RFP Questions and Responses (JK RFP 75FCMC21R0001).xlsx
XLSX spreadsheet 51 KB Posted
- Solicitation number
- 75FCMC21R0001
About this file
This solicitation seeks proposals for a Part A/B Medicare Administrative Contractor to provide specified health insurance benefit administration services for Jurisdiction K. Jurisdiction K encompasses the states of Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island, and Vermont. The selected contractor will be responsible for Medicare claims processing and payment services in support of the Medicare Fee-for-Service program, as well as processing Medicare Home Health and Hospice billings in six states. Proposals are due by February 16, 2021, and award is expected within 8-12 months of receipt. The Department of Health and Human Services Centers for Medicare and Medicaid Services will oversee the contract.
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A. Section B-K
| Question ID | Document | Section | Page # (References reflect prior amendment assignment & may or may not tie to the new updates) | Question | CMS Answer/Action |
| A.1 | RFP | Period of Performance | 17 | The Period of Performance chart shows the RSNAT as a Part A program. Change Request 12025 indicates that this program is applicable to claims billed to Part B, and excludes those billed to Part A. Is the RSNAT workload Part B, and not Part A as indicated on the Table 2 Periods of Performance? If yes, the cutover would need to be updated to reflect the Part B cutover period. | CMS confirms that RSNAT is a Part B activity. CMS has updated the Period of Performance (POP) chart in RFP section F.2 and in Table 2 of the Government Provided Proposal Assumptions (GPPA), Attachment J.23. |
| A.2 | RFP | Section H Special Contract Requirements | 63 | Regarding H.27, Mandatory Contractor Training (MAY 2020): Will CMS please correct the reference to the HHS Policy for Records Management as section 5.11 Contractor Employee Training does not exist? | CMS confirms the reference to Section 5.11 is removed from section H.27. |
| A.3 | RFP | Section H Special Contract Requirements | 63 | Regarding H.27, Mandatory Contractor Training (MAY 2020): Will CMS please confirm if the annual requirement is per calendar year or contract option year? | CMS confirms the annual mandatory training requirement is per Fiscal Year, (Oct 1 - September 30). |
| A.4 | JK Section J List of RFP Attachments_INFORMATIONAL ONLY | N/A | 1 | The JK Section J List of RFP Attachments includes "J.11 Personal Conflicts of Interest Financial Disclosure." Attachment J.11 is not included with the solicitation attachments and is not referenced in the RFP. Will the government please confirm that Attachment J.11 is not required? | CMS confirms that Attachment J.11 is not an RFP attachment and is not required. The information previously captured on Attachment J.11 is now captured in Attachment J.10, Contractor/Offeror Conflict of Interest. |
| A.5 | RFP 75FCMC21R0001 | H.1.e | 38 | Section H.1.e. Subcontractor Flow-Down Terms and Conditions states, "Therefore, the prime contractor shall flow-down terms and conditions H.1 Conflict of Interest and Compliance, of this contract in all subcontracts." Should "and Compliance" be deleted? If not, please provide the reference relative to Compliance that must be flowed down to subcontractors. | CMS confirms "and Compliance" has been removed from the section H.1.e, Subcontractor Flow-Down Considitions. |
| A.6 | Attachment J.10 Contractor/Offeror Conflict of Interest | 1 | The file name and header of Attachment J.10, as well as the Section J List of RFP Attachments, has the document name "Contractor Business Ethics COI and Compliance Program Requirements." However, the first box of the table on Attachment J.10 and Section H.1 of the RFP use the title "Contractor/Offeror Conflict of Interest." Please confirm that "Contractor/Offeror Conflict of Interest" is the correct title for Attachment J.10. | CMS confirms the correct title for Attachment J.10 is "Contractor/Offeror Conflict of Interest". The file's name and header and the Section J List of RFP Attachments have been updated to reflect the correct title. | |
| A.7 | Attachment J.10 Contractor/Offeror Conflict of Interest | C.1 | 2 | Section C.1 PCI Disclosures & Analysis states, "The Contractor/Offeror shall ensure that the organization has analyzed each PCI Financial Disclosure…" What is "each PCI Financial Disclosure" referring to? | CMS confirms Offerors should have their Principals, Managers, and Key Personnel complete financial disclosures to be analyzed internally, these disclosure are not required to be provided to CMS. See also Solicitation Section H.1.d for details. |
| A.8 | Attachment J.10 Contractor/Offeror Conflict of Interest | C.1 | 2 | Section C.1 states, "To assist in the identification and analysis, the offeror/contractor should consider the following, at a minimum, in determining if personal conflicts of interest are present... |
• Assets, sources of income, outside positions, etc for self, spouse/domestic partner and/or any dependent;
• Assets and healthcare related income arrangements or agreements to include healthcare related stock, bond, sector fund, employer or business fees, commissions, honoraria, real estate investment, for self, spouse/domestic partner and/or any dependent;
• Liabilities for self, spouse/domestic partner and/or any dependent;
• Non-employer healthcare travel-related reimbursements or gifts;"
Please confirm that, for all four of the bullet points listed in Section C.1, the information should be specific to only healthcare-related situations. CMS confirms for all four of the bullet points in section C.1, the information should include any/all situations where PCIs, actual, potential, or apparent, may exist.
B. Section L-M
| Question ID | Document | Section | Page # (References reflect prior amendment assignment & may or may not tie to the new updates) | Question | CMS Answer/Action | |
| B.1 | RFP | L.14.1 Proposal Organization | Page 110, | |||
| Page 117 | The Volume III Written Technical Proposal chart on page 110 lists the Mission-Essential Functions that are to be included in Tab F of the Offeror's proposal and the last column (Additional Proposal Instructions) of this chart references section L.14.5. The Mission-Essential Functions listed in the chart on page 110 for Tab F are Implementation, Provider Customer Service Program, Claim Processing, Appeals, Medical Review and Supplemental Medicare Integrity Program (MIP). However, in comparison to the RFP detailed instructions in section L.14.5.3, (page 117) it appears that Provider Enrollment and Audit and Reimbursement functions are missing from the chart on page 110 of the RFP. |
Question: Can CMS please confirm that Provider Enrollment and Audit and Reimbursement are to also be included in Tab F of the Offeror's proposal?
CMS confirms that the table in section L.14.1 was updated to include Audit & Reimbursement and Provider Enrollment.
| B.2 | RFP | L.14.1 Proposal Organization | Page 117, | ||
| Page 118 | Section L.14.5.2 Volume III, TAB E, Staffing Plan, Proposal Instructions includes CLINs 0011 (MPIP), 0018 (MCCM) and 0025 (RSNAT) in sections c. (What changes have been made to the historic/baseline total number of FTEs, skill mix and productivity and why. As part of this response, the Offeror shall:) and d. (Describe how the proposed total number FTEs and skill mix will result in quality performance for this contract) of the mission-essential function (MEF) requirements. MPIP, MCCM and RSNAT are not included in the MEF/SOW sections (items A-F) listed. | ||||
| Question: Should MPIP and RSNAT be included in the Medical Review MEF section? Which MEF section would CMS like to see MCCM included? | CMS confirms that MPIP, MCCM and RSNAT should not be included in the Mission Essential Functions section and further CLIN 0011, CLIN 0018 and CLIN 0025 were removed from section L.14.5.2 items c) and d). | ||||
| B.3 | RFP | L.14.5.4 VOLUME III, TAB F, SUPPLEMENTARY MIP ACTIVITIES TO REDUCE THE IMPROPER PAYMENT RATE, PROPOSAL INSTRUCTIONS | Page 124 | Section L.14.5.4 of the Volume III proposal instructions states that "Offerors are required to document within Tab F existing customizations directed towards improper payment rate reductions that are being proposed for this jurisdiction. Customizations that exist on any Offerors' current contracts that are not documented in Tab F will not be considered part of the Offeror's proposal". | |
| Question: Can an Offeror that is a current MAC contractor only propose for JK, customizations that exist on its current MAC contracts? Can CMS please clarify if an Offeror can propose a new MIP customization activity for JK?. | CMS confirms that Offeror(s) may propose new MIP customization(s) for JK. The intent of the RFP direction is to ensure that any proposed MIP customizations, (new or existing), directed towards improper payment rate reductions, intended to be performed for JK, be detailed in Tab F. | ||||
| B.4 | RFP | L.14.5.4 VOLUME III, TAB F, SUPPLEMENTARY MIP ACTIVITIES TO REDUCE THE IMPROPER PAYMENT RATE, PROPOSAL INSTRUCTIONS | Page 124 | Section L.14.5.4 of the Volume III proposal instructions requires an Offeror to provide significant information concerning the improper payment rate reduction activities that it is proposing for JK. The RFP requires Offerors to provide such information as a description of the customization activities, the benefits to the Government with supporting basis, the anticipated qualitative and quantitative short-term and long-term benefits, SOWs that will benefit, how the associated SOW functions were historically performed and are currently being performed, assumptions used, if CMS approval will be required, dwscription of prior discussions with CMS, etc. This required information will significantly shift Volume III page count from the other Volume III sections to this section. | |
| Question: Please clarify if CMS would create a new Volume III, Tab G for the MIP Improper Payment Rate Reduction section and assign a limit of 5 pages, over and above the 125 page limit currently established for Volume III, Tabs D-F. | CMS confirms the information requested in section L.14.5.4 shall be provided in Tab F and the page limit is 125 pages as directed in section L.14.5.4 of the RFP. | ||||
| B.5 | RFP | L.15 Volume IV, Business Proposal Instructions |
L.15.2 Volume IV, Tab B, Cost Templates L.13 Volume II, Proposal Assumptions Instructions Page 125, Page 128, Page 106,
| Page 107 | Section L.15, page 125 of the JK RFP provides the organization structure in a table that Offerors are to use in preparing the organization of Volume IV, Business Proposal. This table specifically lists that attachments J.21, J.22.A and J.22.B are to be included in TAB B of Volume IV, Business Proposal. However, Section L.15.2, page 128 of the RFP states “…..the Offeror is required to fully complete both Attachment J.22.A and J.22.B and include them in Volume II Tab B of its proposal, in support of its technical and business proposals.” However, Section L.13, Volume II, Proposal Assumptions Instructions, page 106/107 of the RFP, which provides the instructions for the organization of Volume II, provides no instruction for including Attachments J.21, J.22,A and J.22.B in Volume II. | ||||
| Question: Will CMS please clarify that Offerors are to include completed Attachments J.21, J.22.A and J.22B in Volume IV, Business Proposal only and not in Volume II. | CMS confirms the reference to Volume II in section L.15.2 has been corrected to Volume IV. Offerors shall submit Attachments J.22.A and J.22.B in Volume IV. | ||||
| B.6 | RFP | L.14.5.4 Volume III, Tab F, Section M3, Mission-Essential Functions, Evaluation Criteria | Page 124 | Section L.14.5.4, Tab F, Section M.3 includes the evaluation criteria that CMS will use to evaluate the extent to which the Offeror's approach to performance of proposed supplementary MIP-funded activities to reduce the improper payment rate (L.14.5.4) demonstrates an understanding of the improper payment rate reduction challenges........." | |
| Question: If an Offeror is not currently performing a supplementary MIP-funded activity on its current MAC contract and therefore cannot propose a supplementary MIP activity for JK (assuming a CMS currently approved MIP-funded activity on its current MAC contract is a requirement to propose a supplementary MIP-funded activity for JK), how will CMS evaluate the Offeror's proposal relevant to this evaluation criteria? | CMS confirms every proposal will be evaluated as described in the section M.3. A CMS currently approved MIP-funded activity on a current MAC is not a requirement to propose a supplementary MIP funded activity for JK and offerors are not required to propose supplementary MIP-funded activity(ies). The intent of the RFP direction is to ensure that any proposed MIP customizations, (new or existing), directed towards improper payment rate reductions, intended to be performed for JK, be detailed in Tab F. |
| B.7 | RFP | L.11 | 100 | Please confirm that the cost templates are exempt from the page numbering requirement under number 2 listed under "Specifications for electronic submissions:" | CMS confirms Cost Templates are exempt from the page numbering requirements. |
| B.8 | RFP | L.11 | 100 | Given the large number of Cost Templates, and the pagination difficulties when converting an Excel file to a PDF, would CMS consider allowing bidders to only submit electronic copies of the Proposal Self-Check Tool (J.21), Basis of Estimate (J.22),Historic & Propsed FTE, Hours & Gross Cost Worksheet (J.22B), and the Cost Proposal Templates (J.33 - J.63) in Microsoft Excel Version 2013 or newer, and not require bidders to submit Adobe Acrobat or PDF versions of these files? | CMS confirms that Offerors must submit proposals as described in section L.11.a. A PDF version of every volume, in addition to the directed Word and Excel versions is required. |
| B.9 | RFP | L.14.1 | 110 | With the additional Jurisdiction-specific requirements in JK (e.g. HHH, MCCM), as well as the new supplemental MIP activities requirement in Section L.14.5.4, would the CMS consider increasing the page count limit for Volume III to allow bidders additional space to adequately respond? | CMS confirms the page limit of 125 pages as directed in section L.14.5.4. |
| B.10 | RFP | L.14.5.4 | 124 | Please explain how CMS plans to evaluate this section in conjunction with other improper payment/CERT activities included in the proposal. Will this section be evaluated separately? Will the Technical Evaluation Panel be provided guidance on how to address this section in conjunction with other improper payment activities included elsewhere in the proposal? What weight will this section be given in the technical evaluation? | CMS will evaluate every proposal as described in the section M.3. Section L.14.5.4 will not be evalauated separately and is not weighted. The intent of the RFP direction is to ensure that any proposed MIP customizations, (new or existing), directed towards improper payment rate reductions, intended to be performed for JK, be detailed in Tab F. |
| B.11 | RFP | L.11 a | 100 | Item 4) of the specifications for electronic submissions requires each PDF be organized using Bookmarks. Are there any bookmarking requirements for the other file types (Excel, Word, PowerPoint, Project)? If so, please clarify the electronic submission requirements for each file type. | CMS confirms that the PDF files bookmarking requirements are the only bookmarking requirements. There re no bookmarking requirements for Excel or Word documents. |
| B.12 | RFP | L.11 a | 101 | Item 3) of the specifications for electronic submissions requires each volume attachment be submitted in one (1) PDF file with the exception of the Excel files for the business proposal. Please clarify the number of attachments required or allowed for the other non-PDF file types. For example, Volume III shall be submitted in MIcrosoft Word and PDF. In this example, are there any limitation as to the number of Microsoft Word files to be included for Volume III given these files were historically separated by different Tabs in the RFP? | CMS confirms directions in section L.11.a that proposal volumes, specifically the non-PDF documents should mirror the PDF documents. For example, the Word version of Volume III shall be the same as the PDF version. |
| B.13 | RFP | L.11 | 99 | Given the number of federal holidays that precede the Jurisdiction K due date of 2/16/21, would CMS consider extending the due date for proposals to allow bidders adequate time to prepare and submit responses? | CMS confirms the direction in section L.11.a. Proposals are due on or before 11:00 AM EST February 16, 2021. |
| B.14 | RFP | L.14.4 Past Performance/Small Business reporting | 110 | The RFP states, "The Small Business Utilization section is limited to two (2) pages. eSRS reports will not count against the page limit but shall be submitted as part of this section." Will the Government please clarify if the eSRS reports shall be submitted as an appendix to Volume III or inserted into the Past Performance Section? | CMS confirms that Offerors shall submit eSRS reports as part of Volume III, Tab C. |
| B.15 | RFP | L.11.a | 100 | Is it a requirement that the organizational chart be submitted as a separate file, or can it be included in the Program Management section of the Technical Proposal? | CMS confirms instructions in section L.11.a has been updated, the organizational chart shall be submitted in Volume III, Tab D in PDF format and not in a separate file. |
| B.16 | RFP | L.11.a | 100 | Will the government confirm if the file type referenced as "Adobe version not older than 2017" is a PDF file? | CMS confirms Offerors shall submit PDF files. Adobe Acrobat is software that allows a user to read/edit PDF files. Section L.11.a has been updated to clarify the instructions. |
| B.17 | RFP | L.11.e | 102 | Regarding the tab Indexing, will the government please confirm that tab deviders will excluded from page count? | CMS confirms that tab dividers are not included in the page count. |
| B.18 | RFP | L.14.5.4, M.3 | 124 | How will supplementary MIP-funded activities be evaluated in the best value methodology? | CMS confirms supplementary MIP-funded activities will not be evaluateed separately and every proposal will be evaluated as described in the section M.3. Section M.3 has been updated to remove the direction specific to supplementary MIP-funded activities as that language was repetitive. |
| B.19 | Solicitation | Section L.14.5.2 | 117 | CMS lists the six Mission Essential Functions, Provider Enrollment C.5.5, Provider Customer Service Program C.5.7, Claims C.5.8, Appeals C.5.9 and C.5.10, Medical Review C.5.12, and Audit and Reimbursement C.5.11.3, for which they state the Offeror shall separately provide the staffing information described in items 1) Total Staff, 2) Management of Staff, and 3) Sources of Staff. |
Within the individual Total Staffing items, such as 1.c - focus its detailed explanation of productivity changes on any proposed increase of more than 4% between the "historic" level and the proposed CLIN 0003, 0011, 0018, and 0025 levels. (They add in the Jurisdiction Specific Tasks.)
| Question: CMS has included CLINs in the detailed questions that are not part of the MEF WBSs, as identified by CMS. CLIN 0011, CLIN 0018, and CLIN 0025 are WBS P.1.11, WBS P.1.4, and WBS P.1.1 respectively. The P.1.XX WBS is not included as a part of any MEF WBS. Is the Offeror to add the Jurisdiction Specific Tasks to the MEF staffing section? | CMS confirms that CLIN 0011, CLIN 0018 and CLIN 0025 were removed from section L.14.5.2 items c) and d). | ||||
| B.20 | Solicitation | L.15.2 Volume IV, Tab B, Cost Templates, Attachments J.33.through J.63 | 126 | The instructions for the Cost Templates identifies the WBS tabs in the CLIN 0002 - CLIN 0008 Cost Templates that will include Total FTE and Total FTE Hours data with double outlined cells for entry. The double outlined boxes include Direct Labor, Subcontractor, ODCs and Indirect Costs. |
The boxes and extra column for Total FTE and Total FTE Hours is included only on the tabs identified on Page 126.
For the identified summary tabs on the cost templates, Total FTEs and Total FTE hours (Columns B & C), the Offeror is not to include this information for every labor category, but fill in the double outlined boxes only.
Because CMS does not want FTEs by labor category for direct labor in the tabs with the double outlined boxes, we assume that CMS also does not want FTEs by labor category in all other tabs, to remain consistent. We assume all tabs with direct labor will have a Total FTE count for direct labor (cell B20), with no “by labor category” detail for direct labor in any part of the cost templates (cells B10 through B19 are left blank). Is this the correct approach? CMS confirms this description is the correct approach as directed in section L.15.2. CMS only requires total FTEs and total FTE hours for the double border cells.
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C. Section J.1 SOW
| Question ID | Document | Section | Page # (References reflect prior amendment assignment & may or may not tie to the new updates) | Question | CMS Answer/Action | |
| C.1 | SOW | Provider Customer Service Program (PCSP) Activity Report | 97 | REF: Contractor shall separately develop and submit a semiannual PAR for its HH+H work. | ||
| QUESTION: Pub.100-09, Chapter 6 was updated to reflect that MACs are to submit an annual PAR. In order to ensure the SOW matches the most recent IOM changes, shouldn’t the verbiage for the separate HH+H PAR also be annual rather than semiannual? | CMS confirms that the JK SOW, Attachment J.1, was updated to state the Provider Customer Service Program (PCSP) Activity Report submission is an annual requirement. |
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D. Sections J.1-J.11
| Question ID | Document | Section | Page # (References reflect prior amendment assignment & may or may not tie to the new updates) | Question | CMS Answer/Action |
| D.1 | Attachment J.10 Contractor/Offeror Conflict of Interest | 1 | The file name and header of Attachment J.10, as well as the Section J List of RFP Attachments, has the document name "Contractor Business Ethics COI and Compliance Program Requirements." However, the first box of the table on Attachment J.10 and Section H.1 of the RFP use the title "Contractor/Offeror Conflict of Interest." Please confirm that "Contractor/Offeror Conflict of Interest" is the correct title for Attachment J.10. | CMS confirms the correct title for Attachment J.10 is "Contractor/Offeror Conflict of Interest". The file's name and header and the Section J List of RFP Attachments have been updated to reflect the correct title. | |
| D.2 | Attachment J.10 Contractor/Offeror Conflict of Interest | C.1 | 2 | Section C.1 PCI Disclosures & Analysis states, "The Contractor/Offeror shall ensure that the organization has analyzed each PCI Financial Disclosure…" What is "each PCI Financial Disclosure" referring to? | CMS confirms Offerors should have their Principals, Managers, and Key Personnel complete financial disclosures to be analyzed internally, these disclosure are not required to be provided to CMS. See also Solicitation Section H.1.d for details. |
| D.3 | Attachment J.10 Contractor/Offeror Conflict of Interest | C.1 | 2 | Section C.1 states, "To assist in the identification and analysis, the offeror/contractor should consider the following, at a minimum, in determining if personal conflicts of interest are present... |
• Assets, sources of income, outside positions, etc for self, spouse/domestic partner and/or any dependent;
• Assets and healthcare related income arrangements or agreements to include healthcare related stock, bond, sector fund, employer or business fees, commissions, honoraria, real estate investment, for self, spouse/domestic partner and/or any dependent;
• Liabilities for self, spouse/domestic partner and/or any dependent;
• Non-employer healthcare travel-related reimbursements or gifts;"
Please confirm that, for all four of the bullet points listed in Section C.1, the information should be specific to only healthcare-related situations. CMS confirms for all four of the bullet points in section C.1, the information should include any/all situations where PCIs, actual, potential, or apparent, may exist.
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E. Section J.22 BOE
| Question ID | Document | Section | Page # (References reflect prior amendment assignment & may or may not tie to the new updates) | Question | CMS Answer/Action |
| E.1 | Attachment J.22 CMS BOE | Section L.13.2 | The instructions on the J.22 CMS BOE address the inclusion of both productive and non-workload estimating, but does not discuss the inclusion of staff accounted for as ODCs, overhead or G&A. |
Does CMS require the Offeror to include staff identified as ODCs, Overhead and G&A on the J.22 CMS BOE? Does CMS intend to add that verbiage to the Instructions tab?
CMS confirms the BOE Instructions and Example Tab in Attachment J.22, were updated to incorporate direction for Offerors to add lines for Other Direct Costs, Indirect Costs, Overhead, General & Administative (G&A) and/or Subcontractors to document staffing for every WBS as applicable.
E.2 J.22 CMS BOE Bills/Claims Part B - Suspended Claims The Part B Suspended Claims is set at 6.51% in the J.22 CMS BOE which is a higher suspense rate than historically shown in RFPs. Please confirm this is the intended suspense rate for Part B Claims.
CMS confirms that the suspension claims count for PM Part B in the JK BOE has been updated. The Part B suspensions numbers now reflect a 1.06% suspension rate.
E.3 J.22 CMS BOE & J.23 GPPA Prior Authorization Workload 12 CMS provides the Prior Authorization OPD workload as Medical Review in the MIP CLIN. The workload includes Appeal reviews and Telephone Inquiries, which are normally a part of the PM CLIN. Does CMS want the Offerors to propose the Appeals and Telephone costs as part of C.5.12 Medical Review?
CMS confirms Offerors shall propose OPD-specific Telephone Inquries and OPD-specific Appeals as part of C.5.12 as documented in the BOE and in the SOW.
E.4 J.22 CMS BOE & Cost Templates Instructions Column A Row 19, column C Instructions state the Offeror shall propose at the sixth level for C.5.11.3.3.1 Provider Reimbursement and C.5.11.3.3.3 Hospice Cap. However the cost template only goes to the fifth level C.5.11.3.3. Will the cost template be updated to include the sixth level or should the cost template and CMS BOE be submitted at different levels?
CMS confirms Offerors shall complete the cost templates and BOE at the level provided. The cost templates will not be updated for reporting at the sixth level.
E.5 J.22 CMS BOE & J.1 SOW & J.35 thru J.41 Cost Templates Section C.5.11.3.3 Periods of Performance, page 125 in J.1, and Cost Templates C.5.11.3.3 Provider Reimbursement has several workloads included at the sixth level in the SOW and on the J.22 CMS BOE, but they are not broken out on the Cost Templates. This includes C.5.11.3.3.1, C.5.11.3.3.2, C.5.11.3.3.3, C.5.11.3.3.5, C.5.11.3.3.7. Is the Offeror to combine these separate out these workloads to the detailed WBS on the J.22 CMS BOE, but combine on the Cost Templates? Will CMS update the Cost Templates?
CMS confirms Offerors shall complete the cost templates and BOE at the level provided. Offerors shall separate the noted workloads and report to the more detailed sixth level WBS on the BOE. Further, Offerors shall combine these workloads for reporting in the cost templates.
| E.6 | J.22 CMS BOE & J.1 SOW & J.35 thru J.41 Cost Templates | Section C.5.11.3.2.9 | Periods of Performance, page 125 in J.1, and Cost Templates | C.5.11.3.2.9 is Worksheet S-10 Audits in the SOW, and is included on the J.22 CMS BOE with a workload. | |
| On the Cost Templates there is not a designated spot for C.5.11.3.2.9, does CMS intend to update the Cost Templates to include C.5.11.3.2.9? If not, where does the Offeror include the cost for S-10 Reviews in the Cost Templates? | CMS confirms that C.5.11.3.2.9 for MIP A only has been added to the Base Period Cost Template, Attachment J.35 and the Option Year 1 Cost Template, Attachment J.36. None of the other cost templates were impacted or updated based on this issue. |
E.7 J.22 CMS BOE Bills/Claims HH&H Investigated Bills and Suspended Bills Rows 15 & 16 The Proposal Workload for Investigated HH&H bills is higher than the suspended bills, but historically suspended generally are higher than investigated. Will the government please verfify that the intent is to have the investigated bills higher than the suspended bills? CMS confirms both the investigated and suspended claims volumes in the BOE for HH+H were updated. The suspension rate remains 1.6%, the investigated claims number was updated to the national HH+H rate for FY2019 of .63%. This percentage provides a more reasonable investigation to suspension ratio.
E.8 J.22 Basis of Estimate Base Year thru Option Year 6, line 205 WBS C.5.14 Workload Category; MIP MSP Prepay Part B, Workload Subcategory; Follow-up with BCRC is listed on lines 204 & 205, thus duplication. Did CMS intend to duplicate the Workload Subcategory, or is the 2nd row intended to be Non-Workload Estimating Factor?
CMS confirms the duplicative line, Follow-up with the BCRC, was removed from the BOE, Attachment J.22.
E.9 J.22 CMS BOE & J.1 SOW & J.35 thru J.41 Cost Templates Secton C.5.12.2.21 Periods of Performance, page 144 in J.1, and Cost Templates C.5.12.21 is Prior Authorization for Certain Hospital Outpatient Department (OPD) Services in the SOW, and is included on the J.22 CMS BOE with five workloads.
On the Cost Templates there is not a designated spot for C.5.12.2.21, does CMS intend to update the Cost Templates to include C.5.12.2.21?
If not, where does the Offeror include the cost for Prior Authorization in the Cost Templates?
CMS confirms that C.5.12.2.21, for MIP A and MIP B, has been added to the Base Period Cost Template, Attachment J.35 and the Option Year 1 Cost Template, Attachment J.36. None of the other cost templates were impacted or updated based on this issue.
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F. Section J.23 GPPA
| Question ID | Document | Section | Page # (References reflect prior amendment assignment & may or may not tie to the new updates) | Question | CMS Answer/Action |
| F.1 | RFP | Item #36, Supplementary Medicare Integrity Program (MIP) Activities in Support of Improper Payment Rate Reduction | Page 15 | This section of the Government Provided Proposal Assumptions states "CMS is requiring Offerors with current MAC contracts to document within their proposal any customizations that are being proposed for this jurisdiction, specifically addressing any qualitative (i.e. measurable program efficiencies such as improved customer service and reductions to improper payments) and/or quantitative (i.e. measurable cost savings) implications, impacts and or benefits that a) are not already addressed in this RFP and b) represent customized activities currently performed in the Offeror’s current contracts." |
Question: Will CMS please clarify, must an Offeror, who currently is performing these MIP improper payment rate reduction activities in a current MAC, propose similar activities in their JK proposal submission?
CMS confirms that offerors are not required to propose supplementary MIP-funded activity(ies) and that Offeror(s) may propose either new or existing MIP customization(s) for JK. The intent of the RFP direction is to ensure that any proposed MIP customizations (new or existing) directed towards improper payment rate reductions, intended to be performed for JK, be detailed in Tab F.
| F.2 | J.23 | GP Proposal Assumptions/Medicare Care Choices Model (MCCM) | 4,15 | The MCCM SOW (J.30) is out of date. A more current version of the SOW for this work is available and shows that the model ends on 12/31/21. The J.23 indicates the period of performance for cost purposes includes the Base year, as well as all Option Years. Understanding that this program is set to expire, should CMS update the SOW to reflect the expiration date? | CMS confirms the Medicare Care Choices Model (MCCM) will sunset on 12/31/2021 as noted in Technical Direction Letter (TDL) 200519. MCCM was removed from RFP section B.6, Table 2 and Item 33 in the Government Provided Proposal Assumptions (GPPA), Attachment J.23 and references throughout the RFP were removed. Updated Cost Summary Template and updated RSNAT Cost Templates are provided with this amendment. |
| F.3 | J.23 Government Provided Proposal Assumptions | Table 27: Records Storage Facilities | 8 | CMS has EDM Americas, Inc. listed, but per a trade and asset sale of EDM's Records Management business to Access Information Management/Retrievex, the record storage contract is no longer overseen by EDM. Will CMS update this information? | CMS confirms the name and address of a NARA compliant storage vendors for JK has been updated in the GPPA, Attachment J.23.to Retrievex, Inc., 4 First Avenue, Peabody, MA 01960. |
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G. Section J.23.A-J.32
| Question ID | Document | Section | Page # (References reflect prior amendment assignment & may or may not tie to the new updates) | Question | CMS Answer/Action |
| G.1 | RFP | J.23A, Table 19 & J.22 (lines 145 of Base Year & Option Year tabs) | The category of "Individual Appeals" is not included under Cost Report Appeals. Should 'Individual Appeals' be added to Table 19? If so, please identify the count/units that the MAC should bid to? The totals for Table 19 of J.23A roll into the total for this category on J.22. |
CMS confirms Individual Appeals was added to Tabe 19 on Attachment J.23.A. Additionally, CMS has provided direction in the Government Provided Proposal Assumptions (GPPA) document, J.23, noting that the number of Individual Appeals has been provided for information purposes only.
| G.2 | RFP | J.23A, Table 20 & J.22 (lines 146 of Base Year & Option Year tabs) | Table 20 contains the Cost Report Preliminary Position Papers by Provider Type. Table 19 also includes the total Prelimary position papers in Table 20 as part of the Cost Report Appeals. The total workload for Table 20 (93) appears to be a duplicate of the first category in Table 19 - Preliminary Position Papers due PRRB. Does CMS request that Offerors duplicate the level of effort for Cost Report Preliminary Position Papers by Provider Type in both workloads on the CMS BOE and in the cost templates? Or does CMS wants a separate bid/FTEs for Table 20 (this category also appears on J.22, lines 146 of the Base Year and Option Year tabs). | |
| CMS confirms the Government Provided Proposal Assumptions (GPPA) document, J.23, has been updated to note that Table 20 in Attachment J.23.A was provided for information purposes only. Further the BOE, Attachment J.22, has been updated to remove the row that provided Cost Report Preliminary Position Papers by Provider Type. | ||||
| G.3 | RFP | J.23A, Table 15 & J.22 (lines 142 of Base Year & Option Year tabs) | Table 15 includes details related to the Reimbursement Areas in JK. Table 15 appears to be information that will impact the level of effort for the audit workload but does not appear to be a workload in and of itself. However, this information is included as workload in the Basis of Estimate. Please confirm that CMS wants a separate bid/FTEs for Table 15? | CMS confirms the Government Provided Proposal Assumptions (GPPA) document, J.23, has been updated to note that Table 15 in Attachment J.23.A was provided for information purposes only. Further the BOE, Attachment J.22, has been updated to remove the row that provided Reimbursement Areas. |
| G.4 | RFP | J.23A, Table 16 & J.22 (lines 143 of Base Year & Option Year tabs) | Table 16 identifies the number of PIP providers in JK. Table 16 appears to be information that will affect the level of effort for interim rate reviews since PIP rate reviews are included in the Interim Rate Review workload. Please confirm that CMS wants a separate bid/FTEs for Table 16? | CMS confirms the Government Provided Proposal Assumptions (GPPA) document, J.23, has been updated to note that Table 16 in Attachment J.23.A was provided for information purposes only. Further the BOE, Attachment J.22, has been updated to remove the row that provided PIP providers. |
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H. Section J.33-J.49 Question ID Document Section Page # (References reflect prior amendment assignment & may or may not tie to the new updates) Question CMS Answer/Action
I. Cost Realism
| Question ID | Document | Section | Page # (References reflect prior amendment assignment & may or may not tie to the new updates) | Question | CMS Answer/Action |
| I.1 | J.21 Proposal Self-Check Tool | Tab: Aggregate WBS Level | The header on this tab states that "If hours are not reported in the Technical Proposal, the cells for hours in the Technical Proposal column can be left blank." However, on this tab, even if the values for column D, E, and G all match, the formula in column H will return a result of "FALSE" if column E (Technical Proposal) is left blank. Is an adjustment needed to this formula? | CMS confirms an adjustment is not needed to this formula. The instructions in the header on this tab are accurate. The form is functioning as intended. |
J. Other TBD
| Question ID | Document | Section | Page # (References reflect prior amendment assignment & may or may not tie to the new updates) | Question | CMS Answer/Action | |
| I.1 | Standard Form 33 | Page 1 | ||||
| Page 125 | Block 12 of the Standard Form 33 of the JK RFP contains a statement that reads: "In compliance with the above, the undersigned agrees, if this offer is accepted within 0 calendar days from the date for receipt of offers specified above, to furnish any or all items upon which prices are offered at the price set opposite each item, delivered at the designated point(s), within the time specified in the schedule." Will CMS allow Offerors to change the accepted within number of calendar days from "0" to another number of calendar days? Including "0" in this statement appears inconsistent with CMS' direction in Section L.15, of the RFP (page 125) where CMS instructs Offerors to stipulate in its business proposal that its proposal is firm and valid unless the offer is withdrawn by the Offeror, as well as in RFP Attachment J.23 Government Provided Proposal Assumptions, #1 where CMS defines the expected award date of JK as within 8-12 months of receipt of proposals. Question: Would CMS please clarify? |
Based on our contracting writing system, CAMS, the SF 33 Form defaults to zero. Therefore for stipulation instructions please follow Section L.15, pg 125 in the original solicitation document, and ignore the SF 33 block 12 for clarification.
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