JK MAC RFP 75FCMC21R0001 - Sections B-M (Redline).docx

TABLE OF CONTENTS

SECTION B - SUPPLIES OR SERVICES AND PRICES/COSTS

Solicitation Number 75FCMC21R0001 A/B MAC Jurisdiction K

CONTRACTOR FURNISHED PROPERTY

APPROVAL OF CONTRACT ACQUIRED INFORMATION TECHNOLOGY

LIABILITY FOR MEDICARE BENEFIT PAYMENTS – CERTIFYING

OFFICER 47

LIABILITY FOR MEDICARE BENEFIT PAYMENTS – DISBURSING

OPEN GOVERNMENT PROACTIVE PREDISCLOSURE NOTIFICATION (OCT 2013) 56

FAR 52.204-8 ANNUAL REPRESENTATIONS AND CERTIFICATIONS (MAR 2020) .80

FAR 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)

FAR 52.222-22 PREVIOUS CONTRACTS AND COMPLIANCE REPORTS (FEB 1999)

BUSINESS ETHICS, CONFLICTS OF INTEREST AND COMPLIANCE EVALUATION

SECTION B - SUPPLIES OR SERVICES AND PRICES/COSTS

B.1 BRIEF DESCRIPTION OFSERVICES

The purpose of this contract is to obtain a Part A/Part B (A/B) Medicare Administrative Contractor (hereinafter referred to as “the contractor” or “MAC” or “A/B 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 K. Jurisdiction K includes the following states and areas: Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island, and Vermont. The JK MAC is also responsible for processing Medicare Home Health and Hospice (HHH) billings in six states: Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island and Vermont.

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.19).

*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

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

CLIN 0002** – AB MAC SERVICES BASE YEAR OPERATIONS

0002AA

Program Management

0002AB

Medicare Integrity Program

0002AC

Recovery Audit Contractor

TOTAL CLIN 0002 – AB MAC SERVICES

BASE YEAR OPERATIONS

TBD

TBD

TBD

TBD

TBD

TBD

CLIN 0003** – AB MAC SERVICES OPTION YEAR 1 OPERATIONS

0003AA

0003AB

Medicare Integrity Program

0003AC

Recovery Audit Contractor

TOTAL CLIN 0003 – AB MAC SERVICES

OPTION YEAR 1

TBD

TBD

TBD

TBD

TBD

CLIN 0004** – AB MAC SERVICES OPTION YEAR 2 OPERATIONS

0004AA Part A

0004AB Part A Medicare Integrity Program

0004AC Part B Recovery Audit Contractor

TOTAL CLIN 0004 – AB MAC SERVICES

OPTION YEAR 2

TBD

TBD

TBD

TBD

TBD

CLIN 0005** – AB MAC SERVICES OPTION YEAR 3 OPERATIONS

0005AA

0005AB

Medicare Integrity Program

0005AC

Recovery Audit Contractor

TOTAL CLIN 0005 – AB MAC SERVICES

OPTION YEAR 3

TBD

TBD

TBD

TBD

TBD

CLIN 0006** – AB MAC S OPTION YEAR 4 OPER

ERVICES ATIONS

0006AA

0006AB

Medicare Integrity Program

0006AC

Recovery Audit Contractor

TOTAL CLIN 0006 – AB MAC SERVICES

OPTION YEAR 4

TBD

TBD

TBD

TBD

TBD

CLIN 0007** – AB MAC S OPTION YEAR 5 OPER

ERVICES ATIONS

0007AA

0007AB

Medicare Integrity Program

TBD

TBD

TBD

TBD

TBD

TBD

TBD

0007AC

Recovery Audit Contractor

TBD

TBD

TBD

TBD

TBD

TBD

TBD

TOTAL CLIN 0007 – AB MAC SERVICES

OPTION YEAR 5

TBD

TBD

TBD

TBD

TBD

CLIN 0008** – AB MAC S OPTION YEAR 6 OPER

ERVICES ATIONS

0008AA

0008AB

Medicare Integrity Program

0008AC

Recovery Audit Contactor

TBD

TBD

TBD

TBD

TBD

TBD

TBD

TOTAL CLIN 0008 – AB MAC SERVICES

OPTION YEAR 6

TBD

TBD

TBD

TBD

TBD

CLIN 0009 - Outgoing Contractor Workload Transition Activities

TBD

TBD

TBD

TBD

TBD

CLIN 0010*** – MPIP BASE YEAR

CLIN 0011*** – MPIP OPTION YEAR 1

CLIN 0012*** – MPIP OPTION YEAR 2

CLIN 0013*** – MPIP OPTION YEAR 3

CLIN 0014*** – MPIP OPTION YEAR 4

CLIN 0015*** – MPIP OPTION YEAR 5

CLIN 0016*** – MPIP OPTION YEAR 6

CLIN 0017*** – MCCM BASE YEAR

CLIN 0018*** – MCCM OPTION YEAR 1

CLIN 0019*** – MCCM OPTION YEAR 2

CLIN 0020*** – MCCM OPTION YEAR 3

CLIN 0021*** – MCCM OPTION YEAR 4

CLIN 0022*** – MCCM OPTION YEAR 5

CLIN 0023*** – MCCM OPTION YEAR 6

CLIN 001724*** – RSNAT BASE YEAR

CLIN 001825*** – RSNAT OPTION YEAR 1

CLIN 001926*** – RSNAT OPTION YEAR 2

CLIN 002027*** – RSNAT OPTION YEAR 3

CLIN 002128*** – RSNAT OPTION YEAR 4

CLIN 002229*** – RSNAT OPTION YEAR 5

CLIN 002330*** – RSNAT OPTION YEAR 6

TOTAL AB MAC JURISDICTION K

TBD

TBD

TBD

TBD

*Refer to section G.16, Complementary Credits.

**Cost-Plus Award Fee (CPAF) SLIN ***Cost-Plus Fixed Fee (CPFF) SLIN

(END OF SECTION B)

SECTION C - DESCRIPTION/SPECIFICATIONS/WORK STATEMENT

C.1 STATEMENT OFWORK

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 (FEB1998)

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:

52.242-15 STOP WORK ORDER (AUG 1989) ALTERNATE I (APR1984)

F.2 PERIOD OF PERFORMANCE (JAN2014)

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:

Part B Date of contract award - 4 months for Part A* Date of contract award - 6 months for Part B*

BASE PERIOD (Program Management (PM), Medicare Integrity Program (MIP), Support of Recovery Audit Program Operations (RAC))

Part A Part B

8 months for Part A and 6 months for Part B*

OUTGOING CONTRACTOR WORKLOAD TRANSITION ACTIVITIES

A/B

Not to exceed 6 months from exercise of option**

8 months for Part A and 6 months for Part B

BASE (Prior Authorization of Scheduled Non-Emergent Ambulance Transport (RSNAT))

*CLIN 0001 and CLIN 0002 may be overlapping periods of performance **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.

(d) For the PHI deliverables, if unable to send electronically, the contractor is to send a notice to the JK MAC Deliverable electronic mailbox (CMS JK_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.

(e) Hardcopy Implementation deliverables should be sent to the JK Implementation Lead. Refer to JSM Number 10337 for further instructions.

(f) 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

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: JK_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)

SECTION G - CONTRACT ADMINISTRATION DATA

G.1 ACCOUNTING AND APPROPRIATION DATA

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, A/B MAC Jurisdiction K.”

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 Officer.

G.4 SUBCONTRACTINGREPORTING

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.

required) 30 days after completion

G.5 SUBCONTRACTING PROGRAM FOR SMALL AND SMALL DISADVANTAGED BUSINESSES

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, entitled, “Subcontracts (Jun 2020)” 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.

(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:

(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: Mohammed Islam 7500 Security Blvd. Mail-stop: B2-14-21 Baltimore, MD 21244-1850

Phone: 410-786-8156 Email Address: mohammed.islam@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 Medicare and Marketplace Contracts ATTN: Tamara A. Jones 7500 Security Blvd. Mail-stop: B2-14-21 Baltimore, MD 21244-1850

Phone: 410-786-0674 Email Address: tamara.jones@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

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

(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 TECHNICAL DIRECTION

(a) Performance of the work under this contract shall be subject to the technical direction of the COR. The term "technical direction" is defined to include, without limitation, the following:

(1) Direction to the Contractor which redirects the contract effort, shifts work emphasis between work areas or tasks, requires pursuit of certain lines of inquiry, fills in details or otherwise serves to accomplish the contractual SOW.

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

(3) Review and, where required by the contract, approval of technical reports, drawings, specifications, and technical information to be delivered by the Contractor to the Government under the contract.

(b) Technical direction must be within the general Scope of Work stated in the contract. The COR does not have the authority to and may not issue any technical directions which:

(1) Constitutes an assignment of additional work outside the general Scope of Work of the contract.

(2) Constitutes a change as defined in FAR clause 52.243-2 entitled "Changes -Cost Reimbursement (AUG 1987)."

(3) In any manner causes an increase or decrease in the total estimated contract cost, fixed-fee, or the time required for contract performance.

(4) Change any of the expressed terms, conditions, or specifications of the contract.

(c) All technical direction shall be issued in writing by the COR or if provided verbally, shall be confirmed by him/her in writing within five (5) working days after issuance.

(d) The Contractor shall proceed promptly with the performance of technical direction duly issued by the COR in the manner prescribed by this article and within his/her authority under the provisions of this article.

(e) If, in the opinion of the Contractor, any instruction or direction issued by the COR is within one of the categories as defined in (l) through (4) of Section G.9 (b), above, the Contractor shall notify the Contracting Officer in accordance with FAR 52.243-2, Changes-Cost Reimbursement Alt I (APR 1984).

G.10 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:

Centers for Medicare & Medicaid Services 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.11 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.12 CONTRACTOR FURNISHED PROPERTY

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

G.13 PAYMENTS – INVOICES (Reconciled Contracts) (Aug 2020)

Section G: PAYMENTS - INVOICES – (August 2020)

a. GENERAL: Effective August 31, 2020, the contractor/vendor shall create an invoice within the Invoice Processing Platform (IPP), a secure Web-based service for federal agencies and their vendors to manage government invoicing from purchase order (PO) through payment notification. Note: All invoice terms and conditions are contract specific and may vary from contract to contract.

b. 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;

· Attachments

c. INVOICE SUBMISSION: The contractor/vendor shall create an invoice from the Purchase Order (PO)/Contract via the IPP website http://www.ipp.gov/ . For questions, call IPP Customer Support at (866)973-3131 or email the IPP Customer Support at IPPCustomerSupport@fiscal.treasury.gov

d. 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

· FAR 52.212-4 Contract Terms and Conditions – Commercial Items (If applicable)

· FAR 52.216-7 Allowable Cost and Payment

· 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) 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 no later than 30 calendar days after receipt of a proper invoice from the Contractor requested at the paying office designated above. Contracts with a 15-day payment term are not subject to interest payments until after day 30.

e. 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 in IPP.

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

G.14 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.15 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.16 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.17 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 Officer.

(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.18 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 contract.

G.19 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.20 INDIRECTCOSTRATES (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.