J.45 CLIN 0012 Cost Proposal Template - Option Year 2 (MPIP) clean Amend 1.xlsx

XLSX spreadsheet 32 KB Posted

Attached to
Part A/Part B Medicare Administrative Contractor (MAC) Jurisdiction L (JL)
Solicitation number
75FCMC20R0008
Issued by

About this file

This document contains a cost proposal template for a Medicare Administrative Contractor contract. The template provides cost categories including direct labor, fringe benefits, travel, subcontractors, and other direct costs for Contract Line Item Number 0012. Labor rates and hours are to be provided for various labor categories to calculate total costs. The travel schedule requires details on trip purpose, origin, destination, number of travelers, number of trips, number of days, lodging rates, per diem amounts, airfare costs, car rental fees, and other expenses to calculate total trip and total travel costs. The other direct costs section allows itemizing miscellaneous expenses by category. No indirect cost rates or fees are to be included in the template.

The related federal contract opportunity is a solicitation to provide Part A and Part B Medicare Administrative Contractor services for Centers for Medicare and Medicaid Services Jurisdiction L, which covers Delaware, Maryland, New Jersey, Pennsylvania, Washington D.C., and parts of Virginia. The contractor will perform Medicare claims processing, payment services, and other administrative functions to support the Medicare Fee-For-Service Program in the specified region.

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Other files

File Type Posted
J.23 Government Provided Proposal Assumptions (GPPA) redline Amend 2.docx DOCX document
J.23 Government Provided Proposal Assumptions (GPPA) clean Amend 2.docx DOCX document
75FCMC20R0008 Amend 2.pdf PDF
JL Solicitation 75FCMC20R0008 Sections B-M CLEAN Amend 1.pdf PDF
Q and A RFP 75FCMC20R00008.xlsx XLSX spreadsheet
J.34 CLIN 0001 Cost Proposal Template - Implementation clean Amend 1.xlsx XLSX spreadsheet
J.37 CLIN 0004 Cost Proposal Template - Option Year 2 (PM, MIP, RAC) clean Amend 1.xlsx XLSX spreadsheet
J.23 Government Provided Proposal Assumptions (GPPA) redline Amend 1.docx DOCX document
J.48 CLIN 0015 Cost Proposal Template - Option Year 5 (MPIP) clean Amend 1.xlsx XLSX spreadsheet
J.43 CLIN 0010 Cost Proposal Template - Base Year (MPIP) clean Amend 1.xlsx XLSX spreadsheet
J.22 Basis of Estimate redline Amend 1.xlsx XLSX spreadsheet
J.22.A Historic & Proposed FTE, Hours & Gross Cost Instructions & Narrative redline Amend 1.docx DOCX document
J.46 CLIN 0013 Cost Proposal Template - Option Year 3 (MPIP) clean Amend 1.xlsx XLSX spreadsheet
J.1 Statement of Work (SOW) clean Amend 1.docx DOCX document
J.33 Cost Template Summary Sheet clean Amend 1.xlsx XLSX spreadsheet
J.21 Proposal Self-Check Tool clean Amend 1.xlsx XLSX spreadsheet
J.49 CLIN 0016 Cost Proposal Template - Option Year 6 (MPIP) clean Amend 1.xlsx XLSX spreadsheet
J.22.A Historic & Proposed FTE, Hours & Gross Cost Instructions & Narrative clean Amend 1.docx DOCX document
JL Solicitation 75FCMC20R0008 Sections B-M REDLINE Amend 1.pdf PDF
J.40 CLIN 0007 Cost Proposal Template - Option Year 5 (PM, MIP, RAC) clean Amend 1.xlsx XLSX spreadsheet
J.41 CLIN 0008 Cost Proposal Template - Option Year 6 (PM, MIP, RAC) clean Amend 1.xlsx XLSX spreadsheet
J.22 Basis of Estimate clean Amend 1.xlsx XLSX spreadsheet
J.38 CLIN 0005 Cost Proposal Template - Option Year 3 (PM, MIP, RAC) clean Amend 1.xlsx XLSX spreadsheet
J.42 CLIN 0009 Cost Proposal Template - Outgoing Contractor Workload Transition Activities clean Amend 1.xlsx XLSX spreadsheet
J.36 CLIN 0003 Cost Proposal Template - Option Year 1 (PM, MIP, RAC) clean Amend 1.xlsx XLSX spreadsheet
J.1 Statement of Work (SOW) redline Amend 1.docx DOCX document
J.47 CLIN 0014 Cost Proposal Template - Option Year 4 (MPIP) clean Amend 1.xlsx XLSX spreadsheet
J.35 CLIN 0002 Cost Proposal Template - Base Year (PM, MIP, RAC) clean Amend 1.xlsx XLSX spreadsheet
J.23 Government Provided Proposal Assumptions (GPPA) clean Amend 1.docx DOCX document
J.21 Proposal Self-Check Tool redline Amend 1.xlsx XLSX spreadsheet
J.39 CLIN 0006 Cost Proposal Template - Option Year 4 (PM, MIP, RAC) clean Amend 1.xlsx XLSX spreadsheet
J.44 CLIN 0011 Cost Proposal Template - Option Year 1 (MPIP) clean Amend 1.xlsx XLSX spreadsheet
75FCMC20R0008.pdf PDF
J.37 CLIN 0004 Cost Proposal Template - Option Year 2 (PM, MIP, RAC).xlsx XLSX spreadsheet
J.22.A Historic & Proposed FTE, Hours & Gross Cost Instructions & Narrative.docx DOCX document
J.24 Attestations.docx DOCX document
J.45 CLIN 0012 Cost Proposal Template - Option Year 2 (MPIP).xlsx XLSX spreadsheet
J.10 Contractor Business Ethics COI and Compliance Program Requirements.docx DOCX document
J.1.B List of Key Acronyms.docx DOCX document
J.33 Cost Template Summary Sheet.xlsx XLSX spreadsheet
J.35 CLIN 0002 Cost Proposal Template - Base Year (PM, MIP, RAC).xlsx XLSX spreadsheet
J.23.A GPPA Audit & Reimbursement Tables.xlsx XLSX spreadsheet
J.42 CLIN 0009 Cost Proposal Template - Outgoing Contractor Workload Transition Activites.xlsx XLSX spreadsheet
J.2 Deliverable Schedule.docx DOCX document
J.1 Statement of Work (SOW) - Jurisdiction L.docx DOCX document
J.7 AB MAC Award Fee Plan and Self Assessment Template.docx DOCX document
J.9 Non-Disclosure Statement.docx DOCX document
J.40 CLIN 0007 Cost Proposal Template - Option Year 5 (PM, MIP, RAC).xlsx XLSX spreadsheet
J.43 CLIN 0010 Cost Proposal Template - Base Year (MPIP).xlsx XLSX spreadsheet
J.1.A List of Key Definitions.docx DOCX document
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Text version

CLIN 00012

RFP # 75FCMC20R0008

COST TEMPLATE - Attachment J.45

(Provide a cost spreadsheet for each CLIN proposed)
CLIN 0012P.1.11
Total FTEsMedicare Healthcare Provider Intervention Program (MPIP)
HoursRatesTotal
COST ELEMENTS
Direct Labor
0$0.00$0.00
0$0.00$0.00
0$0.00$0.00
0$0.00$0.00
Add Other Appropriate Labor Categories (note: labor categories should match WBS)0$0.00$0.00
0$0.00$0.00
0$0.00$0.00
0$0.00$0.00
0$0.00$0.00
0$0.00$0.00
Subtotal Direct Labor0$0.00$0.00

Fringe Benefits (at ____%) $0

Total Direct Labor $0

Travel (See separate schedule. Total should match)$0
SUBCONTRACTORS
Subcontractor Name0$0.00
Subcontractor Name0$0.00
Subcontractor Name0$0.00
Subcontractor Name0$0.00
Subcontractor Name0$0.00
Subcontractor Name0$0.00
Total Subcontractor0$0.00

Other Direct Costs (See separate schedule. Total should match.) $0

TOTAL ALL DIRECT COSTS $0

Indirect Costs (at ______ %) $0

TOTAL OTHER BEFORE FEE $0

Base Fee (at ____%)$0
Award Fee (at ______%)$0
Fixed Fee (at ______%)$0

TOTAL OTHER AFTER FEE $0

GRAND TOTAL$0
v1 04252012

20181115

75FCMC20R0008

PART A & PART B MEDICARE ADMINISTRATIVE CONTRACTOR

Confidential Procurement Sensitive &P

TRAVEL

RFP # 75FCMC20R0008

COST TEMPLATE - Attachment J.45

TRAVEL SUMMARY
CLIN 0012
Purpose of TripSOW WBS
CrosswalkLabor Category Taking TripTrip OriginDestination# People
(A)# Trips
(B)# Days
(C)# Nights
(D)Lodging Rate
(E)Lodging
(F=E*D*A)M&IE
(G)Total Lodging

and M&IE

(H=F+G)Airfare
(I)Car Rental
(J)Misc
(K)Local

Mileage

(L)Total Per Trip
(M=H+I+J+K+L)Total For All Trips

(N=M*B )

$ -$ -$ -$ -
$ -$ -$ -$ -
$ -$ -$ -$ -
$ -$ -$ -$ -
$ -$ -$ -$ -
$ -$ -$ -$ -
$ -$ -$ -$ -
$ -$ -$ -$ -
$ -$ -$ -$ -
$ -$ -$ -$ -
$ -$ -$ -$ -
$ -$ -$ -$ -
$ -$ -$ -$ -
$ -$ -$ -$ -
$ -$ -$ -$ -
$ -$ -$ -$ -
$ -$ -$ -$ -
$ -$ -$ -$ -
$ -$ -$ -$ -
TOTAL TRAVEL$ -
Travel Assumptions:

75FCMC20R0008

PART A & PART B MEDICARE ADMINISTRATIVE CONTRACTOR

Confidential Procurement Sensitive &P

ODC

RFP # 75FCMC20R0008

COST TEMPLATE - Attachment J.45

CLIN 0012GRAND
Cost ElementAmountTOTAL
$0.00
Add costs by category$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
TOTAL ODCs$0.00$0.00

75FCMC20R0008

PART A & PART B MEDICARE ADMINISTRATIVE CONTRACTOR

Confidential Procurement Sensitive &P

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