75FCMC20R0017 RVC Solicitation amendment 1.pdf

DEPARTMENT OF HEALTH & HUMAN SERVICES

Centers for Medicare & Medicaid Services 7500 Security Boulevard, Mail Stop B3-30-03 Baltimore, Maryland 21244-1850

Office of Acquisition and Grants Management

July 27, 2020

SUBJECT: Recovery Audit Contractor (RAC)Validation Contractor (RVC) Solicitation 75FCMC20R0017 Amendment 1

CMS is providing the following amendment to RFP 75FCMC20Q0017. The following has been amended and highlighted in red font within the respective section or attachment:

RFP

1. Section G.2 Payments-Invoices-Firm Fixed Price Contracts (Sept 2018) “calendar days” has been updated from 30 to 15.

2. Section H.4 CMS Security Clause (Apr 2016) date has been revised to (May 2018). This has been updated in the table of contents as well.

3. Section L.12 Business Proposal Instructions (Volume II)’s chart has been updated to change the word “transmittal” to “cover” and add the cover letter formatting in the descriptive section.

4. Section L.13 tab “D Completed Attachment J.2 Contractor Personal Conflict of Interest Financial Disclosure” has been removed from the chart.

5. Section M.2 Technical Evaluation’s factor chart has been corrected to move Key Personnel to factor 3 from factor 2 and add the words staffing plan to the title.

6. Section M.2 Technical Evaluation’s factor chart has been corrected to move Technical Approach to factor 2 from factor 3 and add the word understanding to the title.

7. Section M.2 Technical Evaluation’s descriptive language has been updated to correct factor 2’s title to Technical Understanding and Approach and factor 3’s title to Key personnel and Staffing Plan.

Attachments

8. Attachment J.1 Recovery Audit Contractor Validation Contractor (RVC) SOW title has been updated to add

(v.3)

9. Attachment J.1 SOW Task 11: Travel revised to reflect up to seven (7) travel dates per year for four (4) individuals.

10. Attachment J.1 SOW Key Personnel revised to provide further details.

11. Attachment J.1 SOW Task 3: Accuracy Reviews revised to provide further details.

12. Attachment J.3’s attachment number has been updated to J.3 on page 1,2, and 3

CMS would like to know if you intend to submit a response to this RFP. Therefore, CMS is asking that each Offeror provide an intent to submit a proposal no later than July 29, 2020.

Please be advised that the intent to submit a quote is not binding and is for planning purposes only. CMS will accept proposals even if the Offer does not provide an intent to submit. A contractor that submits a negative intent to response is not precluded from submitting a quote.

Please submit your proposal submission via email to the attention of Tracy Amos at Tracy.Amos@cms.hhs.gov and Nicole Hoey at Nicole.Hoey@cms.hhs.gov by August 14, 2020 no later than 11:00AM EST.

The proposal acceptance period is 180 days. The Offeror shall make a clear statement that the proposal is valid through this date.

mailto:Tracy.Amos@cms.hhs.gov mailto:Nicole.Hoey@cms.hhs.gov

Also be advised that this RFP does not commit the Government to pay any cost for the preparation and submission of a proposal. In addition, you are reminded that the Contracting Officer is the only person who can legally commit the Government to the expenditure of funds in connection with this proposed procurement.

FAR 52.232-18 Availability of Funds (Apr 1984)

Funds are not presently available for this contract. The Government’s obligation under this contract is contingent upon the availability of appropriated funds from which payment for contract purposes can be made. No legal liability on the part of the Government for any payment may arise until funds are made available to the Contracting Officer for this contract and until the Contractor receives notice of such availability, to be confirmed in writing by the Contracting Officer.

Sincerely, Nicole Hoey Contracting Officer

TABLE OF CONTENTS

PART I - THE SCHEDULE

SECTION B - SUPPLIES OR SERVICES AND PRICES/COSTS

B.1 Description of Services B.2 Type of Contract B.3 Schedule of Services B.4 Schedule of Payments

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 Inspection and Acceptance E.3 Acceptance by the Contracting Officer’s Representative (COR)

SECTION F - DELIVERIES OR PERFORMANCE

F.1 FAR 52.252-2 Contract Clauses Incorporated by Reference (Feb 1998) F.2 Period of Performance (Jan 2014) F.3 Items to be Furnished and Delivery Schedule

SECTION G - CONTRACT ADMINISTRATION DATA

G.1 Accounting and Appropriation Data G.2 Payments – Invoices – Firm Fixed Price Contracts (Sept 2018) G.3 Government Representatives and Responsibilities (Jul 2016) G.4 Service of Consultants/ Subcontract Consent G.5 Correspondence Procedures G.6 Use of Government Data (Reports/Files/Computer Tapes or Discs) G.7 Property Administration G.8 Data to be Delivered G.9 Dissemination, Publication and Distribution of Information G.10 Contractor Performance Evaluation(s) (Oct 2014) G.11 Contract Work Performed Outside the United States (Apr 2016)

SECTION H - SPECIAL CONTRACT REQUIREMENTS

H.1 Business Ethics, Conflict of Interest and Compliance (April 2017) H.2 HIPPA Business Associate Clause (Oct 2014) H.3 CMS-Information Security (Apr 2013) H.4 CMS Security Clause (Apr 2016) May 2018 H.5 HHSAR 352.224-71 Confidential Information (Dec 2015) H.6 HHSAR 352.237-75 Key Personnel (Dec 2015) H.7 Disclosure of Information H.8 Reportable Events H.9 Mandatory Contractor Training (Feb 2020)

PART II - CONTRACT CLAUSES

SECTION I - CONTRACT CLAUSES

I.1 FAR 52.252-2 Clauses Incorporated by Reference (Feb 1998) I.2 Department of Health and Human Services Acquisition Regulations

(HHSAR) Clauses Incorporated by Reference (May 2015) I.3 FAR 52.217-8 Option to Extend Services (Nov 1999) I.4 FAR 52.217-9 Option to extend the Term of the Contract (Mar 2000) I.5 FAR 52.219-17 Section 8(A) Award (Oct 2019) I.6 FAR 52.219-18 - Notification of Competition Limited To Eligible 8(A) Concerns (Mar 2020) I.7 FAR 52.222-35 Equal Opportunity for Veterans (Jun 2020) I.8 FAR 52.222-36 Equal Opportunity for Workers with Disabilities (Jun 2020) I.9 FAR 52.222-42 Statement of Equivalent Rates for Federal Hires (May 2014) I.10 Basic Safeguarding of Covered Contractor Information Systems (Jun 2016)

PART III - LIST OF DOCUMENTS, EXHIBITS AND OTHER ATTACHMENTS

SECTION J - LIST OF ATTACHMENTS AND EXHIBITS

Attachments J.1 Recovery Audit Contractor Validation Contractor (RVC) SOW J.2 Contractor Personal Conflict of Interest Financial Disclosure J.3 Contractor Business Ethics COI and Compliance Program Requirements J.4 Reserved for if applicable “Wage Determination” (To be incorporated at Award)

Exhibits

E.1 Business Proposal Spreadsheet E.2 Past Performance Questionnaire E.3 Responsibility Questionnaire E.4 Virus Detection Certification E.5 Questions – Answers Template E.6 Consent to Subcontract

PART IV -- REPRESENTATIONS AND INSTRUCTIONS

SECTION K – REPRESENTATIONS, CERTIFICATIONS, AND OTHER STATEMENTS OF

OFFERORS OR RESPONDENTS

K.1 FAR 52.252-1 Solicitation Provisions Incorporated by Reference (Feb 1998) 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 (Mar 2020) K.4 FAR 52.204-24 Representation Regarding Certain Telecommunications and Video Surveillance

Services or Equipment (Aug 2019) K.5 FAR 52.209-7 Information Regarding Responsibility Matters (Oct 2018) K.6 52.209-13 Violation of Arms Control Treaties or Agreements-Certification (Jun 2018) K.7 FAR 52.219-1 Small Business Program Representations (Mar 2020)

SECTION L – INSTRUCTIONS, CONDITIONS, AND NOTICES TO OFFERORS OR

RESPONDENTS

L.1 FAR 52.252-1 Solicitation Provisions Incorporated by Reference (Feb 1998) L.2 Department of Health and Human Services Acquisition Regulations (HHSAR)

Provisions Incorporated by Reference (Jan 2016) L.3 FAR 52.215-1 Instructions to Offerors - Competitive Acquisition (Jan 2017) L.4 FAR 52.216-1 Type of Contract (Apr 1984) L.5 FAR 52.233-2 Service of Protest (Sep 2006) L.6 Communications Prior to Contract Award L.7 General Instructions L.8 Proposal Organization L.9 Submission of Questions L.10 Submission of Proposal L.11 Technical Proposal Instructions (Volume I) L.12 Business Proposal Instructions (Volume II) L.13 Business Ethics, Conflict of Interest and Compliance Proposal Submission Instructions

(April 2017) (Volume III)

SECTION M – EVALUATION FACTORS FOR AWARD

M.1 General Procedures for Award M.2 Technical Evaluation M.3 Business Proposal Evaluation M.4 Conflict of Interest Evaluation (April 17)

(End of Table of Contents)

PART I - THE SCHEDULE

SECTION B- SUPPLIES OR SERVICES AND PRICES/COSTS

B.1 Description of Services

The primary purpose of the Recovery Audit Contractor Validation Contractor (RVC) is to review Recovery Audit Contractors’ (RAC) claim determinations on Medicare claims that were paid under part A or B of title XVIII of the Social Security Act, and to ensure that the RACs are not unnecessarily denying Medicare claims that were properly paid as described in detail in Section C, Statement of Work, provided as Attachment J.1. The Recovery Audit Program mission is to reduce Medicare improper payments through the efficient detection and correction of improper payments.

B.2 Type of Contract

The Government anticipates award of a Firm Fixed Price type contract. It is estimated that the total cost to the Government for full performance of this contract will be in accordance with the Contract Line Item Number(s) (CLINs) identified in Section B.3 “Schedule of Services”.

B.3 Schedule of Services

The total negotiated Firm Fixed Price is as follows:

CLIN 0001

Base Period

CLIN/SLI

N Description Total

0001AA SOW Tasks 1, 2, 7, 8, 9, 10, 11, and 13 (Administrative) $

CLIN/SLI

N Description Unit Firm Fixed

Price Per Unit Maximum

Units Ordered Maximum Price

0001AB SOW Task 3 (Accuracy Reviews) Per Review $ 12000 $

0001AC SOW Task 4 (Disputes/Disagrees)

Per Disputes/Disagrees $ 3000 $

0001AD SOW Task 5 (Special Studies) Per Study $ 500 $

0001AE

SOW Task 6.1

(New Issue Proposal Review)

Per Review $ 360 $

0001AF

SOW Task 6.2

(RVC New Issue QA Review)

Per Review $ 360 $

0001AG

SOW Task 6.3

(New Issue Support Services)

Per Support Service $ 10 $

CLIN 0001 TOTAL $

CLIN 0002

Option Period 1

CLIN/SLI

N Description Total

0002AA SOW Tasks 1, 2, 7, 8, 9, 10, 11, and 13 (Administrative) $

CLIN/SLI

N Description Unit Firm Fixed Price Per Unit

Maximum Units Ordered Maximum Price

0002AB SOW Task 3 (Accuracy Reviews) Per Review $ 12000 $

0002AC SOW Task 4 (Disputes/Disagrees)

Per Disputes/Disagrees $ 3000 $

0002AD SOW Task 5 (Special Studies) Per Study $ 500 $

0002AE

SOW Task 6.1

(New Issue Proposal Review)

Per Review $ 360 $

0002AF

SOW Task 6.2

(RVC New Issue QA Review)

Per Review $ 360 $

0002AG

SOW Task 6.3

(New Issue Support Services)

Per Support Service $ 10 $

CLIN 0002 TOTAL $

CLIN 0003

Option Period 2

CLIN/SLI

N Description Total

0003AA SOW Tasks 1, 2, 7, 8, 9, 10, 11, and 13 (Administrative) $

CLIN/SLI

N Description Unit Firm Fixed

Price Per Unit Maximum

Units Ordered Maximum Price

0003AB SOW Task 3 (Accuracy Reviews) Per Review $ 12000 $

0003AC SOW Task 4 (Disputes/Disagrees)

Per Disputes/Disagrees $ 3000 $

0003AD SOW Task 5 (Special Studies) Per Study $ 500 $

0003AE

SOW Task 6.1

(New Issue Proposal Review)

Per Review $ 360 $

0003AF

SOW Task 6.2

(RVC New Issue QA Review)

Per Review $ 360 $

0003AG

SOW Task 6.3

(New Issue Support Services)

Per Support Service $ 10 $

CLIN 0003 TOTAL $

CLIN 0004

Option Period 3

CLIN/SLI

N Description Total

0004AA SOW Tasks 1, 2, 7, 8, 9, 10, 11, and 13 (Administrative) $

CLIN/SLI

N Description Unit Firm Fixed Price Per Unit

Maximum Units Ordered Maximum Price

0004AB SOW Task 3 (Accuracy Reviews) Per Review $ 12000 $

0004AC SOW Task 4 (Disputes/Disagrees)

Per Disputes/Disagrees $ 3000 $

0004AD SOW Task 5 (Special Studies) Per Study $ 500 $

0004AE

SOW Task 6.1

(New Issue Proposal Review)

Per Review $ 360 $

0004AF

SOW Task 6.2

(RVC New Issue QA Review)

Per Review $ 360 $

0004AG

SOW Task 6.3

(New Issue Support Services)

Per Support Service $ 10 $

CLIN 0004 TOTAL $

CLIN 0005

Option Period 4

CLIN/SLI

N Description Total

0005AA SOW Tasks 1, 2, 7, 8, 9, 10, 11, and 13 (Administrative) $

CLIN/SLI

N Description Unit Firm Fixed

Price Per Unit Maximum

Units Ordered Maximum Price

0005AB SOW Task 3 (Accuracy Reviews) Per Review $ 12000 $

0005AC SOW Task 4 (Disputes/Disagrees)

Per Disputes/Disagrees $ 3000 $

0005AD SOW Task 5 (Special Studies) Per Study $ 500 $

0005AE

SOW Task 6.1

(New Issue Proposal Review)

Per Review $ 360 $

0005AF

SOW Task 6.2

(RVC New Issue QA Review)

Per Review $ 360 $

0005AG

SOW Task 6.3

(New Issue Support Services)

Per Support Service $ 10 $

CLIN 0005 TOTAL $

CLIN 0006

Transition/Closeout

CLIN/SLI

N Description Total

0006 SOW Task 12 (Transition/Contract Closeout) $

CLIN 0006 TOTAL $

GRAND TOTAL $

B.4 Schedule of Payment

The Government anticipates award of a Firm Fixed Price type contract. It is estimated that the total cost to the Government for full performance of this contract will be in accordance with the Contract Line Item Number(s) (CLINs) identified in Section B.1 “Brief Description of Services” set forth above.

(End of Section B)

SECTION C - DESCRIPTION/SPECIFICATIONS/STATEMENT OF WORK

C.1 Statement of Work

Independently and not as an agent of the Government, the Contractor shall furnish all the necessary services, qualified personnel, material, equipment, facilities, and supplies, not otherwise provided by the Government as needed to perform the requirements set forth in the Statement of Work (SOW), Attachment J.1, entitled “Recovery Audit Contractor Validation Contractor (RVC) SOW”.

(End of Section C)

SECTION D - PACKAGING AND MARKING

D.1 Packaging and Marking

All deliverables required under this contract shall be packaged, marked and shipped in accordance with Government specifications. The Contractor shall guarantee that all required materials shall be delivered in immediate usable and acceptable condition.

(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:

http://www.acquisition.gov/far/

Federal Acquisition Regulation (FAR) Clauses:

NUMBER TITLE DATE

52.246-4 Inspection of Services – Fixed Price Aug 1996

E.2 Inspection and Acceptance

a. All work under this contract is subject to inspection and final acceptance by the

Contracting Officer or the duly authorized representative of the Government.

b. The Contracting Officer Representative or Alternate Contracting Officer Representative is a duly authorized representative of the Government and is responsible for inspection and acceptance of all items to be delivered under this contract.

c. Inspection and acceptance of the Contractor's performance shall be in accordance with the applicable FAR Clauses in Section E.1 above.

E.3 Acceptance by the Contracting Officer’s Representative (COR)

All items to be delivered to the Contracting Officer’s Representative (COR) who will be deemed to have been accepted 60 calendar days after the date of delivery, except as otherwise specified in this contract if written approval or disapproval has not been given within such period. The COR’s acceptance or revision to the items submitted shall be within the general scope of the work stated in this contract.

(End of Section E)

SECTION F - DELIVERABLES OR PERFORMANCE

F.1 FAR 52.252-2 Contract 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:

NUMBER TITLE DATE

52.242-15 Stop-Work Order Aug 1989 52.242-17 Government Delay Of Work Apr 1984

F.2 Period of Performance (Jan 2014)

The period of performance of this contract is a 12 month period of performance to be determined during the time of award.

This contract includes the following Option Periods:

CLIN Period of Performance 0002 – Option Period 1 TBD 0003 – Option Period 2 TBD

0004 – Option Period 3 TBD 0005 – Option Period 4 TBD

F.3 Items to be Furnished and Delivery Schedule

The Contractor shall furnish the items required under this contract in accordance with the reporting instructions and delivery schedule set forth below:

TASK DESCRIPTION RECIPIENT DELIVERY

1 Project Plan CMS RVC COR By close of business on the 10th business day after initial meeting with CMS.

RVC Operations Manual

CMS RVC COR

Draft manual is due by close of business 20 business days after project plan is accepted by CMS. If no comments are received from CMS within 10 business days after draft submission, the RVC shall submit the final document within 10 business days. Quarterly thereafter (4 times a year).

3.1 Accuracy Reviews:

Accuracy Report CMS RVC COR By close of business 20 business days after receipt of the sample claim package from the RACs.

3.2a Accuracy Reviews:

NI and Policy Recommendations

Report

By the close of business 20 business days after receipt of the sample claim package from the RACs. A separate report is required with the monthly Accuracy Report for each RAC if appropriate.

3.2b Accuracy Reviews:

Error Code

Recommendations

CMS RVC COR By close of business 20 business days after receipt of the sample claim package from the RACs. To be included in the Accuracy Report.

3.3 Accuracy Reviews:

RACDW Upload Results

Document

CMS RVC COR By close of business 20 business days after receipt of the sample claim package from the RACs.

TASK

DESCRIPTION

RECIPIENT

DELIVERY

RAC Disputes/Disagrees

By close of business 7 business days after receipt of the dispute form from CMS RVC COR.

4.1

RAC Disputes/Disagrees:

Overturns

Updated Accuracy Report and Corrective Action Plan: Submit with completed dispute form by the close of business on the 7th business day after dispute is received from CMS RVC COR.

4.2

RAC

Disputes/Disagrees:

The CMS Decision to Disagree with Upheld

Dispute

Updated Accuracy Report and Corrective Action Plan: Submit by the close of business on the 2nd business day after receipt of CMS final decision to disagree with the RVC.

5.1 Special Studies:

Special Study Report CMS RVC COR By close of business 25 business days after receipt of the package.

5.2 Special Studies:

RACDW Upload Results

Document CMS RVC COR By close of business 25 business days after receipt of the sample claim package from the RACs.

6.1a

NI Review:

NI Proposal Vulnerability

Report, Checklist, etc.

NI Proposal Vulnerability Report checklist, etc.: By close of business on the 10th business day, after proposal is received.

6.2 NI Review:

NI (QA) Checklist

CMS RVC COR The RVC has 15 business days to submit the updated NI packages with track changes and the NI QA Checklist.

7 Contractor Quality

Assurance Plan CMS RVC COR Included in the RVC Operations Manual.

Monthly Progress Report

By close of business on the 7th business day of the month for the previous month’s effort.

9 Annual Report CMS RVC COR By close of business 60 calendar days after the end of the fiscal year.

10 Conference Calls CMS RVC COR Once/week with CMS; Once per month for each RAC; and as needed.

RVC

Transitions/Contract

Closeout:

Closeout Plan

By close of business 90 calendar days before the end of the contract.

Ensuring Compliance with CMS Security Systems

CMS RVC COR

and CMS

Security Officer or Designee

Weekly report (verbal or written) in CMS/RVC Meetings and follow up as needed.

(End of Section F)

SECTION G - CONTRACT ADMINISTRATION DATA

G.1 Accounting and Appropriation Data (To be filled in at time of award)

Action Appropriation Object Class CAN Amount Award

G.2 Payments-Invoices-Firm Fixed Price Contracts (Sept 2018)

a. GENERAL: The Contractor shall submit to the Government an invoice 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 INVOICE: FAR 32.905 Payment Documentation and Process, provides the required content for a proper invoice. In addition to the requirements of FAR 32.905, the following items shall also be included on the invoice to be considered proper:

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. INVOICE SUBMISSION: Invoices 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 – See G.3 Government Representatives and

Responsibilities COR - See G.3 Government Representatives and Responsibilities.

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

Number, Task/Delivery Order Number (if applicable), Invoice 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: Invoice attachments shall be submitted in .pdf format. Only one invoice shall be attached per email. The first page of the attachment shall be the invoice, followed by any supporting documents 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

e. PAYMENTS: The Government shall make payment of all proper invoices in accordance with the following clauses:

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

Management, FAR 52.232-1 Payments, and FAR 52.212-4 Contract Terms and Conditions – Commercial Items (If applicable)

Payment shall be made upon acceptance by the Contracting Officer’s Representative (COR), if one is appointed, in accordance with the applicable FAR Inspection and Acceptance clause and the Contracting Officer’s approval, as appropriate.

Reimbursement for invoices submitted under this contract shall be made not later than 30 15 calendar days after receipt of a proper invoice 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 invoice 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.3 Government Representatives and Responsibilities (Jul 2016)

Following are the Government Representatives and their respective roles and responsibilities on 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:

Office of Acquisition & Grants Management Acquisition Support Group (ASG) Division of Program Integrity and Financial Management Contracts (DPIFMC) ATTN: Nicole Hoey 7111 Security Blvd.

Mail-stop: B3-30-03 Baltimore, MD 21244-1850

Phone: 410-786-0489 Email Address: Nicole.Hoey@cms.hhs.gov mailto:Nicole.Hoey@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 Acquisition Support Group Division of Program Integrity and Financial Management Contracts ATTN: Tracy Amos 7500 Security Blvd.

Mail-stop: B2-14-21 Baltimore, MD 21244-1850

Phone: 410-786-4815 Email Address: Tracy.Amos@cms.hhs.gov

c. Contracting Officer’s Representative

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

Centers for Medicare & Medicaid Services Center for Program Integrity

ATTN: TBD

7500 Security Blvd.

Mail-stop: TBD Baltimore, MD 21244-1850

Phone: TBD 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.

Technical direction 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

(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;

mailto:Tracy.Amos@cms.hhs.gov

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.4 Service of Consultants/ Subcontract Consent

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

b. To facilitate the review of a proposed subcontract, by the COR and the Contracting

Officer, the Contractor shall submit the information required by the FAR Clause 52.244-2 entitled, “Subcontracts”, to the assigned COR (Copy the CO), who shall in turn forward the information, with his/her recommendation to the Contracting officer.

The Contractor shall complete the attached Subcontract Checklist (Attachment J-10) to facilitate this request either prior to, or after award. The Contracting Officer shall review the request for subcontract approval and the COR recommendation, and shall advise the Contractor of his/her decision to consent or dissent from the proposed subcontract, in writing.

c. Consent is granted to the following subcontractors: TBD

G.5 Correspondence Procedures

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

Technical Correspondence - Technical correspondence (as used herein, this term excludes technical 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 Officer.

a. Other Correspondence - All other correspondence shall be addressed to the Contracting Officer, in duplicate, with an informational copy of the basic correspondence to the COR.

b. Subject Lines - All correspondence shall contain a subject line, commencing with the contract number as illustrated below:

EXAMPLE: Contract No. 18C00

G.6 Use of Government Data (Reports/Files/Computer Tapes or Discs)

Any data given to the contractor by the Government shall be used only for the performance of the contract unless the Contracting Officer specifically permits another use, in writing. Should the Contracting Officer permit the contractor the use of Government-supplied data for a purpose other than solely for performance of this contract and if such use could result in a commercially viable product, the Contracting Officer and the contractor must negotiate a financial benefit to the Government. This benefit should most often be in the form of a reduction in the price of the contract; however, the Contracting Officer may negotiate any other benefits he/she determines are adequate compensation for the use of these data.

Upon the request of the Contracting Officer or the expiration date of this contract, whichever shall come first, the contractor shall, upon instructions from the Contracting Officer, return or destroy all data given to the contractor by the Government. However, the Contracting Officer may direct that the data be retained by the contractor for a specific period of time, which period shall be subject to agreement by the contractor. Whether the data are returned, retained, or destroyed shall be the decision of the Contracting Officer with the exception that the contractor may refuse to retain the data. The contractor shall retain no data, copies of data, or parts thereof, in any form, when the Contracting Officer directs that the data be returned or destroyed. If the data are to be destroyed, the contractor shall directly furnish evidence of such destruction in a form the Contracting Officer shall determine is adequate. In absence of direction from the CO, the Contractor shall assume data will need to be returned to the Government.

G.7 Property Administration

a. General:

The CMS Contract Property Administrator, Property and Distribution Management Section, Division of General Services, 7500 Security Blvd., Baltimore, Md. 21244, is hereby designated the property administration function for this contract. The Contractor agrees to furnish information regarding Government Property to the Property Administrator in the manner and to the extent required by the Property Administrator, his duly designated successors, and in accordance with FAR Part 45 and DHHS Manual entitled, Contractor's Guide for Control of Government Property, (2007).

If equipment is procured in order to provide services, CMS will retain title to the equipment.

CMS must be notified as part of the itemized billing arrangement if there is an equipment acquisition, included in the cost of the contract.

All original tapes, video, CD ROM(s), manual, brochures, pamphlets shall remain the property of the CMS. The contractor shall provide to CMS all final, complete and editable web-based training course files.

b. Notice of Non-Allowability of Costs for General Purpose Office Equipment:

General Purpose Office Equipment (GPOE) means those equipment’s normally found in a business office such as desks, chairs, typewriters, calculators, file cabinets, etc., that are obtainable in the open market.

Contractors are expected to have the necessary facilities to perform the requirements of this solicitation/contract. This includes any GPOE necessary to perform the requirements herein.

Notwithstanding the "Allowable Cost and Payment" clause of this contract, costs for the acquisition of GPOE shall not be considered as an allowable direct charge to this contract.

G.8 Data to be delivered

a. Any working papers, interim reports, data given 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.

b. 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 contract.

G.9 Dissemination, Publication and 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 disclosed.

Also, 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 "Disputes" clause.

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 made available under the Federal Freedom of Information Act.

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 project funding levels, 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 acknowledgement substantially, as follows:

"The analyses upon which this publication is based were performed under Contract Number [ ], entitled, "[ ]," sponsored by the Centers for Medicare and Medicaid Services, Department of Health and Human Services."

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

G.10 Contractor Performance Evaluation(s) (Oct 2014)

a. General:

In accordance with Federal Acquisition Regulation (FAR) 42.15, Contractor Performance Information, past performance evaluations shall be prepared at least annually and at the time the work under a contract or order is completed. Additional interim performance evaluations may be prepared at Contracting Officer discretion, as necessary.

CMS will utilize the Contractor Performance Assessment Reporting System (CPARS), the Government-wide evaluation reporting tool for all past performance reports on contracts and orders, as appropriate. CPARS is a secure Internet website located at https://www.cpars.gov.

b. CPARS Process:

1. CPARS Training: Contractors may obtain CPARS training material and register for on-line training https://www.cpars.gov.

2. Post-Award Contract Registration: CMS is responsible for registering the contract in CPARS within 30 calendar days of contract award. The Contractor shall:

i. Designate at least one (1) point of contact that will be responsible for serving as the

Contractor’s Representative (CR). Additional CRs may also be identified; and,

ii. Provide the CMS Contract Specialist with the name(s) and email address (es) of the CPARS point(s) of contact.

Once CMS registers the contract in CPARS, the CR(s) will receive an automated CPARS email message that contains User IDs and instructions for creating a password for future past performance evaluation processing.

https://www.cpars.gov/ https://www.cpars.gov/

3. Interim, Annual and Final Past Performance Evaluation Reports:

i. Issuing the Evaluation: Once the CMS Assessing Official (AO) issues an evaluation to the Contractor in CPARS, the CR(s) will receive an email instructing them to login to CPARS to review the evaluation.

ii. Contractor Comments: The CR has the option to provide comments on the evaluation, indicate if they concur or do not concur with the evaluation, sign, and then return the evaluation to the AO. The CR has a total of 60 days following the AO’s evaluation signature date to submit comments. If the CR submits comments within the first 14 days following the AO’s signature date and the AO closes the evaluation, the evaluation will become available in Past Performance Information Retrieval System - Report Card (PPIRS-RC) within 1 day.

On day 15 following the AO’s evaluation signature date, the evaluation will become available in PPIRS-RC with or without CR comments and whether or not it has been closed by the AO. If no CR comments have been sent and the evaluation has not been closed, it will be marked as “Pending” in PPIRS-RC.

If the CR sends comments at any time prior to 61 days following the AO’s evaluation signature date, those comments will be reflected in PPIRS-RC within 1 day. On day 61 following the AO’s evaluation signature date, the CR will be “locked out” of the evaluation and may no longer send comments.

G.11 Contract Work Performed Outside the United States (Apr 2016)

To comply with requirements of Homeland Security Presidential Directive -12 (HSPD-12) and Personal Identity Verification (PIV) of Federal Employees and Contractors, CMS must achieve appropriate security assurance for multiple CMS information systems by efficiently verifying the claimed identity of individuals working on the contract. The Contractor and its subcontractor(s) shall not perform any activities under this contract, including the transmission of data or other information, outside of the United States (U.S.) and its Territories without the prior written approval of the Contracting Officer. If work must be performed outside the U.S., the Contractor shall submit a request to the Contracting Officer, in writing, at least 45 calendar days prior to the work beginning.

The Contracting Officer will consider the following factors in making a decision whether to authorize the performance of work outside the U.S. and its Territories:

1. Statement of Work requirements, which are being requested to be completed outside the U.S. and its Territories;

2. Total projected dollar value of the work to be performed outside the U.S.;

3. The desired country/location where the work will be performed;

4. FAR Part 25, Foreign Acquisitions, and all other laws and regulations applicable to the performance of work outside the United States;

5. Whether the contractor and/or its subcontractor(s) have plans in place to adequately protect and secure CMS data, as well as abide by all applicable laws and regulations when work is performed outside of the U.S. and its Territories. Plans shall include -

a. Adequate contract terms regarding system security;

b. Adequate contract terms regarding the confidentiality and privacy requirements for information and data protection;

c. Adequate contract terms that are otherwise relevant, including the requirements of the Statement of Work;

d. The Contractor’s corporate compliance plan and internal policies and procedures designed to prevent and detect violations of applicable law, regulations, rules and ethical standards by employees, agents and others; and,

6. Whether the approval would be in best interests of the United States.

The Contractor’s request for authorization to perform work outside the U.S. shall demonstrate that the performance of the work outside the U.S. satisfies all of the above factors. Contracting Officer approval to perform work outside the U.S. may require additional Statement of Work requirements, additional contract terms and conditions and/or Federal Acquisition Regulation (FAR) clauses to be incorporated into the contract.

(End of Section G)

SECTION H - SPECIAL CONTRACT REQUIREMENTS

H.1 BUSINESS ETHICS, CONFLICT OF INTEREST AND COMPLIANCE (APR 2017)

a. General: It is imperative that the Contractor and the services provided under this contract be free, to the greatest extent possible, of all Organizational and Personal Conflicts of Interest. In this clause, all references to Organizational and/or Personal Conflicts of Interests will be referred to individually or collectively, as the text justifies, as Conflicts of Interest (COI). Except as provided below, the Contracting Officer shall not maintain a contract with a Contractor that the Contracting Officer determines has, or has the potential for, an unresolved COI. However, in accordance with FAR 9.503 Waiver, the Contracting Officer may contract with a Contractor that has an unresolved COI if the Contracting Officer determines that it is in the best interest of the Government to do so.

b. Definitions:

Actual COI– means that the COI is currently in existence as determined by the Offeror’s or Contractor’s Compliance Officer and/or as determined by CMS. This form of COI will require avoidance, neutralization or mitigation acceptable to CMS.

Affiliates – As defined in FAR 2.101 means associated business concerns or individual(s) if, directly or indirectly either one controls or can control the other; or a third party controls or can control both.

For purposes of this contract, affiliate control or influence may include, but is not limited to:

(a) Interlocking management or ownership (e.g., individuals serving in similar capacities in several companies);

(b) Identity of interests among family members such as spouse/domestic partner and/or any dependent of the respondent;

(c) Shared facilities and equipment;

(d) Common use of employees; or

(e) A business concern organized just prior to, or immediately following, the release of a solicitation or request for information, which has the same or similar management, ownership, or principal employees as the offeror or Contractor.

Any business, whether or not it is organized for profit or located in the United States or its outlying areas, or person may be found to be an affiliate. Control may be affirmative or negative and it is immaterial whether it is exercised so long as the power to control exists.

Apparent (Perceived) COI – means that the COI on first observation appears to be an actual or potential COI, but may or may not be after analysis. Even if the apparent COI is determined to be non-existent, this perception may still require further explanation.

Avoidance – means Government action taken in one acquisition that is intended to prevent a COI in that acquisition or in a future action. Methods of avoiding COIs include, but are not limited to:

• Drafting the statement of work (SOW) to exclude tasks that require Contractors to utilize subjective judgment; or

• Obtaining advice from more than one source on any issue on which there are concerns about an COI so that there is no area in which the Government is relying solely on the advice of any one of the sources; or

• Excluding an offeror from participation in a contract award.

Financial Interests/Relationships – means a healthcare related direct or indirect ownership or investment interest (including an option or non-vested interest) in any entity that exists through equity, debt, or other means and includes any indirect ownership or investment interest no matter how many levels removed from a direct interest.

A financial interest/relationship may arise from the following non-exclusive examples:

(a) Compensation, including wages, salaries, commissions, professional fees, or fees for business referrals;

(b) Current or known future arrangements or requirements for which you are defined as an interested party, including, but not limited to, an entity that may create one or more of the three forms of COI;

(c) Consulting relationships, including commercial and professional consulting and service arrangements, scientific and technical advisory board memberships, or serving as an expert witness in litigation;

(d) Services provided in exchange for honorariums including travel expense reimbursements;

(e) Research funding or other forms of research support;

(f) Healthcare related investment in the form of stock or bond ownership, including healthcare sector investment only mutual funds;

(g) Healthcare business ownership or partnership interests;

(h) Patents, copyrights, and other intellectual property interests;

(i) Seeking or negotiating for prospective employment or business; or

(j) Gifts, including travel.

Mitigation– means action taken by the Contractor to reduce the COI risk to a level acceptable to CMS on a present

Neutralization – means excluding or restricting a Contractor from offering, as a prime or subcontractor, on future contracts while allowing the Contractor to perform on the instant contract. This method protects the Government’s interests in cases where the Contractor’s work on the instant contract could be biased or impaired by virtue of its expectation of future work, or when the Contractor would have an unfair advantage in competing for award of the future work.

Organizational Conflict of Interest – In accordance with FAR 2.101 Definitions, means that because of other activities or relationships with other persons, a person is unable, or potentially unable, to render impartial assistance or advice to the Government, or the person’s objectivity in performing the contract work is, or might be, otherwise impaired, or a person has an unfair competitive advantage.

For purposes of this contract, the conflict of interest definition includes direct or indirect relationships including, but not limited to, the Contractor and its parent company, subsidiaries, affiliates, subcontractors, clients and principals.

Personal Conflicts of Interest – A situation in which a person has a financial interest, personal activity, or relationship that could impair the person’s ability to act impartially and in the best interest of the Government when performing under this contract.

(a) Among the sources of personal conflicts of interest are—

(i)Financial interests of the person, spouse/domestic partner and/or any other dependent of the person, as defined for Federal tax purposes;

(ii)Other employment or financial relationships (including seeking or negotiating for prospective employment or business) and,

(iii) Gifts, including travel.

(b) For example, financial interests referred to in paragraph (a)(i) of this definition may arise from— (i)Compensation, including wages, salaries, commissions, professional fees, or fees for business referrals;

(ii)Consulting relationships;

(iii) Services provided in exchange for honoraria or travel expense reimbursements;

(iv) Research funding or other forms of research support;

(v)Healthcare related investments;

(vi) Real estate investments;

(vii) Patents, copyrights, and other intellectual property interests; or

(viii) Business ownership and investment interests.

Potential COI – means that the COI could become an actual COI due to contingency events and/or as determined by CMS. This form of COI will require avoidance, neutralization or mitigation acceptable to CMS.

Principal – As defined in FAR…