall not apply funding designated for costs incurred in performing its Program Management functions under Section 1874A to Medicare Integrity Program activities.

G.14 SEPARATION OF TRUST FUND EXPENDITURES/ACCOUNTING FROM

ADMINISTRATIVE EXPENDITURES/ACCOUNTING

Any costs which are properly chargeable by a provider of services, physician, or supplier as benefit costs in accordance with Title XVIII of the Social Security Act, its implementing regulations and this contract, shall not be chargeable to this contract as administrative costs (i.e., either Medicare Integrity Program or Program Management costs). The Contractor shall separately account for benefit payments made by it from costs incurred to perform its Medicare Integrity Program activities and its Program Management functions under this contract.

G.15 COMPLEMENTARY CREDITS

The contractor shall separately account for complementary credits and reflect the current and cumulative totals on their monthly invoice. The estimated amounts for complementary credits shall be shown as a reduction to the total costs amount (i.e. after application of any fees) within each applicable CLIN. Complementary Credits for crossover claims will be accounted for on a cash basis.

G.16 CORRESPONDENCE PROCEDURES

To promote timely and effective administration, correspondence (except for invoices), submitted under this contact shall be subject to the following procedures:

(a) Technical Correspondence - Technical correspondence (as used herein, this term excludes correspondence which proposes or otherwise involves waivers, deviations or modifications to the requirements, terms or conditions of this contract) shall be addressed to the COR with an informational copy of the basic correspondence to the Contracting

(b) Other Correspondence - All other correspondence shall be addressed to the Contracting

Officer with an informational copy of the basic correspondence to the COR.

(c) Subject Lines - All correspondence shall contain a subject line, commencing with the contract number and assigning consecutive numbers (serial numbers to permit accountability), as illustrated below:

EXAMPLE: Contract No. – 75FCMCXXXX Sequence # - XX (YEAR) – XXXX Subject - Request for Subcontract Consent

G.17 DATA TO BE DELIVERED

Any working papers, interim reports, data provided by the Government or first produced by the Contractor under the contract or collected or otherwise obtained by the Contractor under the contract, or results obtained or developed by the Contractor (subcontractor or consultants) pursuant to the fulfillment of this contract are to be delivered, documented, and formatted as directed by the Contracting Officer.

In addition, information and/or data, which are held by the Contractor related to the operation of their business and/or institution and which are obtained without the use of Federal funds, shall be considered "PROPRIETARY DATA" and are not "subject data" to be delivered under this

G.18 AWARD FEE EVALUATION PLAN

A sample Performance Evaluation Award Fee Plan and Self-Assessment Template upon which the determination of award fee is based is identified herein as Attachment J.7. The award fee plan contains details with respect to how the Contractor will be evaluated periodically for its performance. The general criteria upon which the Contractor will be evaluated on can be found in the aforementioned Attachment J.7.

The Contractor may submit self-evaluations of performance for each period under consideration.

The Performance Evaluation Board in reaching its determination will consider these self-evaluations.

A sample Performance Evaluation Award Fee Plan is provided. The final award fee plan will be provided at time of contract award.

G.19 INDIRECT COST RATES (SEP 2014)

a. INDIRECT COST BILLING, CEILING and FINAL RATES (To be completed at time of award):

1. Billing Rates:

a. Federal Acquisition Regulation (FAR) 52.216-7(e) Billing Rates, states, “Until final annual indirect cost rates are established for any period, the Government shall reimburse the Contractor at billing rates established by the Contracting Officer or by an authorized representative (the cognizant auditor), subject to adjustment when the final rates are established.

These billing rates—

(1) Shall be the anticipated final rates; and,

(2) May be prospectively or retroactively revised by mutual agreement, at either party’s request, to prevent substantial overpayment or underpayment.”

Therefore, the Government shall reimburse the Contractor at the established Billing Rates, as established by the Cognizant Federal Agency (CFA) or cognizant auditor. Any change(s) to the Billing Rate(s) established, shall be approved by the CFA or cognizant auditor. In the event the Billing Rate(s) exceed any Ceiling Rate(s) established in G.19.a.2. below, the Government shall reimburse the Contractor at the Ceiling Rate(s).

b. Interim Billing Rates: In the event that the Contractor does not have

Contracting Officer or authorized representative (cognizant auditor) established Billing Rates, the following Interim Billing Rates apply to this contract:

INTERIM BILLING RATES:

Indirect Cost…