RFP_Document_-_75H70419R00033.pdf

Solicitation #: 75H70419R00033 Medicare Cost Reporting Services

SECTION B – PRODUCTS OR SERVICES AND PRICES/COSTS

B.1. TYPE OF CONTRACT (FAR 52.216-1 (APR 1984))

The Government contemplates award of a firm-fixed price contract resulting from this solicitation.

B.2. CONSIDERATION AND PAYMENT

The Contractor shall provide the commercial services described in Section C, Description/ Specifications/Work Statement. Except as otherwise specified in the contract, the Contractor shall furnish the necessary personnel, materials, services, facilities, and otherwise provide all tasks necessary for or incident to the performance of the work set forth herein.

B.3. CONTRACT PRICE

The total firm-fixed price of this contract is:

_______________ (Base Period)

______$25,000.00 (Base Period Travel, Not To Exceed)

_______________ (Option Period One)

______$25,000.00 (Option Period One Travel, Not To Exceed)

_______________ (Option Period Two)

______$25,000.00 (Option Period Two Travel, Not To Exceed)

_______________ (Option Period Three)

______$25,000.00 (Option Period Three Travel, Not To Exceed)

_______________ (Option Four)

______$25,000.00 (Option Period Four Travel, Not To Exceed)

_______________ TOTAL CONTRACT COST (Cumulative)

The Contractor shall be paid upon submission of an invoice and completion and acceptance (if deliverable) or verification (if service) by the Contracting Officer's Representative (COR), of the deliverables and/or services indicated below. Invoices shall be submitted in accordance with the instructions contained in FAR clause 52.232-25, Prompt Payment, and Section G.2 of this contract.

SECTION C – DESCRIPTION/SPECIFICATIONS/STATEMENT OF WORK

C. TITLE

Medicare Cost Reporting Services

C.1. BACKGROUND

The IHS provides comprehensive primary health care and disease prevention services to approximately 2.1 million American Indians and Alaska Natives through a network of over 632 hospitals, clinics, and health stations on or near Indian reservations. Facilities are predominantly located in rural primary care settings and are managed by IHS, Tribal, and Urban Indian health programs. The IHS provides a wide range of clinical, public health and community services primarily to members of 576 federally recognized Tribes. Under special legislative authority, Social Security Act (SSA), Title 18 and Title 19, the IHS is eligible for Medicare and Medicaid payment for services provided to these beneficiaries. The IHS is required to submit Medicare cost reports (Method A) to establish inpatient and outpatient Medicare and Medicaid rates used as the basis to set Medicare and Medicaid rates for reimbursement. Over $1 billion annually in collections from Medicare and Medicaid is used to maintain its current level of health care.

The IHS requires contract support services to complete 40 Medicare hospital cost reports, IHS wide management cost analyses, documented explanations of cost variances for determining the cost of delivering health care and developing specific reimbursement rates used by IHS, Tribal hospitals, and clinics. In addition, this includes allocating Headquarters (HQs) and Home Office costs to areas and hospital facilities. The Contractor must develop separate rates for 9 Critical Access Hospitals (CAH) based on a separate financial analysis. In order to properly allocate ancillary costs, the Contractor must conduct a chart cost audit to develop a statistical ratio split of ancillary costs between inpatient and outpatient service categories in Option Period 1 and Option Period 4 of the contract.

C.2. SCOPE OF WORK

The Contractor shall develop and deliver Medicare cost reports, management cost analyses, cost report variances/explanations, support to determine the cost of delivering health care and developing recommendations on cost of care for Medicare and Medicaid to support rate setting, CAH financial analysis, CMS Disproportionate Share Hospitals (DSH) Analysis, and an ancillary cost ratio development.

C.3. SPECIFIC REQUIREMENTS

C.3.1. Task 1: Monthly Progress Reports

The Contractor shall submit a monthly technical progress report to the Contracting Officer’s Representative (COR) within 10 calendar days after the end of each month. The report shall include a review of the activities by task undertaken to date; problems and barriers to implementation/completion that have arisen and agreed-upon solutions; and activities planned for the next month addressing scope of work deliverables.

C.3.2. Task 2: Medicare Method A - Hospital Cost Report Preparation

Medicare Method A - cost report preparation is the major portion on the work under the Contract. The Medicare cost reports are required by the Centers for Medicare and Medicaid Services (CMS) at all 40 hospitals in order to set IHS Medicare and Medicaid hospital rates. In addition, in order to allocate home office costs, the Contractor shall complete home office cost reports at HQs, 10 Area offices and 1 Tribal consortium, (Alaska Native Tribal Health Consortium), and 1 Tribal Organization (SCF).

The cost reports shall include all required worksheets to complete the Method A cost report for all-inclusive rate providers, accounting notes, and variance analysis and hospital workload data.

The sites below (in bold print) consist of both Federal operated and Tribal operated hospitals.

The IHS Financial Management Officer will certify the initial obligation data that is used to prepare the cost reports as “final” before the Contractor undertakes significant work. The IHS receives the initial obligation data by the end of October/early November of each contract year.

To ensure coordination, the IHS will supply at least one person as the main contact at each site and will provide necessary data using a uniform collection tool to be provided by the Contractor.

In addition to preparation of the cost reports, the Contractor shall compare fully allocated costs from IHS data on Worksheet B, Part 1, to the prior year cost report. Where significant variances are noted, further review of inquiry must be made and documented, including written responses to CMS and IHS upon request.

Financial data/obligations and any specific data requirements will be provided by IHS to the Contractor by November of each year. The Contractor shall base their time estimates for completion of the cost reports on this information provided by IHS in November of each year.

The Contractor shall provide an “Exit Conference” at the end of each site visit. The Contractor shall also follow-up with a call to these sites to answer any remaining questions. However, site reviews are not necessary for all facilities. Draft copies of work paper pages are sent for review by the facility and the Contractor shall document the major changes that affect any cost report work sheets.

The Contractor shall ensure conformity for the 40 cost reports per the Method-A model and provide uniform materials for collecting data. The IHS staff at the hospital will certify the draft cost reports.

The contractor shall provide responses from CMS audit staff upon their review of the cost report audits. The contractor shall be responded within 5 working days to CMS and IHS staff on follow up questions.

Locations are as follows:

LOCATION NAME

Rockville, MD IHS Headquarters

GREAT PLAINS AREA:

Eagle Butte, SD PHS Hospital – Eagle Butte Pine Ridge, SD Pine Ridge Hospital Belcourt, ND Quentin N Burdick Memorial

Hospital Rosebud, SD USPHS Hospital – Rosebud Aberdeen, SD Great Plains Area Office

ALBUQUERQUE AREA:

Albuquerque, NM (ACL) Acoma Canoncito Laguna Mescalero, NM Mescalero Indian Hospital Santa Fe, NM Santa Fe Indian Hospital Albuquerque, NM (Zuni) USPHS Hospital – Zuni Albuquerque, NM Albuquerque Area Office

BEMIDJI AREA:

Cass Lake, MN Cass Lake Indian Hospital Red Lake, MN PHS Indian Hospital – Red Lake Bemidji, MN Bemidji Area Office

BILLINGS AREA:

Browning, MT Blackfeet Community Hospital Crow Agency, MT (Billings, MT)

Crow/Northern Cheyenne Indian Hospital

Fort Belknap, MT Fort Belknap Service Unit Billings, MT Billings Area Office

NASHVILLE AREA:

Cherokee, NC Cherokee Indian Hospital Philadelphia, MS Choctaw Indian Hospital Nashville, TN Nashville Area Office

NAVAJO AREA:

Chinle, AZ Chinle Comprehensive Care Facility Crownpoint, NM Crownpoint Indian Hospital Fort Defiance, AZ Fort Defiance Indian Hospital Gallup, NM Gallup Indian Medical Center Farmington, NM (Shiprock) Northern Navajo Medical Center Tuba City, AZ Tuba City Medical Center Window Rock, AZ Navajo Area Office

OKLAHOMA:

Ada, OK Carl Albert Indian Health Facility

C.3.3. Task 3: Various Management Reports – Clinical Workload Compilation, Comparative Cost Analysis, and Medicare and Medicaid Rate Calculation

The Contractor shall extract information for the reports from the Medicare cost reports, national inpatient and outpatient workload data, Medicare and other legislation affecting or potentially affecting IHS revenue, ancillary costs reviews and studies and historical knowledge regarding IHS unit cost and Medicare and Medicaid method(s) of payment to IHS facilities.

As the Medicare cost reports are being completed, the Contractor shall gather information on workload from several National IHS data sources and compile information from each of the hospitals to identify Medicare and Medicaid billable workload. After the cost reports have been

Talihina, OK Choctaw Health Center Claremore, OK Claremore Indian Hospital Lawton, OK USPHS Hospital – Lawton Tahlequah, OK WW Hastings Memorial Hospital Oklahoma City, OK Oklahoma City Area Office

PHOENIX AREA:

Keams Canyon, AZ (Hopi) Hopi Health Care Center Gila River, AZ Hu Hu Kam Memorial Hospital Phoenix, AZ (Service Unit) Phoenix Indian Medical Center San Carlos, AZ San Carlos Indian Hospital Parker, AZ USPHS Hospital – Parker Whiteriver, AZ USPHS Hospital – Whiteriver Phoenix, AZ Phoenix Area Office

TUCSON AREA:

Tucson, AZ (Sells) Sells Public Health Indian Hospital Tucson, AZ Tucson Area Office

ALASKA AREA:

Anchorage, AK (Service Unit) Alaska Native Medical Center

(ANMC)

Anchorage, AK Southcentral Foundation Dillingham, AK Kanakanak Hospital (Bristol Bay) Kotzebue, AK Maniilaq Medical Center Sitka/Juneau, AK Mount Edgecumbe Hospital Barrow, AK Samuel Simmonds Memorial Hospital Bethel, AK Yukon-Kuskukwim Anchorage, AK Alaska Area Office

Anchorage, AK (ANTHC) Alaska Native Tribal Health Consortium completed, the Contractor shall summarize applicable cost report data elements and integrate IHS workload data to form a basis to evaluate and analyze cost of delivering health care in IHS facilities. This analysis is the basis for determining the per diem payments for Medicare and Medicaid inpatient and outpatient services.

The Contractor shall provide special expertise and assistance to help the IHS in its review and interpretation of the Medicare hospital cost reports planned for completion during the contracting period. The Contractor shall provide data analysis and integration of the Medicare and Medicaid workload with the Medicare hospital cost reports to assist in the development of individual hospital estimates of the costs for a wide range of inpatient and outpatient services. Based on this analysis, the Contractor shall assist IHS in evaluating alternatives for use in evaluating cost and to consider in the development of rates.

Management reports include:

1. Summary of payments made by the Medicare Fiscal Intermediary (FI) (from Program Summary and Reimbursement [PS&R]), data with a view toward identifying areas where additional revenue may be possible

2. Comparison of hospital cost, workload and unit cost for each hospital, Fiscal Years (FY) 2019-2024, where Medicare hospital cost reports were completed

3. A report evaluating interim Calendar Year (CY) inpatient and outpatient rates and revenue impacts for CAH facilities and recommending rate changes as appropriate

4. An evaluation of financial impact potential for the conversion of selected hospitals to CAH status

5. Developing outpatient visit workload and finalizing inpatient workload consistent with FY cost reports for the Lower 48 state facilities and Alaska

6. Questionnaires provided to facilities and templates used to prepare and complete cost reports provided electronically

7. Ancillary cost review and ratio development (only available for the Option Period 2 and Option Period 4, See Section C.3.7 Task 7).

C.3.4. Task 4: Disproportionate Share Hospital Reimbursement Calculation

Disproportionate Share Hospital Reimbursement is an add-on to DRG payments for hospitals that serve a large number of low-income patients for which virtually all IHS non-CAH hospitals qualify. One component for calculating the add-on is the number of Medicaid-eligible days. This has always been a complex undertaking but not needed for all but two of the IHS hospitals because the payment for hospitals under 100 beds was capped at 12%. The IHS cost reports submitted to CMS seldom, if ever, reported the number of Medicaid eligible days since the hospitals were paid prospectively without settlement or reconciliation of amounts due to or from Medicare from changes in DSH reimbursement. In FY14, the DSH reimbursement shifted to a two-part calculation. Twenty-five percent of the payment is based on the original method though the 12% cap was removed. The other seventy-five percent of the payment is based on the number of Medicaid days reported on previously submitted cost reports. The use of the Method A reporting allows the actual settlement or reconciliation of amounts due to/from Medicare.

Some of the IHS hospitals will benefit more than others but the overlap of patients among IHS hospitals makes it prudent to include as many patient databases as possible.

The following analysis is needed to determine the DSH reimbursement rate as part of the cost report development as follows:

• Obtain raw data for analysis from federal and tribal facilities

• Perform various data validation exercises to normalize the total patient data

• Verify patient Medicaid eligibility through third party vendor

• Analyze and test the validity of the Medicaid eligibility information obtained or received from third party vendors.

• Ensure patients identified as Medicaid by the Hospital have proper Medicaid eligibility information.

• Perform out-of-state eligibility analysis

• Perform separate analysis to match newborns with mother’s eligibility.

• Review and test proposed final eligibility results.

• Respond to any related audit questions by CMS Fiscal Intermediary by working with the hospitals to fulfill documentation requests and responding to questions.

C.3.5. Task 5: Critical Access Hospital (CAH) Analysis Reports

Currently, the number of CAHs is nine as of 2019. The contractor shall consider CAH requirements when conducting the cost reports and prepare and annual report to IHS of any recommended facilities that may benefit from converting to CAH hospital status. In order to project applicability of CAH conversion, this requires reports and analysis of the financial and workload data to include revenue projections for current CAHs and for other hospitals that meet the basic 25 or less bed requirements. Follow-up work may be necessary to address CAH audit finds by the Medicare FI. For potential sites, technical assistance must be provided to assist in the conversion to CAH. The Contractor shall develop a report summarizing selected information from the cost reports and information from the Medicare FI Payment System to assist IHS sites in evaluating the potential for converting and becoming a CAH and evaluating the impact of prior year conversion. Analysis may need to be conducted on a periodic basis to assist IHS in determining if certain facilities would benefit from a cost perspective by converting to CAH status.

C.3.6. Task 6: All Inclusive Rate (AIR) Calculation (Optional Task)

Under the authority of sections 321(a) and 322(b) of the Public Health Service Act (42 U.S.C. §§ 248 and 249(b)), Public Law 83-568 (42 U.S.C. § 2001(a)), and the Indian Health Care Improvement Act (25 U.S.C. 1601 et seq.), the IHS develops rates for inpatient and outpatient medical care provided by IHS facilities for Medicare and Medicaid beneficiaries, beneficiaries of other Federal programs, and for recoveries under the Federal Medical Care Recovery Act (42 U.S.C. §§ 2651-2653) on an annually. The contractor shall provide within 60 days following the end of the FY a detailed analysis based on the cost reports that have been developed and propose an annual AIR to be proposed for the following calendar year based on the previous year Medicare Cost Reports. The contractor shall work with IHS to develop briefing documents in support of the proposed rates to brief Senior IHS leadership, the Center for Medicaid and Medicare Services (CMS), the Department of Health and Human Services (HHS) and the Office of Management and Budget (OMB) to obtain approval of the proposed rate.

The inpatient rates for Medicare Part A shall be excluded from this rate, as Medicare inpatient payments for IHS hospital facilities are made based on the prospective payment system or reasonable costs when IHS facilities are designated as Medicare Critical Access Hospitals and are not considered as part of the AIR.

C.3.7. Task 7: Ancillary Ratio Development (Optional Task)

The objective of the ancillary cost study is to develop an ancillary ratio that is representative of the population, is statistically valid, auditable, and supportable with patient charts. Rather than utilizing 78 separate universes and 78 different sample selections (40 inpatient and 40 outpatients), the population should be a combination of all facilities into only four separate universes (Critical Access Hospitals and Non-Critical Access Hospitals). Samples will be selected from the following four subsets.

- Critical Access Hospital Inpatients

- Critical Access Hospital Outpatients

- Other Hospital Inpatients

- Other Hospital Outpatients

A total of the 2,220 patient charts shall be reviewed to document the cost relationship between an inpatient day and an outpatient visit. The total chart samples should include 1,067 inpatient charts and 1,153 outpatient charts should be reviewed for the nine CAH’s. Two sample frames for the CAH inpatient chart review be drawn and a second frame be utilized if the first review results in an outpatient to inpatient ratio above 60% or below 20%. Should the second sample frame review be necessary, the second frame ancillary outpatient ratio result should be utilized for the CAH’s.

For the non- CAH hospitals to be reviewed, a total of 749 inpatient charts and a total of 769 outpatient charts should be reviewed. It is believed that a 769 outpatient chart review or 95% confidence level is necessary because of the large variation in the size of each of the remaining hospitals.

Specific optional task requirements include:

A. Coding and pricing of ancillary services for all charts including inpatient charts (admissions) and outpatient charts (visits) provided by each facility in accordance with Medicare reimbursement rules to be provided by IHS. A certified coder is required to code all the charts.

Chart documentation must be maintained on coded charts with the summary file submitted.

B. A summary by Service Unit of each inpatient and outpatient cost by revenue code utilizing the guideline provided by IHS in excel format.

C. The Contractor shall provide an electronic record (copies) of the charts provided by the hospitals listing of charts by patient and specific medical coding and pricing by patient and revenue code to the Service Unit to enable CMS and/or the FI to review and audit if necessary.

D. The Contractor shall provide a summary of all facilities on excel spreadsheet. The Contractor shall also provide summary statistics for all facilities in excel format of evaluation and maintenance codes and revenue codes. The ancillary costs analysis shall include two face to face meetings with the COR for Option Period 1 and Option Period 4.

SECTION D – PACKAGING AND MARKING

D.1. PACKAGING

All deliverables shall be preserved, packaged, and packed in accordance with normal commercial practices to meet the packing requirements of the carrier including that which is necessary to prevent deterioration and damages due to the hazards of shipping, handling, and storing.

D.2. MARKING

Each package/container shall be delivered to the address shown in Section G.1.3 entitled “Contracting Officers’ Representative Appointment and Authority” and shall be clearly marked as follows:

A. Name of Contractor B. Contract Number C. Description of Items Contained Therein D. Consignee’s Name and Address

SECTION E – INSPECTION AND ACCEPTANCE

E.1. INSPECTION AND ACCEPTANCE

All work under this contract is subject to inspection and final acceptance by the Contracting Officer or the duly authorized representative of the government. The COR, as a duly authorized representative of the Contracting Officer, shall assume the responsibilities for monitoring the Contractor’s performance, evaluating the quality of services provided by the Contractor, and performing final inspection and acceptance of all deliverables and services called for by the contract.

E.2. FEDERAL ACQUISITION REGULATION (48 CFR CHAPTER 1) CLAUSES

FAR Clause No. Title and Date 52.246-04 Inspection of Services – Fixed Price (AUG 1996)

SECTION F – DELIVERIES OR PERFORMANCE

F.1 PERIOD OF PERFORNMANCE

The period of performance is a base period of 12 months with four (4) 12 month option periods, unless the period is extended by modification to this contract. The Government may exercise options to extend the period of performance in accordance with FAR Clause 52.217-9 – Option to Extend the Term of the Contract (MAR 2000); upon written notification by the Contracting Officer within 30 days of contract expiration.

The period of performance shall be as follows:

Base Period: 9/29/2019 through 9/28/2020 Option Period One: 9/29/2020 through 9/28/2021 Option Period Two: 9/29/2021 through 9/28/2022 Option Period Three: 9/29/2022 through 9/28/2023 Option Period Four: 9/29/2023 through 9/28/2024

F.2. PLACE OF PERFORMANCE

The Contractor shall perform the required services at the IHS hospitals and Area and Headquarters Offices including the following Government site:

U.S. Department of Health and Human Services Indian Health Service Office of Resource Access and Partnerships 5600 Fishers Lane Rockville, MD 20857

F.3. DELIVERABLE SCHEDULE

The Contractor shall submit the below deliverable items to the COR at the address shown in Section G.1.3.

Items specified for delivery below are subject to the review and approval of the COR prior to acceptance. The Contractor shall be required to make revisions deemed necessary by the COR.

Task: Deliverable: Due Date:

Kickoff Meeting Kick off call Within 5 working days of contract execution date

Monthly Progress Reports Monthly Status Report Within 10 calendar days after each month end

Business Associate Agreement, Confidentiality and Records Sharing Agreement, Required Trainings

BAA, CARSA, Required Trainings

Within 10 calendar days of the contract execution date.

Critical Access Hospital Cost Reports

Cost reports delivered to CMS February 28th each calendar year

Method A Cost Reports Cost reports delivered to CMS June 30th each FY Disproportionate Share Hospital Reimbursement Analysis Report

DSH analysis report annually 60 days following September 30 each year

Critical Access Hospital Analysis Report

CAH analysis report annually 60 days following September 30 each year

All Inclusive Rate Calculation AIR Analysis & Proposal 60 days following September 30 each year

Ancillary Ratio Analysis Report

Ancillary Ratio Analysis Report

60 days following September 30th in Option years 2 & 4.

F.4. DELIVERY REQUIREMENTS

When a deliverable due date occurs on a weekend or a Government holiday, the deliverable will be due on the following Government business day.

GOVERNMENT HOLIDAYS

New Year’s Day January 1 Martin Luther King’s Birthday Third Monday in January President’s Day Third Monday in February Memorial Day Last Monday in May Independence Day July 4 Labor Day First Monday in September Columbus Day Second Monday October Veteran’s Day November 11 Thanksgiving Day Fourth Thursday November Christmas Day December 25

SECTION G – CONTRACT ADMINISTRATION

G.1. AUTHORITIES OF GOVERNMENT PERSONNEL

Notwithstanding the Contractor’s responsibility for total management during the performance of this Contract, the administration of the Contract will require maximum coordination between the Government and the Contractor. The following individuals will be the Government’s points of contact during the performance of this Contract.

G.1.1. Contracting Officer

The IHS Contracting Officer is the only individual authorized to modify this Contract. The Contracting Officer responsible for administrative and contractual issues concerning this Contract is:

Kenneth Truesdale, Deputy Director – Division of Acquisition Policy Indian Health Service/ Division of Acquisition Policy 5600 Fishers Lane, M/S 09E70 Rockville, MD 20857 Phone: N/A Email: kenneth.truesdale@ihs.gov

All communications pertaining to contractual and/or administrative matters under the contract shall be sent to the address above and to the following Contract Specialist:

G.1.2. Contract Specialist

All Contract administration shall be performed by:

Brendon Moran, Contract Specialist Indian Health Service/Division of Acquisition Policy 5600 Fishers Lane, M/S 09E70 Rockville, MD 20857 Phone: N/A Email: brendon.moran@ihs.gov

G.1.3. Contracting Officer’s Representative Appointment and Authority

The name and address of the COR assigned to this project is:

Tina Conners, Contracting Officer’s Representative Indian Health Service/Office of Resource Access & Partnership 5600 Fishers Lane, M/S 09E70 Rockville, Maryland 20857 Phone: N/A; Fax: N/A; Email: tina.conners@ihs.gov mailto:kenneth.truesdale@ihs.gov mailto:brendon.moran@ihs.gov mailto:tina.conners@ihs.gov

Technical Monitoring:

a) Performance of work under this contract must be subject to the technical direction of the Contracting Officers’ Representative identified above, or a representative designated in writing.

The term “technical direction” includes, without limitation, direction to the contractor that directs or redirects the labor effort, shifts the work between work areas or locations, fills in details and otherwise serves to ensure that tasks outlined in the work statement are accomplished satisfactorily.

(b) Technical direction must be within the scope of the specification(s)/work statement.

The Contracting Officers’ Representative does not have authority to issue technical direction that:

(1) Constitutes a change of assignment or additional work outside the specification(s)/statement of work;

(2) Constitutes a change as defined in the clause entitled “Changes”;

(3) In any manner causes an increase or decrease in the contract price, or the time required for contract performance;

(4) Changes any of the terms, conditions, or specification(s)/work statement of the contract;

(5) Interferes with the contractor's right to perform under the terms and conditions of the contract; or

(6) Directs, supervises or otherwise controls the actions of the contractor's employees.

(c) Technical direction may be oral or in writing. The Contracting Officers’ Representative shall confirm oral direction in writing within five work days, with a copy to the Contracting Officer.

(d) The contractor shall proceed promptly with performance resulting from the technical direction issued by the Contracting Officers’ Representative. If, in the opinion of the contractor, any direction of the Contracting Officers’ Representative, or his/her designee, falls within the limitations in (b), above, the contractor shall immediately notify the Contracting Officer no later than the beginning of the next Government work day.

(e) Failure of the contractor and the Contracting Officer to agree that technical direction is within the scope of the contract shall be subject to the terms of the clause entitled “Disputes.”

G.2. INVOICE SUBMISSION

The Contractor shall submit invoices once per month. A complete invoice with all required back-up documentation shall be sent electronically via e-mail to:

1. Contract Specialist* (CS): Brendon Moran, brendon.moran@ihs.gov

2. Contracting Officer’s Representative (COR): Tina Conners,tina.conners@ihs.gov

3. Indian Health Service, Office of Finance & Accounting, HQInvoices@ihs.gov

* No other non-invoice related documents (i.e. deliverables, reports, balance statements) shall be sent to the CS or the Office of Finance & Accounting. Failure to submit directly to the offices listed above will delay prompt payment of your invoice.

mailto:brendon.moran@ihs.gov mailto:tina.conners@ihs.gov mailto:HQInvoices@ihs.gov

For invoices submitted by email: the subject line of your email invoice submission shall contain the contractor name, contract number, and invoice. The Contractor shall send one email per contract monthly. The email may have multiple invoices for the contract. Invoices must be in one of the following formats: PDF, TIFF, or Word. No Excel formats will be accepted. The electronic file cannot contain multiple invoices; example, 10 invoices requires 10 separate files (PDF, TIFF, or Word).

Additionally, the Contractor is required to include its Data Universal Numbering System (DUNS) number on each invoice. For additional information about the Dun & Bradstreet (D&B) DUNS number, please visit http://fedgov.dnb.com/webform.

Invoices shall be submitted in accordance with the contract terms, i.e. payment schedule, progress payments, partial payments, deliverables, etc.

All information set forth in FAR Clause 52.212-4(g), Invoice, must be included in all invoices for it to constitute a proper invoice.

FAR 52.212-4(g) Invoice.

(1) The Contractor shall submit an original invoice and three copies (or electronic invoice, if authorized) to the address designated in the contract to receive invoices. An invoice must include-

(i) Name and address of the Contractor;

(ii) Invoice date and number;

(iii) Contract number, contract line item number and, if applicable, the contract number;

(iv) Description, quantity, unit of measure, unit price and extended price of the items delivered;

(v) Shipping number and date of shipment, including the bill of lading number and weight of shipment if shipped on Government bill of lading;

(vi)Terms of any discount for prompt payment offered;

(vii) Name and address of official to whom payment is to be sent;

(viii) Name, title, and phone number of person to notify in event of defective invoice;

(ix) Taxpayer Identification Number (TIN). The Contractor shall include its TIN on the invoice only if required elsewhere in this contract.

(x) Electronic funds transfer (EFT) banking information.

(A) The Contractor shall include EFT banking information on the invoice only if required elsewhere in this contract.

(B) If EFT banking information is not required to be on the invoice, in order for the invoice to be a proper invoice, the Contractor shall have submitted correct EFT banking information in accordance with the applicable solicitation provision, contract clause (e.g., 52.232-33, Payment by Electronic Funds Transfer-Central Contractor Registration, or 52.232-34, Payment by Electronic Funds Transfer-Other Than Central Contractor Registration), or applicable agency http://fedgov.dnb.com/webform https://www.acquisition.gov/far/current/html/52_232.html#wp1153351 https://www.acquisition.gov/far/current/html/52_232.html#wp1153375 procedures.

(C) EFT banking information is not required if the Government waived the requirement to pay by EFT.

(2) Invoices will be handled in accordance with the Prompt Payment Act (31 U.S.C. 3903) and Office of Management and Budget (OMB) prompt payment regulations at 5 CFR Part 1315.

In accordance with OMB Memorandum, M-11-32, Agencies shall make payments to small businesses as soon as practicable, with the goal of making payments within 15 days of receipt of a proper invoice. If a small business contractor is not paid within this (15 day) accelerated period, the contractor will not be given a late-payment interest penalty. Interest penalties, as prescribed by the Prompt Payment Act, remain unchanged by means of this memorandum. All small businesses shall label all invoices as “Small Business.”

Additionally, in accordance with OMB Memorandum, M-12-16, all prime contractors are encouraged to disburse funds received from the Federal Government to their small business subcontractors in a prompt manner. To assist prime contractors in expediting contractor payments to small business subcontractors, Agencies shall, to the full extent permitted by law, temporarily establish an earlier, accelerated date for making agency payments to all prime contractors. Consistent with OMB Memorandum M-11-32 above, Agencies shall have a goal of paying all prime contractors within 15 days of receiving proper documentation. In an effort to support small business growth, drive economic activity and job creation, the Contractor is encouraged to accelerate payments to their small business subcontractors.

In accordance with the requirements of the Debt Collection Improvement Act of 1996, all payments under this contract will be made by electronic funds transfer (EFT). The Contractor shall provide financial institution information to the Finance Office designated above in accordance with FAR 52.232-33 Payment by Electronic Funds Transfer - Central Contractor Registration.

Failure to submit directly to the offices listed above will delay prompt payment of your invoice.

G.3. HHSAR 352.270-05 KEY PERSONNEL (JAN 2006)

The key personnel specified in this Contract are considered to be essential to work performance.

At least 30 days prior to diverting any of the specified individuals to other programs or Contracts (or as soon as possible, if an individual must be replaced, for example, as a result of leaving the employ of the Contractor), the Contractor shall notify the Contracting Officer and shall submit comprehensive justification for the diversion or replacement request (including proposed substitutions for key personnel) to permit evaluation by the Government of the impact on performance under this Contract. The Contractor shall not divert or otherwise replace any key personnel without the written consent of the Contracting Officer. The Government may modify the Contract to add or delete key personnel at the request of the Contractor or Government.

http://uscode.house.gov/uscode-cgi/fastweb.exe?getdoc+uscview+t29t32+1665+30++%2831%29%20%20AND%20%28%2831%29%20ADJ%20USC%29%3ACITE%20%20%20%20%20%20%20%20%20

The following labor categories are to be considered key personnel:

Name Title To be completed at time of award TBD

G.4. GOVERNMENT FURNISHED PROPERTY

The IHS will provide part-time office space and materials for one Contractor staff that focuses on management level reports, analysis of workload and rates, and reimbursement policy. The Contractor shall work on-site 1-3 days a week depending on the Government’s need.

Government property will include a desk chair, bookcase, telephone, and desktop computer. All property tags are in accordance with the IHS property system.

G.5. GOVERNMENT FURNISHED INFORMATION/REFERENCE MATERIALS

A. The IHS website (www.ihs.gov) for background information on Hospital and Clinic delivery system/goals of IHS, description of facilities, etc.

B. Existing Cost Reports from previous years

C. Information from CMS regulations on Method A (available at www.CMS.gov)

G.6. TRAVEL AND OTHER DIRECT COSTS

The Contractor shall work remotely from their home site/facility and as needed travel to the locations identified in section 6.2 to compete appropriate time studies in order to complete the requirements of the cost reports or to clarify any data obtained from the financial report data provided by IHS. All the data is accessible through the Unified Financial Management System and Resource Patient Management System, which can be accessed remotely. Travel to hospitals may be necessary to discuss and conduct time studies for various labor/cost categories.

Site visits may be necessary only when data issues arise that cannot be resolved remotely. The data for the Area Offices and HQ can be accessed remotely. Discussions with on-site staff at these sites may be necessary only when issues arise. Contractor Travel must be conducted in a responsible manner with minimized administrative costs so the resulting costs will be comparable to the rates identified via the Federal Travel Regulations (FTR). Travel will only be reimbursed at the applicable FTR rates determined via https://www.gsa.gov/travel/plan-book/per-diem-rates.

http://www.ihs.gov/ http://www.cms.gov/ https://www.gsa.gov/travel/plan-book/per-diem-rates https://www.gsa.gov/travel/plan-book/per-diem-rates

SECTION H – SPECIAL CONTRACT REQUIREMENTS

H.1. CONTRACTOR PERFORMANCE EVALUATION REPORT

During the life of this contract, Contractor performance will be evaluated on an interim and final basis pursuant to FAR Subpart 42.15. This evaluation shall become a part of the contract file and shall be used as past performance information in evaluating the Contractor’s, and any significant subcontractors’ or affiliates, past performance on future contracts. Contractor Performance Assessment Report System (CPARS) is an on-line reporting system https://www.cpars.gov/. The Contractor Performance Report is completed by the COR electronically and sent to the Contractor for review and approval at the end of each performance period as an interim report and at the end of the contract performance as a final report. After review by the Contracting Officer, the report becomes a permanent record of the Contractor’s past performance.

H.2. ELECTRONIC AND INFORMATION TECHNOLOGY ACCESSIBILITY

Pursuant to Section 508 of the Rehabilitation Act of 1973 (29 U.S.C. 794d), as amended by the Workforce Investment Act of 1998, all electronic and information technology (EIT) products and services developed, acquired, maintained, or used under this contract must comply with the “Electronic and Information Technology Accessibility Provisions” set forth by the Architectural and Transportation Barriers Compliance Board (also referred to as the “Access Board”) in 36 CFR part 1194. Information about Section 508 is available at www.section508.gov. The complete text of Section 508 Final Provisions can be accessed at www.access-board.gov/sec508/provisions.htm.

The Section 508 accessibility standards applicable to this contract are identified below in the HHSAR citation of 352.239-74(c). In the event of a modification(s) to this contract, which adds new EIT products or services or revises the type of, or specifications for, products or services the Contractor is to provide, including EIT deliverables such as electronic documents and reports, the Contracting Officer may require that the contractor submit a completed HHS Section 508 Product Assessment Template to assist the Government in determining that the EIT products or services support Section 508 accessibility standards. Instructions for documenting accessibility via the HHS Section 508 Product Assessment Template may be found under Section 508 policy on the HHS Office on Disability Web site www.hhs.gov/od.

This contract is subject to Section 508 of the Rehabilitation Act (the Act) of 1973 (29 U.S.C.

794d), as amended by the Workforce Investment Act of 1998, and the Architectural and Transportation Barriers Compliance Board (Access Board) Electronic and Information Accessibility Provisions (36 CFR Part 1194). Section 508 of the Act requires that, unless an exception applies, all communications products and services that require a contractor or consultant to produce content in any format that is specifically intended for publication on, or delivery via, a Federal owned or Federal funded Web site permit the following:

(1) Federal employees with disabilities to have access to and use information and data that is comparable to the access and use of information and data by Federal employees who https://www.cpars.gov/ http://www.section508.gov/ http://www.hhs.gov/od are not individuals with disabilities.

(2) Members of the public with disabilities seeking information or services from a Federal agency to have access to and use of information and data that is comparable to the access and use of information and data by members of the public who are not individuals with disabilities.

(Note: Information about Section 508 of the Act is available at http://www.section508.gov/ . The complete text of Section 508 can be accessed at http://www.access-board.gov/sec508/provisions.htm.)

Accordingly, regardless of format, all Web content or communications materials specifically produced for publication on, or delivery via, HHS Web sites, including text, audio, or video, under this contract shall conform to applicable Section 508 accessibility standards. Remediation of any materials that do not comply with the applicable accessibility standards of 36 CFR Part 1194 as set forth herein shall be the responsibility of the Contractor.

This language is applicable to Statements of Work (SOW) or Performance Work Statements (PWS) generated by the Department of Health and Human Services (HHS) that require a contractor or consultant to (1) produce content in any format that could be placed on a Department-owned or Department-funded Web site; or (2) write, create or produce any communications materials intended for public or internal use; to include reports, documents, charts, posters, presentations (such as Microsoft PowerPoint) or video material that could be placed on a Department-owned or Department-funded Web site.

All contractors (including subcontractors) or consultants responsible for preparing or posting content intended for use on an HHS-funded or HHS-managed Web site must comply with applicable Section 508 accessibility standards, and where applicable, those set forth in the referenced policy or standards documents below.

The following Section 508 provisions apply to the content or communications material identified in the SOW (or PWS):

36 CFR 1194.21(a)-(j) References:

• HHS Policy for Section 508 Electronic and Information Technology (E&IT) (January 2005):

http://www.hhs.gov/od/Final_Section_508_Policy.html

• HHS Section 508 Web site: http://508.hhs.gov/

• HHS ASPA Web Communications Division Web site:

http://www.hhs.gov/web/policies/index.html

• US General Services Administration (GSA) Section 508 Web site:

http://www.section508.gov/index.cfm http://www.section508.gov/ http://www.access-board.gov/sec508/provisions.htm http://www.access-board.gov/sec508/provisions.htm http://www.hhs.gov/od/Final_Section_508_Policy.html http://508.hhs.gov/ http://www.hhs.gov/web/policies/index.html http://www.section508.gov/index.cfm

HHSAR 352.239-73

Electronic and Information Technology Accessibility Notice (December 18, 2015)

(a) Section 508 of the Rehabilitation Act of 1973 (29 U.S.C. 794d), as amended by the Workforce Investment Act of 1998 and the Architectural and Transportation Barriers Compliance Board Electronic and Information (EIT) Accessibility Standards (36 CFR part 1194), require that when Federal agencies develop, procure, maintain, or use electronic and information technology, Federal employees with disabilities have access to and use of information and data that is comparable to the access and use by Federal employees who are not individuals with disabilities, unless an undue burden would be imposed on the agency. Section 508 also requires that individuals with disabilities, who are members of the public seeking information or services from a Federal agency, have access to and use of information and data that is comparable to that provided to the public who are not individuals with disabilities, unless an undue burden would be imposed on the agency.

(b) Accordingly, any offeror responding to this solicitation must comply with established HHS EIT accessibility standards. Information about Section 508 is available at http://www.hhs.gov/web/508. The complete text of the Section 508 Final Provisions can be accessed at http://www.access-board.gov/guidelines-and-standards/communications-and-it/about-the-section-508-standards.

(c) The Section 508 accessibility standards applicable to this solicitation are stated in the clause at 352.239- 74, Electronic and Information Technology Accessibility.

In order to facilitate the Government’s determination whether proposed EIT supplies meet applicable Section 508 accessibility standards, offerors must submit an HHS Section 508 Product Assessment Template, in accordance with its completion instructions. The purpose of the template is to assist HHS acquisition and program officials in determining whether proposed EIT supplies conform to applicable Section 508 accessibility standards. The template allows offerors or developers to self-evaluate their supplies and document—in detail—whether they conform to a specific Section 508 accessibility standard, and any underway remediation efforts addressing conformance issues. Instructions for preparing the HHS Section 508 Evaluation Template are available under Section 508 policy on the HHS website http://www.hhs.gov/web/508.

In order to facilitate the Government’s determination whether proposed EIT services meet applicable Section 508 accessibility standards, offerors must provide enough information to assist the Government in determining that the EIT services conform to Section 508 accessibility standards, including any underway remediation efforts addressing conformance issues.

(d) Respondents to this solicitation must identify any exception to Section 508 requirements. If a offeror claims its supplies or services meet applicable Section 508 accessibility standards, and it is later determined by the Government, i.e., after award of a contract or order, that supplies or services delivered do not conform to the described accessibility standards, remediation of the supplies or services to the level of conformance specified in the contract will be the responsibility of the Contractor at its expense.

*NOTE: The HHS Section 508 Product Assessment Template has been replace by the Information Technology Industry Council’s Voluntary Product Accessibility Template (VPAT®) which can be found at:

https://www.itic.org/policy/accessibility/vpat https://www.hhs.gov/web/508 http://www.access-board.gov/guidelines-and-standards/communications-and-it/about-the-section-508-standards http://www.access-board.gov/guidelines-and-standards/communications-and-it/about-the-section-508-standards https://www.hhs.gov/grants/contracts/contract-policies-regulations/hhsar/part-352-solicitation-provisions-contract-clauses/index.html#352.239-74 https://www.hhs.gov/grants/contracts/contract-policies-regulations/hhsar/part-352-solicitation-provisions-contract-clauses/index.html#352.239-74 https://www.hhs.gov/web/508 https://www.itic.org/policy/accessibility/vpat

The included standards that must be met for this contract are taken from the following two resources. Compliance with these standards is mandatory for Federal agencies subject to Section 508 of the Rehabilitation Act of 1973, as amended (29 U.S.C. 794d).

Section 508 Standards and Guidelines: https://www.access-board.gov/guidelines-and-standards/communications-and-it/about-the-ict-refresh/final-rule/text-of-the-standards-and-guidelines

Web Content Accessibility Guidelines (WCAG) 2.0: https://www.w3.org/TR/WCAG20/

• Appendix A – Section 508 of the Rehabilitation Act: Application and Scoping Requirements o E101.2 – Equivalent Facilitation o E203 – Access to Functionality o E204 – Functional Performance Criteria o E205 – Electronic Content

For Web Based Content, Electronic Content or Documentation

• WCAG – All WCAG 2.0 A & AA Success Criteria

EXCEPTION:

Non-Web documents shall not be required to conform to the following four WCAG

2.0 Success Criteria: 2.4.1 Bypass Blocks, 2.4.5 Multiple Ways, 3.2.3 Consistent Navigation, and 3.2.4 Consistent Identification.

E205.4.1 Word Substitution when Applying WCAG to Non-Web Documents. For non-Web documents, wherever the term “Web page” or “page” appears in WCAG

2.0 Level A and AA Success Criteria and Conformance Requirements, the term “document” shall be substituted for the terms “Web page” and “page”. In addition, in Success Criterion in 1.4.2, the phrase “in a document” shall be substituted for the phrase “on a Web page”.

• Appendix A – Section 508 of the Rehabilitation Act: Application and Scoping Requirements o E208 Support Documentation and Services

• Appendix C – Functional Performance Criteria and Technical Requirements o 302 - Functional Performance Criteria o 602 – Support Documentation o 603 – Support Services

• Electronic content must be accessible to HHS acceptance criteria. Checklist for various formats are available at http://508.hhs.gov, or from the IHS Section 508 Coordinator listed at https://www.hhs.gov/web/section-508/additional-resources/section-508-contacts/index.html, (email: IHSSection508@ihs.gov). Materials that are final items for delivery should be accompanied by the appropriate checklist, except upon approval of the Contracting Officer or Representative.

https://www.access-board.gov/guidelines-and-standards/communications-and-it/about-the-ict-refresh/final-rule/text-of-the-standards-and-guidelines https://www.access-board.gov/guidelines-and-standards/communications-and-it/about-the-ict-refresh/final-rule/text-of-the-standards-and-guidelines https://www.access-board.gov/guidelines-and-standards/communications-and-it/about-the-ict-refresh/final-rule/text-of-the-standards-and-guidelines https://www.w3.org/TR/WCAG20/ http://508.hhs.gov/ https://www.hhs.gov/web/section-508/additional-resources/section-508-contacts/index.html https://www.hhs.gov/web/section-508/additional-resources/section-508-contacts/index.html

HHSAR 352.239-74

Electronic and Information Technology Accessibility (December 18, 2015)

(a) Pursuant to Section 508 of the…