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Instructions
| Attachment J.22 | BASIS OF ESTIMATE |
| RFP # 75FCMC22R0002 | April 8, 2022 |
| PURPOSE: The purpose of the Basis of Estimate (BOE) is to assist the Centers for Medicare & Medicaid Services (CMS) in its evaluation of the Offeror’s technical and business proposals. Specifically, the BOE and other relevant historical data available to CMS will be used as a baseline tool for measuring and understanding how the Offeror proposes to perform the Statement of Work (SOW) requirements in contrast to how the Offeror has historically performed similar Medicare Administrative Contractor (MAC) work. Unexplained or unsupported variances between an Offeror’s proposed productivity rates, total number of hours and skill mix and its historically experienced productivity rates, total number of hours and skill mix with similar work as a MAC may result in a technical finding and/or a cost realism adjustment pursuant to Federal Acquisition Regulation (FAR) 15.404-1(d). |
| INSTRUCTION: The Offeror shall complete the BOE for the Base Year and Option Years 1 through 6. A tab is provided for each option period. In order to assist the Offeror in completing this BOE, CMS has provided instructions for populating the template. In addition, CMS has provided a sample calculation for the Offeror under the Example Tab. |
NOTE: The Offeror shall submit the TOTAL proposed staffing (inclusive of existing staff, direct and indirect labor, inter-organizational transfers, subcontracts, etc., as applicable) to perform the work from implementation through contract end. The Offeror shall use the BOE format provided, inclusive of any formulas or formatting. The Offeror is instructed to copy-paste additional rows, as necessary, including any formulas and formatting from a similar row.
Proposal accuracy and consistency across your technical proposal, business proposal, basis of estimate and all other Request for Proposal (RFP) attachments is very important to CMS. All data across all parts of your proposal must be accurate and consistent. The RFP includes a Self-Check Tool (Attachment J.21) for you to use to ensure you submit an accurate and consistent proposal. The Self-Check tool will be used by the Government to validate the accuracy of your data and must be submitted with your proposal package.
NOTE: At its option, if applicable conditions are met, the Offeror may abbreviate its BOE submission for Option Year (OY) 3 through OY6 (Contract Line Item Numbers (CLINs) 0005 through 0008) to the extent permitted by RFP L.13.2.
Column A, Row 4 The Offeror will fill in its company name on each worksheet in the space provided next to "OFFEROR NAME".
| Column A, | |
| Statement of Work (SOW) Work Breakdown Structure (WBS) Crosswalk | | PURPOSE: The purpose of this column is to enable CMS to sort on proposed labor by function to allow for meaningful crosswalks between the BOE and the Offeror's contract line item number (CLIN) templates and Technical Proposal. |
INSTRUCTION: The Offeror shall identify the Work Breakdown Structure (WBS) at the level necessary to provide clear and relevant distinctions for the associated hours by labor category. WBS levels are counted starting with the “letter” level, for instance “D,” so, for example D.1.2.6 is the fourth level of the WBS for that function. The pre-populated SOW WBS Crosswalk numbers provided in Column A are intended as a guide. The Offeror should update these numbers to the appropriate level as indicated below. The Offeror may also change the WBS, as necessary, to accurately reflect where it charges costs for these activities.
| Please note the further breakout required for the following areas: |
| * Claims Processing (D.1) - the Offeror shall propose hours at (at least) the third level of the WBS. |
| * Redeterminations (D.2) - the Offeror shall propose hours at (at least) the third level of the WBS. |
| * Medical Review (E.4) - the Offeror shall propose hours at (at least) the fourth level of the WBS (in cases where the fourth level is not available, the third level). |
| Column B, | | |
| SLIN Crosswalk | | PURPOSE: The purpose of this column is to enable the Government to sort on proposed labor by sub-line item (SLIN) and allow for crosswalks between the BOE and the Offeror's CLIN templates and Technical Proposal. | |
| | | INSTRUCTION: The Offeror shall identify the SLIN for the associated workload category. |
| Column C, | | |
| Workload Category | | PURPOSE: The purpose of this column is to identify the overall workload performed or supported by the proposed level of effort. | |
| | | INSTRUCTION: The Offeror shall use the workload category names provided. When copy-pasting additional rows into a section, the Offeror will ensure this column contains the appropriate workload category for the labor described in the rest of the row. (See Example tab.) |
| Column D, | | |
| Workload Subcategory | | PURPOSE: The purpose of this column is to identify the driver of the proposed level of effort for the workload. CMS defines labor in two ways - "productive" and "non-productive." CMS defines "productive" labor as that labor that is solely dependent on workload volume and is directly responsible for performing the workload; as workload volume increases, productive labor hours increase at a proportionate rate. Conversely, CMS defines "non-productive" labor as labor that is not solely driven by workload volume. Rather, "non-productive" labor may be fixed labor with no ties to workload fluctuations, or it may be labor that increases based on other factors, such as supervisor hours that are based on management to staff ratios or labor categories that perform support or oversight functions in tandem with the productive labor categories that are directly responsible for performing the workload. | |
| | | INSTRUCTION: The Offeror shall use the workload subcategory names provided by CMS to identify the driver for a given productive labor category. In the event that workload does not drive the proposed level of effort for a given labor category, the Offeror shall classify its non-productive labor categories with the label "Non-Workload Estimating Factor" and group these rows at the end of the respective workload category section. (See Example tab.) |
| | | NOTE: There is a blank “Non-Workload Estimating Factor” row available at the end of each workload category section to be used (or deleted) as necessary to capture the "non-productive" labor categories that support a workload. |
| | | Note: The Offeror shall add rows at the end of each workload category section (as necessary) and at the bottom of each Period of Performance tabs (as necessary) to include all level of effort proposed as Other Direct Costs (ODC), Indirect Costs, Overhead, and General & Administrative (G&A). Each row shall be the sum of all full-time equivalents (FTEs) per cost category and completed for the columns (A, B, C, D, G, L, N, R, T, V) as indicated per the Example tab. |
| PROPOSAL | | |
| Column E, | | |
| RFP Workload | | PURPOSE: The purpose of this column is to ensure the Offeror uses the Government's workload assumptions when estimating the proposed level of effort. | |
| | | INSTRUCTION: The Government has pre-populated this column with the Government's workload assumptions. The Offeror shall NOT change the RFP workloads in this column. The Offeror shall leave this column blank for a row relating to “Non-Workload Estimating Factor” (a non-productive labor category). |
| | | NOTE: Recovery Audit Contractor (RAC) related Appeals workloads are shown as "—". The Offeror shall not delete these rows. The RAC related Appeals/Qualified Independent Contractor (QIC)/Administrative Law Judge (ALJ) workloads (SOW WBS C.5.6) are included in the cooresponding Appeals workloads (SOW WBS D.2) for BOE completion purposes only. |
| Claims Processing |
| CMS is no longer providing Paper and Electronic claim counts separately. Paper and Electronic Bills and Claims are combined. Rows have been added for Part B Claims - Electronic & Paper, Part B Investigated Claims - Electronic & Paper, and Part B Suspended Claims - Electronic & Paper. |
In claims processing the majority of claims are processed through the standard system, with only a percentage of claims suspending for manual review. Suspended claims are claims that are not auto-adjudicated and that have been moved to a suspended status location during the course of processing the claim, either per CMS direction related to shared system fixes or for the MAC to further develop the claim (i.e., manually resolve edits and/or supply missing/incorrect information). Investigated claims are suspended claims that require further development by the MAC. Investigated claims require contact during the month by telephone, correspondence, or automatic inquiry with physician, beneficiary, supplier, social security office, or other entities outside the MAC for missing, incorrect, or inconsistent information.
Offerors shall provide the level of effort for the claims workload program area in its entirety, inclusive of the level of effort to identify and process suspended and investigated claims, on the Electronic/Paper Claims lines, Row 8. Additionally, Offerors shall also provide the total level of effort on their historic baseline contracts to perform the entire Claims function, including investigated claims, suspended claims and any non-workload estimating factors. Please note that if an Offeror's total proposed level of effort for the entire claims function differs significantly from its historic baseline, the Offeror must explain the difference in the Basis of Estimate column. The level of effort to process suspended claims shall be separated out and reported on Row 11. The level of effort to process investigated claims shall be separated out and reported on Row 10. NOTE: The Offeror shall not change the mandatory RFP workloads provided. (If the Offeror does change a mandatory RFP workload, it MUST also provide an explanation in Column N.)
| Provider Outreach and Education Activities (PM and MIP Provider Customer Service Workloads) |
| The Offeror shall enter the types and volumes of provider outreach and education activities in this column. See below for more information on the assumptions to be used for these proposed workloads. |
The Offeror shall use the jurisdiction-specific DMEPOS supplier populations shown in Attachment J.23, Government Provided Proposal Assumptions (GPPA) to determine the workload appropriate for each type of provider outreach and education activity. There are no minimum requirements for this function, so the Offeror must develop its own strategy for how it can best service the provider population.
| Local Coverage Determinations |
| The Local Coverage Determinations (LCD) workload categories were moved out of the Medical Review area and the SOW reference was updated to E.5. CMS has provided LCD workloads in the Basis of Estimate, Offerors are directed to use the provided workloads. NOTE: The Offeror shall not change the mandatory RFP workloads provided. |
| Medical Review |
| CMS has provided Medical Review workloads in the Basis of Estimate, Offerors are directed to use the provided workloads to support its MR Strategy. (Please see instructions for column A for more detail on the WBS breakout required for Medical Review.) NOTE: The Offeror shall not change the mandatory RFP workloads provided. |
| Provider/Supplier Duplicate Primary Payments (DPP) |
| Previously CMS provided an annual workload for the Number of DPP Cases Received from the Benefit Coordination and Recovery Center/Commercial Repayment Center (BCRC/CRC) & Established by the MAC. This Workload Subcategory now captures the annual Number of Claims Reprocessed from Duplicate Primary Payment (DPP) Cases Received from the Benefit Coordination and Recovery Center/Commercial Repayment Center (BCRC/CRC) & Established by the MAC. |
| Supplementary PM and MIP Activities |
| CMS has added Supplementary Program Management (PM) and Medicare Integrity Program (MIP) Activities rows at the bottom of each period of performance (POP) tab within the BOE. CMS is not providing workloads on these rows. Some MAC contracts include customized activities, not specifically identified within the SOW. To the extent applicable, if such customized approaches are being proposed for this jurisdiction, CMS is requiring Offerors to document these customizations within their proposal, specifically addressing any qualitative (i.e. measureable 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 are not already addressed in this RFP. The Offeror shall complete the BOE information for each of the customizations included in their proposal. |
| Column F, | | |
| Proposal Workload | | PURPOSE: The purpose of this column is to understand the few instances in which the Offeror is proposing a workload or deriving a workload that differs from the RFP workload. For most workload subcategories, the total proposed workload will mirror the RFP workload, given that workload assumptions are mandatory for bidding purposes. Column E and Column F reflect the same workload numbers except for the Telephone Inquiries Workload, as described in Attachment J.23.B, CSR-Handled Telephone Inquiries Table. Certain workloads, namely Provider Telephone Inquiries and/or Clerical Error Reopenings, are potentially impacted by various processes that allow for automation or self-service, thus potentially reducing the workload to be processed by the productive labor categories. The unshaded cells in column F for Provider CSR-Handled Telephone Inquiries and Clerical Error Reopenings contain a double border around the cell. For proposal purposes, these double bordered cells are the only cells that may not match the RFP workload listed in column E. If the Offeror chooses to propose its own workload for Provider CSR-Handled Telephone Inquiries and/or Clerical Error Reopenings, column F should display the Offeror's proposed workload(s). For these two workloads only, the Offeror may propose its own workload(s) in Column F. The Offeror must then also explain in the technical proposal the rationale for the proposed workload number(s), e.g. automation or self-service activity. | |
| | | INSTRUCTION: For all other workload subcategories (except Provider CSR-Handled Telephone Inquiries and/or Clerical Error Reopenings) the Offeror will not change the mandatory RFP workloads already provided in column E. For Provider Telephone Inquiries and/or Clerical Error Reopenings, the Offeror shall identify its Proposal Workloads for Provider CSR-Handled Telephone Inquiries and Clerical Error Reopenings. The Offeror shall leave this column blank for a row relating to “Non-Workload Estimating Factor” (a non-productive labor category). |
| Provider Telephone Inquiries (CSR-Handled) |
| CMS has formulated estimates for the volume of provider telephone inquiries that will need to be answered by a person (a Customer Service Representative, or CSR), and has provided these agency estimates in Column F. The Offeror will complete the BOE, and formulate its technical and business proposal, using either the CMS-provided estimates or the Offeror's workload estimates for CSR-handled telephone inquiries. The workloads and explanations the Offeror includes in Attachment J.23.B, CSR-Handled Telephone Inquiries Table must match the workloads and explanations shown in the BOE. |
| Clerical Error Reopenings |
| CMS has formulated estimates for the volume of Clerical Error Reopenings and has provided these agency estimates in Column F. The Offeror will complete the BOE, and formulate its technical and business proposal, using its own Proposal Workload for Clerical Error Reopenings. |
| Column G, | | |
| Labor Category (Proposed) | | PURPOSE: The purpose of this column is to disclose the labor categories that will perform or support a given workload subcategory. (This includes both productive and non-productive labor categories.) The Government may consider this information in determining the reasonableness of the Offeror's proposed labor (skill) mix. | |
| | | INSTRUCTION: For each workload subcategory, the Offeror shall identify all the labor categories required to perform the functional requirements of the statement of work. Each labor category shall be displayed using a separate row. This may require the Offeror to insert additional rows. The Offeror shall copy and paste all formulas and formatting into each inserted row. In the event that the Offeror wishes to display separate productivities for the same labor category to process the same workload subcategory, the Offeror shall display all productivities sequentially in the BOE. For example, if the Offeror has a Claims Analyst position that processes claims in State A and State B, the Offeror may display separate productivities by State for the Claims Analyst in the BOE. However, if the Offeror displays separate productivities, the Offeror shall display those productivities and associated hours on sequential rows. Similarly, if the Offeror wants to display separate productivities for a single labor category based on varying difficulty in a workload subcategory, the Offeror shall ensure that those productivities are also listed sequentially in the BOE. |
POSITION DESCRIPTIONS: For each labor category identified in the BOE the Offeror shall also complete the Position Description tab of this template to describe the specific job tasks, qualifications, and experience for each proposed labor category. The instructions for completing the position descriptions are found at the end of this Instructions tab.
| Column H, | | |
| % Workload Processed by Labor Category (Proposed) | | PURPOSE: The purpose of this column is to explain to CMS the percentage of the workload to be processed by the respective labor category. This is especially useful in understanding how a particular workload subcategory is allocated across more than one productive labor category, where applicable. For example, the Offeror may use Claims Analysts I and II to process claims that suspend for manual review. Claims Analyst I may handle the easier claims, while Claims Analyst II may handle the more difficult claims. Therefore, using this example, each labor category would not process 100% of the suspended claims, but a subset specific to their tasks (e.g., 75% of claims go to Claims Analyst I and 25% go to Claims Analyst II). | |
| | | INSTRUCTION: For each workload subcategory the Offeror shall identify the percentage of the annual workload to be processed by each specific labor category. The Offeror shall only identify a percentage in this column if the Offeror defines that position as "productive." The Offeror shall leave this column blank for a row relating to “Non-Workload Estimating Factor” (a non-productive labor category). |
| Column I, | | |
| Workload Distribution (Proposed) | | PURPOSE: The purpose of this column is to explain to CMS the distribution of workload across more than one productive labor category. | |
| | | INSTRUCTION: The Offeror shall NOT alter the contents of this column, as these cells will auto-populate once data is entered in the previous column. The Offeror shall leave this column blank for a row relating to “Non-Workload Estimating Factor” (a non-productive labor category). |
| Column J, | | |
| Annual Productive Hours (Proposed) | | PURPOSE: The purpose of this column is to explain to CMS the proposed annual productive hours used to calculate the FTEs for the respective labor category. | |
| | | INSTRUCTION: The Offeror shall provide the proposed annual productive hours for each labor category identified. |
| Column K, | | |
| Hourly Production per FTE (Proposed) | | PURPOSE: The purpose of this column is to identify the proposed productivity driving the hours for the productive labor category. CMS may verify the Offeror's proposed productivity against its history and its proposed approach discussed in the Offeror's technical proposal. | |
| | | INSTRUCTION: For any productive labor category identified, the Offeror shall provide the workload that can be accomplished by one (1) FTE in one (1) hour. The Offeror shall leave this column blank for a row relating to “Non-Workload Estimating Factor” (a non-productive labor category). |
| Column L, | | |
| Total Hours (Proposed) | | PURPOSE: The purpose of this column is to identify the proposed hours for a specific labor category to perform or support a given workload subcategory. CMS may verify total hours proposed with the Offeror's history, as well as its business and technical proposal to ensure consistency. | |
| | | INSTRUCTION: For productive labor categories the Offeror shall NOT alter the contents of this column, as these cells will auto-populate once data is entered in previous columns. For a row relating to “Non-Workload Estimating Factor” (a non-productive labor category), the Offeror shall enter the total hours proposed for the labor category to support the workload. The Offeror should ensure the total hours proposed for a workload category crosswalk to the Offeror's history shown in the BOE, as well as historic data available to CMS for both productive and non-productive labor categories. The Offeror shall describe and provide rationale for any variances in Column N. |
| Column M, | | |
| Total FTEs (Proposed) | | PURPOSE: The purpose of this column is to identify the total proposed FTEs for a specific labor category to perform or support a given workload subcategory so that the Government can crosswalk the rationale for the proposed FTEs to the FTEs identified in the Offeror's technical approach. | |
| | | INSTRUCTION: The Offeror shall NOT alter the contents of this column, as these cells will auto-populate once data is entered in previous columns. The Offeror shall ensure the total FTEs shown for a workload category crosswalk to the Offeror's CLIN templates and Technical Proposal. |
| BASIS OF ESTIMATE | |
| Column N, | |
| Basis of Estimate | | PURPOSE: The purpose of this column is to provide a summary, narrative explanation to CMS to support the proposal elements in light of the Offeror’s history, including the Proposal Workload, the proposed hours and productivity, and the proposed labor (skill) mix. |
| INSTRUCTION: The Offeror shall provide a summary, narrative explanation in this column to ensure CMS has adequate understanding of the Offeror’s proposal in light of the Offeror’s own history. The Offeror may also provide additional narrative in support of this summary in Volume II, Tab C, Offeror Proposal Assumptions. If additional narrative is provided in the Offeror Proposal Assumptions, the Offeror shall include a page reference to the additional narrative within the summary in this column N. |
| NOTE: Due to the Public Health Emergency (PHE), historic data provided by Offerors in Columns N-U shall not be for any period after February 2020. |
| The Offeror shall use historic data as its baseline for the effort proposed on this contract. (An Offeror without historic MAC workloads should indicate the basis for the proposal, whether through similar historic workloads or through other assumptions used.) Therefore, the Offeror shall disclose the following information in Column N as it relates to the Offeror’s history: |
| 1. WORKLOAD - WORKLOAD DISTRIBUTION – PRODUCTIVITY – HOURS. The Offeror shall specify the basis of its Proposal Workload, workload distribution, hours, and productivity for each labor category identified, such as using its historic experience and/or process improvement proposed for this contract, with a focus on any variances from its history for these proposed elements. |
| Impacts and Changes to Level of Effort: The Offeror shall describe any impacts on or changes to its historic level of effort that resulted in changes to its proposed level of effort. Impacts may include, but are not limited to the following: |
| a) Proposed technical solutions for the contract such as a process improvement, |
| b Improvements implemented during the 12-month period used to derive the historic data, |
| c) One-time occurrences/temporary requirements that occurred during the 12-month historic timeframe, but are not part of this contract, and/or |
| d) Trends in performance (actual and/or anticipated). |
| This section also explains why variances exist between an Offeror's proposal and its history, such as the elimination of historic labor categories, as well as any variances between the history shown in the BOE and the historic data available to CMS. |
| 2. SOURCE. The Offeror shall identify the contract name and the system from which the historic data was derived. The Offeror shall also identify the time period used. |
| Time period. The Offeror shall use a minimum of 12 months of historic hours and production data as the baseline for this contract (i.e., the Offeror's most recent performance). If the Offeror chooses to use a productivity baseline period of less than 12 months’ duration, the Offeror shall provide detailed rationale to support the use of the shorter baseline period for its proposed productivity metrics. Moreover, when electing a shorter baseline period, the Offeror shall still provide its historic month-by-month hours and production performance for the full 12 consecutive months’ time span, highlighting the months actually used by the Offeror for the basis of estimate. This is to ensure that CMS may view the proposed limited historic baseline in the context of a full 12 consecutive months’ worth of performance. The Offeror should place this additional data in Volume II, Tab C, Offeror Proposal Assumptions. |
| 3. PROVIDER TELEPHONE INQUIRIES: For the Proposal Workload for provider telephone inquiry workload, the Offeror shall provide the basis for the Offeror's proposed Provider CSR-handled telephone inquiries workload volume. The Offeror must follow all instructions in Attachment J.23.B, CSR-Handled Telephone Inquiries Table when proposing this Proposal Workload. The Offeror shall also provide in Volume II, Tab C, Offeror Proposal Assumptions, the following historical data points for the BOE 12-month historic baseline period, including the following: |
| 1. Interactive Voice Response (IVR) Handle Rate (as reported in the Provider Inquiries Evaluation System) – reported as a percentage |
| 2. Customer Service Representative (CSR) Calls Handled – reported in number of calls (not as percentages) |
| 3. Web-Portal Utilization Rate – reported as the percentage of inquiries handled to completion through the Offeror’s web portal |
4. CLERICAL ERROR REOPENINGS: For the Proposal Workload for the Clerical Error Reopenings (CER) workload, the Offeror shall provide the basis for the Offeror's proposed CER volume to be performed by FTEs.
| HISTORY - BASELINE | | |
| Column O, | | |
| Historic Workload | | An Offeror should repeat (copy/paste) its 12-month history baseline data from the Base Year tab (CLIN 0002) into the tabs for all of the Option Years (CLINs 0003-0008). | |
| | | PURPOSE: The purpose of this column is to demonstrate workload differences between the proposed workload and the Offeror's historic workload (12 month baseline) so CMS can understand potential impacts of the history on the level of effort proposed. CMS may verify the Offeror's stated historic workloads against historic data available to CMS. |
| | | INSTRUCTION: The Offeror shall identify the historic workload (12 month baseline) for the respective labor subcategory that impacted its proposed productivity and level of effort. The Offeror shall leave this column blank for a row relating to “Non-Workload Estimating Factor” (a non-productive labor category). |
| Column P, | | |
| % Workload Processed by Labor Category (Historic) | | PURPOSE: The purpose of this column is to explain to CMS the percentage of the workload that was processed by the respective labor category. This is especially useful in understanding how a particular workload subcategory was allocated historically across multiple productive labor categories, where applicable. For example, the Offeror may have used Claims Analysts I and II to process claims that suspended for manual review. Claims Analyst I may have handled the easier claims, while Claims Analyst II may have handled the more difficult claims. Therefore, in this example each labor category would not have processed 100% of the claims, but a subset specific to their tasks (e.g., 75% of claims went to Claims Analyst I and 25% went to Claims Analyst II). | |
| | | INSTRUCTION: For each workload category the Offeror shall identify the percentage of the historic workload (12 month baseline) that was processed by the respective labor category, where applicable. The Offeror shall only identify a percentage in this column if the Offeror defined that position as "productive." The Offeror shall leave this column blank for a row relating to “Non-Workload Estimating Factor” (a non-productive labor category). |
| Column Q, | | |
| Workload Distribution (Historic) | | PURPOSE: The purpose of this column is to understand the distribution of historic workload (12- month baseline) across more than one productive labor category. | |
| | | INSTRUCTION: The Offeror shall NOT alter the contents of this column, as these cells will auto-populate once data is entered in the previous column. The Offeror shall leave this column blank for a row relating to “Non-Workload Estimating Factor” (a non-productive labor category). |
| Column R, | | |
| Annual Productive Hours (Historic) | | PURPOSE: The purpose of this column is to understand the historic annual productive hours used to calculate the FTEs for the respective labor category. | |
| | | INSTRUCTION: The Offeror shall provide the historic annual productive hours (12-month baseline) for each position identified. |
| Column S, | | |
| Hourly Production per FTE (Historic) | | PURPOSE: The purpose of this column is to identify the historic productivity (12 month baseline) driving hours for the productive labor category so that CMS can make relevant comparisons between the Offeror's history and its proposal. | |
| | | INSTRUCTION: For any productive" labor category identified the Offeror shall provide the historic workload that was accomplished by one (1) FTE in one (1) hour using this column. The Offeror shall leave this column blank for a row relating to “Non-Workload Estimating Factor” (a non-productive labor category). |
| Column T, | | |
| Total Hours (Historic) | | PURPOSE: The purpose of this column is to identify the historic hours (12 month baseline) for a specific labor category to perform or support a given workload subcategory. CMS may verify the Offeror's stated historic total hours against historic data available to CMS. | |
| | | INSTRUCTION: The Offeror shall identify the total historic labor hours for the respective labor category to perform the associated workload. The Offeror should ensure the total hours shown for a workload category or subcategory align with the hours charged historically in CMS ART. The Offeror shall explain in Column N any variances between the total historic hours shown and historic data available to CMS. |
| Column U, | | |
| Total FTEs (Historic) | | PURPOSE: The purpose of this column is to identify the total historic FTEs for a specific labor category to perform or support a given workload subcategory so that CMS can make relevant comparisons and to clearly understand how an Offeror's proposed technical approach may lead to FTE counts that differ from an Offeror's historic experience. | |
| | | INSTRUCTION: The Offeror shall NOT alter the contents of this column, as these cells will auto-populate when all other columns are completed. |
| Column V, | | |
| Item Number | | PURPOSE: The purpose of this column is to provide an item number for each row to facilitate sorting of data. | |
| | | INSTRUCTION: The pre-populated numbers in this column are intended as a guide. Upon completion of the entire tab the Offeror shall overwrite the pre-populated numbers and enter sequential numbers in this column, top to bottom for each row. |
| POSITION DESCRIPTION INSTRUCTIONS |
| The instructions below are specific to the Position Descriptions tab found after the Option Year 6 tab. |
| PURPOSE: The purpose of the position description tab is two-fold. First, this tab provides the Government with the necessary information to assess the reasonableness of the proposed labor (skill) mix to accomplish the SOW requirements and the distribution of workload among productive labor categories for each Proposal Workload. Second, this tab explains to the Government changes in the types of labor an Offeror historically used to process the work as compared to the types of labor proposed to do the work, which assists the Government in validating historic level of effort. |
| INSTRUCTION: For each labor category identified in the BOE, the Offeror and/or subcontractor(s) shall provide a description of the activities performed and the minimum required education and/or experience requirements. The Offeror shall provide a description of activities performed specific to each SOW WBS line item. When the same labor category is identified for multiple SOW WBS line items (e.g., Analyst I is proposed for D.1.2 and D.2.1.1), the Offeror shall provide a separate line/row for each SOW WBS item performed by the labor category. The Offeror shall submit this information (as prescribed in the Position Description tab) as part of its Basis of Estimate. |
| The Offeror shall also clarify any changes to its proposed labor categories (mix of staff) from its history (the 12-month period of historic data the Offeror used to determine level of effort and productivity). Reasons for differences may include, but are not limited to: |
| a) Elimination of category based on proposed approach |
| b) Elimination of category based on solution implemented in current operations within the 12-month timeframe |
| c) Consolidation of associated activities within another labor category |
| d) Revision to labor category name |
| The Offeror shall capture any changes in labor mix using Columns E and F of the Position Descriptions tab only when there is a change in labor category. The Offeror shall use Column E to capture the name/classification of the history labor category and use Column F to provide a summary rationale for the change between the Offeror's proposed labor category name/classification and the Offeror's history. If the Offeror has eliminated a historic labor category, the Offeror shall identify this labor category in Column E, provide a rationale for the elimination in Column F, and identify the function it was eliminated from in Column C. The Offeror should also identify page references to its Proposal where additional narrative exists explaining the change. |
Example
| Attachment J.22 | BASIS OF ESTIMATE |
| RFP # 75FCMC22R0002 | April 8, 2022 |
Note: The Claims Processing example below is for illustration purposes only.
| OFFEROR NAME: | | | | | | | | | | | | | | | | | | | | | |
| Durable Medical Equipment (DME) MAC Medicare Administrative Contractor (MAC) Basis of Estimate - Base Year | | | | DO NOT ALTER THE CONTENTS OF THE SHADED CELLS IN COLUMNS E, F, I, L, M, Q AND U. (THESE CELLS WILL AUTO-POPULATE WHEN VALUES ARE ENTERED INTO ADJACENT CELLS.) SEE INSTRUCTIONS TAB FOR MORE INFORMATION ON THESE COLUMNS. | | | | | | | | | | | | | | | | | |
| Note: The Claims Processing example below is for illustration purposes only. | | | | | | | | PROPOSAL | | | | | | | | | HISTORY/BASELINE | | | | |
| Statement of Work (SOW) Work Breakdown Structure (WBS) Crosswalk | Sub-contract Line Item Number (SLIN) Crosswalk | Workload Category | Workload Subcategory | RFP Workload | Proposal Workload | Labor Category (Proposed) | % Workload Processed with Direct Labor (Proposed) | Workload Distribution (Proposed) | Annual Productive Hours (Proposed) | Hourly Productivity per FTE (Proposed) | Total Hours (Proposed) | Total FTEs (Proposed) | BASIS OF ESTIMATE | Historic Workload | % Workload Processed with Direct Labor (Historic) | Workload Distribution (Historic) | Annual Productive Hours (Historic) | Hourly Productivity per FTE (Historic) | Total Hours (Historic) | Total FTEs (Historic) | Item Number |
| D.1.2 | AC | Bills/Claims Part B | Bills/Claims - EMC | 44,667,081 | 2,233,354 | Claims Analyst I - WI | 50% | 1,116,677 | 788 | 75 | 14,889.03 | 18.89 | SUSPENSE RATE: EMC suspense rate of 5% based on implemented edits in March 2014 (see page 15, Tab F.1, Volume III) | | | | | | | | |
SOURCE: CMS ART MSR Reports for July 2013 through June 2014; specific month by month suspense rates are included on page 15, Tab C, Volume II.
PRODUCTIVITY: Increased productivity by 15 units per hour based on projected productivity trend. As of additional edits implemented in March 2014, Claims Analysts are processing at a rate of 68 claims/hr. We anticipate the trend to continue, resulting in 75 claim/hr for Base Year operations.
| SOURCE: JX DME MAC contract, CMS ART July 2013 through June 2014 - the specific data by month along with our anticipated forecast and rationale is included on pages 15-18 of Tab C, Volume II. | 2,579,684 | 50.00% | 1,289,842 | 788.00 | 60.00 | 21,497.37 | 27.28 | 1 | | | | | | |
| D.1.2 | AC | Bills/Claims Part B | Bills/Claims - EMC | 44,667,081 | 2,233,354 | Claims Analyst I - FL | 50% | 1,116,677 | 788 | 75 | 14,889.03 | 18.89 | SUSPENSE RATE: EMC suspense rate of 5% based on implemented edits in March 2014 (see page 15, Tab F.1, Volume III) |
SOURCE: CMS ART MSR Reports for July 2013 through June 2014; specific month by month suspense rates are included on page 15, Tab C, Volume II.
PRODUCTIVITY: Increased productivity by 15 units per hour based on projected productivity trend. As of additional edits implemented in March 2014, Claims Analyst's are processing at a rate of 68 claims/hr. We anticipate the trend to continue, resulting in 75 claim/hr for Base Year operations.
| SOURCE: JX DME MAC contract, CMS ART July 2013 through June 2014 - the specific data by month along with our anticipated forecast and rationale is included on pages 15-18 of Tab C, Volume II. | 2,579,684 | 50.00% | 1,289,842 | 788.00 | 60.00 | 21,497.37 | 27.28 | 2 | | | | | | |
| D.1.2 | AC | Bills/Claims Part B | Bills/Claims - Paper | 1,555,516 | 311,103 | Claims Analyst I | 65% | 202,217 | 788 | 65 | 3,111.03 | 3.95 | PRODUCTIVITY: Based on historic experience |
| SOURCE: JX DME MAC contract, CMS ART July 2013 - June 2014 | 347,999 | 65.00% | 226,199 | 788.00 | 65.00 | 3,479.99 | 4.42 | 3 | | | | | | |
| D.1.2 | AC | Bills/Claims Part B | Bills/Claims - Paper | 1,555,516 | 311,103 | Claims Analyst II | 35% | 108,886 | 788 | 50 | 2,177.72 | 2.76 | PRODUCTIVITY: Based on historic experience |
| SOURCE: JX DME MAC contract, CMS ART July 2013 - June 2014 | 347,999 | 35.00% | 121,800 | 788.00 | 50.00 | 2,435.99 | 3.09 | 4 | | | | | | |
| D.1.1 | AC | Bills/Claims Part A | Non-Workload Estimating Factor | | | Service Center A - Support I | | | 788 | | 1,250.00 | 1.59 | HOURS: Paper claims are imaged into the system. These costs are allocated in our service center. An explanation of how we allocated these cost in provided on page 2 of Volume II, Tab C. |
| SOURCE: JX DME MAC contract, CMS ART, July 2013 through June 2014 | | | | 788.00 | | 1,575.00 | 2.00 | 5 | | | | | | |
| D.1.2 | AC | Bills/Claims Part B | Non-Workload Estimating Factor | | | Systems Analyst V | | | 788 | | 1,300.00 | 1.65 | HOURS: Hours based on historic experience on our JX DME MAC contract. |
| SOURCE: JX DME MAC contract, CMS ART, July 2013 through June 2014 | | | | 788.00 | | 1,300.00 | 1.65 | 6 | | | | | | |
| D.1.2 | AC | Bills/Claims Part B | Non-Workload Estimating Factor | | | Quality Analyst II | | | 788 | | 500.00 | 0.63 | HOURS: Hours based on historic experience on our JX DME MAC contract. |
| SOURCE: JX DME MAC contract, CMS ART, July 2013 through June 2014 | | | | 788.00 | | 500.00 | 0.63 | 7 | | | | | | |
| D.1.2 | AC | Bills/Claims Part B | Non-Workload Estimating Factor | | | Claims Analyst, Sr. | | | 788 | | 7,014.00 | 8.90 | HOURS: Based on our historic experience, 1 claims analyst senior positions is needed for every 5 claims analyst positions. |
| SOURCE: JX DME MAC contract, CMS ART - July 2013 through June 2014. | | | | 788.00 | | 9,782.00 | 12.41 | 8 | | | | | | |
| D.1.2 | AC | Bills/Claims Part B | Non-Workload Estimating Factor | | | Claims Lead | | | 788 | | 240.00 | 0.30 | HOURS: Based on improved uses of internal dashboards, we have seen an ongoing downward trend in the hours needed for the claims lead position. Currently, the claims lead is charging 60 hours per month, which is down from 80 hours per month in January 2014. We project that our dashboard improvements will continue to reduce the "on-hand" activities of the claims lead to only 40 hours per month. |
| SOURCE: JX DME MAC contract, CMS ART - July 2013 through June 2014. The month by month data along with our projected efficiency gains for this position are on Page 19, Tab C, Volume II. | | | | 788.00 | | 800.00 | 1.02 | 9 | | | | | | |
BASIS OF ESTIMATE
Page &P of &N
Base Year
| Attachment J.22 | BASIS OF ESTIMATE |
| RFP # 75FCMC22R0002 | April 8, 2022 |
| OFFEROR NAME: | | | | | | | | | | | | | | | | | | | | | |
| Durable Medical Equipment (DME) Medicare Administrative Contractor (MAC) Basis of Estimate - Base Year | | | | DO NOT ALTER THE CONTENTS OF THE SHADED CELLS IN COLUMNS E, F, I, L, M, Q AND U. (THESE CELLS WILL AUTO-POPULATE WHEN VALUES ARE ENTERED INTO ADJACENT CELLS.) SEE INSTRUCTIONS TAB FOR MORE INFORMATION ON THESE COLUMNS. | | | | | | | | | | | | | | | | | |
| NOTE: The estimated base period used to calculate the workloads below are as follows: Part B workload is 6 months. | | | | | | | | PROPOSAL | | | | | | | | | HISTORY/BASELINE | | | | |
| Statement of Work (SOW) Work Breakdown Structure (WBS) Crosswalk | Sub-contract Line Item Number (SLIN) Crosswalk | Workload Category | Workload Subcategory | RFP Workload | Proposal Workload | Labor Category (Proposed) | % Workload Processed with Direct Labor (Proposed) | Workload Distribution (Proposed) | Annual Productive Hours (Proposed) | Hourly Productivity per FTE (Proposed) | Total Hours (Proposed) | Total FTEs (Proposed) | BASIS OF ESTIMATE | Historic Workload | % Workload Processed with Direct Labor (Historic) | Workload Distribution (Historic) | Annual Productive Hours (Historic) | Hourly Productivity per FTE (Historic) | Total Hours (Historic) | Total FTEs (Historic) | Item Number |
| D.1 | | Bills/Claims Part B | Claims - Electronic & Paper | 5,964,404 | 5,964,404 | | | 0 | | | | | | | | 0 | | | | | 1 |
| D.1 | | Bills/Claims Part B | Non-Workload Estimating Factor | | | | | | | | | | | | | | | | | | 2 |
| D.1 | | Bills/Claims Part B | Investigated Claims - Electronic & Paper | 2,719 | 2,719 | | | 0 | | | | | | | | 0 | | | | | 3 |
| D.1 | | Bills/Claims Part B | Suspended Claims - Electronic & Paper (do not include Investigated Bills) | 605,813 | 605,813 | | | 0 | | | | | | | | 0 | | | | | 4 |
| D.1 | | Bills/Claims Part B | Non-Workload Estimating Factor | | | | | | | | | | | | | | | | | | 5 |
| D.3.1 | | Reopenings Part B | Clerical Error Reopenings (Processed) | 83,275 | 83,275 | | | 0 | | | | | | | | 0 | | | | | 6 |
| D.3.1 | | Reopenings Part B | Non-Clerical Error Reopenings (Processed) | 7,018 | 7,018 | | | 0 | | | | | | | | 0 | | | | | 7 |
| D.3.1 | | Reopenings Part B | Non-Workload Estimating Factor | | | | | | | | | | | | | | | | | | 8 |
| D.2 | | Appeals Part B | Redeterminations (Adjudicated Claims Cleared) | | | | | | | | | | | | | | | | | | |
| Note: This includes Recovery Audit Contractor (RAC) Redeterminations (Adjudicated Claims Cleared) | 28,515 | 28,515 | | | 0 | | | | | | | | 0 | | | | | 9 | | | | |
| D.2 | | Appeals Part B | Redeterminations (Dismissed Claims Cleared) | | | | | | | | | | | | | | | | | | |
| Note: This includes RAC Redeterminations (Dismissed Claims Cleared) | 2,004 | 2,004 | | | 0 | | | | | | | | 0 | | | | | 10 | | | | |
| D.2 | | Appeals Part B | QIC Requests Supported (Case Files Forwarded) | | | | | | | | | | | | | | | | | | |
| Note: This includes RAC QIC Case File Requests | 5,193 | 5,193 | | | 0 | | | | | | | | 0 | | | | | 11 | | | | |
| D.2 | | Appeals Part B | Effectuations of Redeterminations (Claims) | 14,503 | 14,503 | | | 0 | | | | | | | | 0 | | | | | 12 |
| D.2 | | Appeals Part B | Effectuations of Qualified Independent Contractor (QIC) Decisions (Claims) | | | | | | | | | | | | | | | | | | |
| Note: This includes RAC QIC Effectuations | 1,883 | 1,883 | | | 0 | | | | | | | | 0 | | | | | 13 | | | | |
| D.2 | | Appeals Part B | Effectuations of Administrative Law Judge (ALJ) Decisions (Claims) | | | | | | | | | | | | | | | | | | |
| Note: This includes RAC ALJ Effectuations | 1,693 | 1,693 | | | 0 | | | | | | | | 0 | | | | | 14 | | | | |
| D.2 | | Appeals Part B | Non-Workload Estimating Factor | | | | | | | | | | | | | | | | | | 15 |
| C.5.6 | | Adjustments to RA Part B (Claims) - SLIN 000X AC | Automated and Complex Adjustments | 8,277 | 8,277 | | | 0 | | | | | | | | 0 | | | | | 16 |
| C.5.6 | | Adjustments to RA Part B (Claims) - SLIN 000X AC | RAC Redeterminations (Adjudicated Claims Cleared) | | | | | | | | | | | | | | | | | | |
| Note: The RAC workload is not reflected on this line as it is included in the workload that is provided above in Redeterminations (Adjudicated Claims Cleared). | — | — | | | | | | | | | | | 0 | | | | | 17 | | | | |
| C.5.6 | | Adjustments to RA Part B (Claims) - SLIN 000X AC | RAC Redeterminations (Dismissed Claims Cleared) | | | | | | | | | | | | | | | | | | |
| Note: The RAC workload is not reflected on this line as it is included in the workload that is provided above in Redeterminations (Dismissed Claims Cleared. | — | — | | | | | | | | | | | 0 | | | | | 18 | | | | |
| C.5.6 | | Adjustments to RA Part B (Claims) - SLIN 000X AC | RAC QIC Case File Requests | | | | | | | | | | | | | | | | | | |
| Note: The RAC workload is not reflected on this line as it is included in the workload that is provided above in QIC Requests Supported. | — | — | | | | | | | | | | | 0 | | | | | 19 | | | | |
| C.5.6 | | Adjustments to RA Part B (Claims) - SLIN 000X AC | RAC QIC/ALJ Effectuations | | | | | | | | | | | | | | | | | | |
| Note: The RAC workload is not reflected on this line as it is included in the workload that is provided above in Effectuations of QIC Decisions & Effectuations of ALJ Decisions. | — | — | | | | | | | | | | | 0 | | | | | 20 | | | | |
| C.5.6 | | Adjustments to RA Part B (Claims) - SLIN 000X AC | Non-Workload Estimating Factor | | | | | | | | | | | | | | | | | | 21 |
| D.6.3 | | Program Management (PM) Beneficiary Inquiries Part B | Complex Beneficiary Inquiry Responses | 1,666 | 1,666 | | | 0 | | | | | | | | 0 | | | | | 22 |
| D.6.3 | | PM Beneficiary Inquiries Part B | Complex 2nd Level Screenings (Receipts) | 2,580 | 2,580 | | | 0 | | | | | | | | 0 | | | | | 23 |
| D.6.3 | | PM Beneficiary Inquiries Part B | Non-Workload Estimating Factor | | | | | | | | | | | | | | | | | | 24 |
| C.8 | | Freedom of Information Act (FOIA) requests | | | | | | | | | | | | | | | | | | | |
| (Includes requests for Duplicate Medicare Summary Notices (MSNs) and Remittance Advice (RA) requests) | FOIA Requests (FOIA, FOIA/Privacy, Privacy) Received | 289 | 289 | | | 0 | | | | | | | | 0 | | | | | 25 | | | |
| D.5.1 | | PM Provider Customer Service Part B | Provider Outreach and Education Activities | | | | | | | | | | | | | | | | | | |
| Note: See Assumptions for more detail on this requirement | Complete columns G, J, and L. | | | | | | | | | | | | 0 | | | | | 26 | | | | |
| D.5.1 | | PM Provider Customer Service Part B | Non-Workload Estimating Factor | | | | | | | | | | | | | | | | | | 27 |
| D.5.1 | | Medicare Integrity Program (MIP) Provider Customer Service Part B | Provider Outreach and Education Activities | | | | | | | | | | | | | | | | | | |
| Note: See Assumptions for more detail on this requirement | Complete columns G, J, and L. | | | | | | | | | | | | 0 | | | | | 28 | | | | |
| D.5.1 | | MIP Provider Customer Service Part B | Non-Workload Estimating Factor | | | | | | | | | | | | | | | | | | 29 |
| D.5.2 | | Provider Inquiries Part B | Telephone Inquiries (Customer Service Representative (CSR) Answered & Interactive Voice Response (IVR) Handled) | | | | | | | | | | | | | | | | | | |
(Includes Electronic Data Interchange (EDI) Inquiries)
| Note: See J.23.B CSR-Handled Telephone Inquiries Table for more detail on this requirement | 101,507 | 45,185 | | | 0 | | | 0 | | 30 | |
| D.5.2 | | Provider Inquiries Part B | Written Inquiries (Received) | 1,465 | 1,465 | 0 | | 0 | | 31 |
| D.5.2 | | Provider Inquiries Part B | Congressionals (Received) | 1 | 1 | 0 | | 0 | | 32 |
| D.5.2 | | Provider Inquiries Part B | Non-Workload Estimating Factor | | | | | | | 33 |
| D.5.2 | | Provider Inquiries - Provider Relations Research Specialist (PRRS) Part B | PRRS Written & Phone Inquiries (Received) | 654 | 654 | 0 | | 0 | | 34 |
| D.5.2 | | Provider Inquiries - PRRS Part B | Non-Workload Estimating Factor | | | | | | | 35 |
| C.5.3 | | PM Non MSP Overpayment Demand Letters Sent Part B | Demands | 57,433 | 57,433 | 0 | | 0 | | 36 |
| C.5.3 | | PM Non MSP Overpayment Demand Letters Sent | Non-Workload Estimating Factor | | | | | | | 37 |
| C.5.4 | | PM Non MSP Overpayments - Part B | Non-MSP Collections - Voluntary Refunds (Received) | 5,586 | 5,586 | 0 | | 0 | | 38 |
| C.5.4 | | PM Non MSP Overpayments - Part B | Non-MSP Collections - Solicited Checks (Received) | 5,386 | 5,386 | 0 | | 0 | | 39 |
| C.5.4 | | PM Non MSP Overpayments - Part B | Non-MSP collections - Debt Collection and Referral | 4,858 | 4,858 | 0 | | 0 | | 40 |
| C.5.4 | | PM Non MSP Overpayments - Part B | Non-Workload Estimating Factor | | | | | | | 41 |
| C.5.6 | | Non MSP Overpayments Identified by RA - Part B | RAC Demands | 4,722 | 4,722 | 0 | | 0 | | 42 |
| C.5.6 | | Non MSP Overpayments Identified by RA - Part B | RAC Solicited Checks | 622 | 622 | 0 | | 0 | | 43 |
| C.5.6 | | Non MSP Overpayments Identified by RA - Part B | Non-Workload Estimating Factor | | | | | | | 44 |
| C.4 | | Change Management | Draft Change Requests | 317 | 317 | 0 | | 0 | | 45 |
| C.4 | | Change Management | Finalized and Issued Change Requests Requiring Shared System Changes | 41 | 41 | 0 | | 0 | | 46 |
| C.4 | | Change Management | Finalized and Issued Change Requests Not Requiring Shared System Changes | 20 | 20 | 0 | | 0 | | 47 |
| C.4 | | Change Management | Technical Direction Letters | 303 | 303 | 0 | | 0 | | 48 |
| C.4 | | Change Management | Early Involvement Calls | 16 | 16 | 0 | | 0 | | 49 |
| C.4 | | Change Management | Agile-Related Calls | 30 | 30 | 0 | | 0 | | 50 |
| C.4 | | Change Management | Non-Workload Estimating Factor | | | | | | | 51 |
| E.3.1 | | MIP MSP Prepay Part B | Claims Edits Resolved | 62,091 | 62,091 | 0 | | 0 | | 52 |
| E.3.1 | | MIP MSP Prepay Part B | Follow-up with BCRC | 3 | 3 | 0 | | 0 | | 53 |
| E.3.1 | | MIP MSP Prepay Part B | Non-Workload Estimating Factor | | | | | | | 54 |
| E.2 | | MIP Benefit Integrity Part B | Unified Program Integrity Contractor (UPIC) Support Services & Requests (Non Law Enforcement, Law Enforcement, and QIC) | 268 | 268 | 0 | | 0 | | 55 |
| E.2 | | MIP Benefit Integrity Part B | Number of edits installed at the request of the UPIC | 92 | 92 | 0 | | 0 | | 56 |
| E.2 | | MIP Benefit Integrity Part B | Number of Overpayment recoupment actions received from the UPIC | 56 | 56 | 0 | | 0 | | 57 |
| E.2 | | MIP Benefit Integrity Part B | UPIC Suspensions Received | 77 | 77 | 0 | | 0 | | 58 |
| E.2 | | MIP Benefit Integrity Part B | Effectuation of UPIC Decisions | 252 | 252 | 0 | | 0 | | 59 |
| E.2 | | MIP Benefit Integrity Part B | Non-Workload Estimating Factor | | | | | | | 60 |
| E.3.2 | | MIP MSP Postpay Part B | Provider/Supplier Duplicate Primary Payments | | | | | | | |
| (Number of Claims Reprocessed from Duplicate Primary Payment (DPP) Cases Received from the Benefit Coordination and Recovery Center/Commercial Repayment Center (BCRC/CRC) & Established by the MAC) | 410 | 410 | | | 0 | | | 0 | | 61 | |
| E.3.2 | | MIP MSP Postpay Part B | General MSP Inquiries Received | 96 | 96 | 0 | | 0 | | 62 |
| E.3.2 | | MIP MSP Postpay Part B | Debt Collection and Referrals | | | | | | | |
| (Number of Provider, Physician or Other Supplier MSP Debts Referred to Treasury) | 4 | 4 | | | 0 | | | 0 | | 63 | |
| E.3.2 | | MIP MSP Postpay Part B | Non-Workload Estimating Factor | | | | | | | 64 |
| E.5 | | MIP Local Coverage Determinations (LCDs) Part B | Number of Valid LCD Reconsideration Requests that Result in a Coverage Change | 3 | 3 | 0 | | 0 | | 65 |
| E.5 | | MIP Local Coverage Determinations (LCDs) Part B | New LCDs Developed (# of new LCDs finalized and published for notice) | 1 | 1 | 0 | | 0 | | 66 |
| E.5 | | MIP Local Coverage Determinations (LCDs) Part B | Non-Workload Estimating Factor | | | | | | | 67 |
| E.4 | | MIP Medical Review (MR) Part B | All other MR activities/workloads not specified below | Complete columns G, J, and L. | | | | | | 68 |
This is the start of the file's text. The full file is on GovTribe.
