E.2 Q&A - Responses to Draft RFP, Amend.01.pdf

Section Subsection Page number Contractors Question CMS Response

Exhibit 7, Section L (E.7 Section L)

L.3

PROCUREMEN

T TIMELINE

CMS states: "Final Questions Due: January 27, 2025 by 9:00 A.M EST".

Question: Based on the release of the revised Draft RFP (Amendment 1) on January 17, 2025, containing a number of new sections not previously released, as well as, attachments and exhibits, would CMS consider a 3-day extension until January 30, 2025 to allow for additional questions?

An extension will not be granted.

Exhibit 7, Section L (E.7 Section L)

L.3

PROCUREMEN

T TIMELINE

CMS states: "Final Questions Due: January 27, 2025 by 9:00 A.M EST".

In response to a previous question (E.2 Q&A - Responses to Amendment 1, Row 17), CMS states: "All attachments and exhibits will be provided in the final RFP. Offerors will be provided an opportunity to submit 'new' questions to any 'new' information provided for in the release of the final RFP."

Question: Does CMS still intend to provide an opportunity to submit new questions for any new information provided in the final RFP?

The Draft RFP, Amend. 01 and the Final RFP are substantially the same with only a few minor differences are noted in this Q&A. As such, no new questions will be accepted.

Exhibit 7, Section L (E.7 Section L)

L.3

PROCUREMEN

T TIMELINE

CMS states: "Proposals Due: February 10, 2025 by 9:00 A.M (EST)"

Question: Based on the release of the revised Draft RFP (Amendment 1) on January 17, 2025, containing a number of new sections not previously released, as well as, attachments and exhibits, would CMS consider an extension from the current proposal due date until February 14, 2025, assuming there are no further changes in the final RFP when released?

The proposal due date is being extended to Tuesday, Febaury 18, 2025 by 9:00 A.M.

(EST).

Exhibit 7, Section L (E.7 Section L)

L.3

PROCUREMEN

T TIMELINE

CMS States: Proposal (RFP) Released: TBD, 2025".

Question: The release date of the final RFP indicates "TBD". Is there an anticipated release date for the final

RFP?

The final RFP will be released no later than Friday, February 7, 2025.

Exhibit 7, Section L (E.7 Section L)

L.6 PROPOSAL

ORGANIZATIO

N

CMS states: "The Offeror's proposal shall be submitted in three separate PDFs, unless otherwise stated, as identified below:"

In response to a previous question (E.2 Q&A - Responses to Amendment 1, Row 21), CMS states: "A PDF is expected for each volume unless otherwise stated. To the extent feasible, it is preferred, but not required, Volume I and III be a single PDF inclusive of appendices, exhibits, and/or attachments as applicable. It is anticipated that Volume II will consist of more than one separate file."

Question: Can CMS clarify and/or confirm that "Volume III - Conflict of Interest & Section 508 Compliance" is preferred (but not required) to be a single PDF for the for the "Attachment J.2 Contractor/Offeror Conflict of Interest", as well as the current "Voluntary Product Accessibility Template"?

To the extent feasible, it is preferred, but not required, Volume III be a single PDF inclusive of appendices, exhibits, and/or attachments as applicable.

RFP Questions

RFP: 75FCMC25RJ003

E.2 Q&A - Responses to Draft RFP, Amend.01

CONFLICT OF INTEREST

(AUG 2024)

CONFLICT OF

INTEREST

(AUG 2024),

Subsection c.1.b.ii and c.2.i

CMS states (in c.1.iii): "iii) Has other contracts and grants with the Federal Government such as a MAC, UPIC, QIC or claims processing system contractor."

CMS stated (in c.2.i): "i) A RAC may not become a MAC, UPIC, QIC, AdQIC, or RVC; and"

In response to a previous question (E.2 Q&A - Responses to Amendment 1, Row 43), CMS states: A RAC may not become a MAC, UPIC, QIC, AdQIC, or RVC, regardless of jurisdictional/regions.

Under the RAC 2 RFP (RFP 75FCM21F0018), the most recent prior RAC RFP), under section: C.13 (CONFLICT OF INTEREST (OCT 2020): c. Significant Potential Conflict of Interest, 2 Proposed Restraint on Future Contractor Activities, CMS stated: "A RAC may not become a MAC, UPIC, BFCC-QIO, QIN-QIO, QIC, AdQIC, ESRD, or SSM at any time in the jurisdiction where it holds a RAC contract.

For purposes of this proposed restraint, a “UPIC” is defined as any of the Jurisdictional task orders awarded under the UPIC IDIQ (e.g. Northeastern Jurisdiction, Midwestern Jurisdiction, etc.)"

Question: Can CMS clarify the proposed restraint for UPIC is the same as it was previously defined under the RAC 2 RFP: For purposes of this proposed restraint, a “UPIC” is defined as any of the Jurisdictional task orders awarded under the UPIC IDIQ (e.g. Northeastern Jurisdiction, Midwestern Jurisdiction, etc.)"?

The previously provided definition of a UPIC under the RAC 2 RFP will become obsolete as the UPIC recompetes will be stand alone contracts and not task orders under an IDIQ. As such, there will be no definition of a UPIC in the current RAC solicitation or subsequent awards.

Section Subsection Page number Contractors Question CMS Response

IV. Personnel Requirements

A. Key Personnel, 3.

Medical Review (MR) Manager

CMS states (in SOW Amendment 1): "For this SOW, fully dedicated” means that the individual identified for any key personnel position shall be a full time equivalent (FTE) employee. The PM, MR Manager, and CMD may serve as a designated back up, or in an ancillary capacity, on another RAC contract with CMS COR approval; they may not fulfill the role of a primary key personnel on another contract. The primary MR Manager, CIO and SSO may serve in the primary key personnel role, or backup key personnel role, on more than one RAC contract, with CMS COR approval. Key personnel may not perform duties on any Medicare/non- Medicare contract or commercial line of business, other than a RAC contract, without approval by the CO and

CMS RAC COR."

In response to a previous question (E.2 Q&A - Responses to Amendment 1, Row 48), CMS states: "Yes, the MR Manager may serve in the primary key personnel role, or backup key personnel role, on more than one RAC contract, with CMS COR approval. The SOW has been updated to reflect this clarification."

Question: Given the change made to the SOW under Amendment 1 (in sentence 3 above), can CMS make a further clarification to the preceding sentence (sentence 2 above) in the SOW to remove the reference to the MR Manager, given the MR Manager statement was clarified to be consistent with the CIO and SSO, such that it might read: The PM and CMD may serve as a designated back up, or in an ancillary capacity, on another RAC contract with CMS COR approval; they may not fulfill the role of a primary key personnel on another contract?

SOW updated to remove MR Manager from the second sentence.

V. Statement of Work Tasks, Task 10:

B. Initial Claim Upload 40 of 84

CMS states (on page 40): "The RAC shall delay sending ADRs until at least 60 calendar days after the claim paid date. This delay is necessary to minimize the likelihood of reviewing a claim that had a prepayment review done by a MAC."

Question: A prepayment review by a MAC for a claim would be complete prior to day zero (claim paid date) and if prepayment review is being performed, then an exclusion should be entered into the RACDW by the MAC. Can CMS clarify the statement to remove or revise the RAC delaying for 60 calendar days after the claim paid date?

CMS has designated this 60-day wait time to allow ample time for MACs to upload reviews into the RACDW.

SOW Questions

V. Statement of Work Tasks, Task 10:

G. Demand Letter Date and Demand

Amounts, F.

RACDW

Reporting of Identified Improper Payments

42 of 84, 41 of 84

CMS States (in paragraph F.) : "The RAC shall enter the necessary claim information and/or status updates within two business days of the event. The CMS will provide the specific format after contract award. All updates to the file format shall be shared with the RAC prior to implementation. The RAC shall use the current version of the RACDW claims upload file format."

CMS states (in paragraph G): "The RAC shall be responsible for uploading the finalized adjustment date. The RAC updates the RACDW with the date of MAC demand letter, as well as the demanded amount (negative values for underpayments). Because this information is provided to the RAC from the MAC, this information does not have to be uploaded into the RACDW within two business days of the Demand Letter date but should be entered by the RAC within 10 business days of receiving the information from the MAC."

In response to a previous question (E.2 Q&A - Responses to Amendment 1, Row 54), CMS states: "Please see updated SOW."

Question: While Paragraph F was updated per the previous question referenced, Paragraph G was not updated.

Can CMS also clarify Paragraph G (referenced above) to have the MAC responsible for these RACDW uploads since it relates to their source information, which allows for more accurate and real-time reporting in the RACDW. For Paragraph G, can CMS clarify to have the MAC update the RACDW with the finalized adjustment date as well as the demanded amount, instead of the RAC?

No.

Section Subsection Page number Contractors Question CMS Response none; N/A

Section Subsection Page number Contractors Question CMS Response none; N/A

MISC Questions

Attachments Questions

Questions