AD180727 CMS Reporting RFB.docx

State of Wisconsin Wis. Statutes s.16.75

DOA-3070 (R05/2014)

Department of Administration Consolidated Agency Purchasing Services 101 E Wilson Street, 6th Floor Madison, WI 53703 If using PO Box: P.O. Box 7867, 53707-7867 Late Bids will be rejected. Bids MUST be date and time stamped by the soliciting purchasing office on or before the date and time that the Bid is due. Bids dated and time stamped in another office will be rejected. Receipt of a Bid by the mail system does not constitute receipt of a Bid by the purchasing office. Any Bid which is inadvertently opened as a result of not being properly and clearly marked is subject to rejection. Bids must be submitted separately, i.e., not included with sample packages or other Bids. Bid openings are public unless otherwise specified. Records will be available for public inspection after issuance of the notice of intent to award or the award of the contract. Bidder should contact the person named below for an appointment to view the Bid record. Bids shall be firm for acceptance for sixty (60) days from date of Bid opening, unless otherwise noted. The attached terms and conditions apply to any subsequent award.

REQUEST FOR BID # AD180727

THIS IS NOT AN ORDER

BIDDER (Name and Address) Bids MUST be in this office no later than

Name (Contact for further information)

Amber Rademacher

Quote Price and Delivery FOB

Destination

Item No.

Quantity and Unit

Per Unit

Total

REQUEST FOR BID

Workers’ Compensation Center for Medicare Reporting Compliance Services (CMS Reporting)

LATE BIDS SHALL BE REJECTED

FAXED OR EMAILED BIDS ARE NOT ACCEPTED

|_| We claim minority Bidder preference [Wis. Stats. s. 16.75(3m)(b)(3)]. Under Wisconsin Statutes, a 5% preference may be granted to CERTIFIED Minority Business Enterprises. Bidder must be certified by the Wisconsin Supplier Diversity Program. If you have questions concerning the certification process, contact the Wisconsin Supplier Diversity Program, 6th Floor, 101 E. Wilson St., Madison, Wisconsin 53703, (608) 267-9550. Does Not Apply to Printing Bids.

|_| We claim disabled veteran owned business Bidder preference [Wis. Stats. s. 16.75(3m) (b)(3)]. Under Wisconsin Statutes, a 5% preference may be granted to CERTIFIED Disabled Veteran Owned Businesses. Bidder must be certified by the Wisconsin Supplier Diversity Program. If you have questions concerning the certification process, contact the Wisconsin Supplier Diversity Program, 6th Floor, 101 E. Wilson St., Madison, Wisconsin 53703, (608) 267-9550. Does Not Apply to Printing Bids.

|_| We are a work center certified under Wis. Stats. s. 16.752 employing persons with severe disabilities. Questions concerning the certification process should be addressed to the Work Center Program, State Bureau of Procurement, 6th Floor, 101 E. Wilson St., Madison, Wisconsin 53702, (608) 266-5462.

Wis. Stats. s. 16.754 directs the state to purchase materials which are manufactured to the greatest extent in the United States when all other factors are substantially equal. Materials covered in our Bid were manufactured in whole or in substantial part within the United States, or the majority of the component parts thereof were manufactured in whole or in substantial part in the United States. |_| Yes |_| No |_| Unknown

In signing this Bid we also certify that we have not, either directly or indirectly, entered into any agreement or participated in any collusion or otherwise taken any action in restraint of free competition; that no attempt has been made to induce any other person or firm to submit or not to submit a Bid; that this Bid has been independently arrived at without collusion with any other Bidder, competitor or potential competitor; that this Bid has not been knowingly disclosed prior to the opening of Bids to any other Bidder or competitor; that the above statement is accurate under penalty of perjury.

We will comply with all terms, conditions and specifications required by the state in this Request for Bid and all terms of our Bid.

This form can be made available in alternate formats to individuals with disabilities upon request.

INSTRUCTIONS TO BIDDERS

You received this Request for Bid (RFB) because of the NIGP codes selected during your registration on the State of Wisconsin’s VendorNet system. If you received this RFB in any other way, please contact the purchasing agent identified in this RFB. You may also register to become a Bidder at: https://vendornet.wi.gov/. This RFB contains all necessary statutory language required by law. It is organized to help you determine if this is a business opportunity for your company. The RFB contains information regarding what the State intends to purchase, how pricing should appear and describes a clear process you must follow in order to submit a response to the RFB.

1. Review Section 1.0, “Introduction and Purpose” to gain a general understanding of what the State intends to purchase. Reviewing this section will help you determine your ability to meet the Procuring Agency’s needs.

2. Review Section 2.0 “Bidder Qualifications and Requirements” section. This section will explain what a company needs in order to provide the commodity or service. This may include a specific license or certification, a history of providing this commodity or service in a similar environment to the State or for you to be in a prescribed geographical location. Reviewing this section will help you determine your ability to meet the Procuring Agency’s needs.

3. The details of the commodity or service will be found in Section 3.0, “Mandatory Required Specifications of Bid.” Read this section carefully and determine if your product meets ALL requirements. RFB requirements are mandatory and therefore, if you can’t meet a requirement, it is likely that your Bid will be rejected unless no Bidder can meet an individual RFB requirement. Reviewing this section will help you determine your ability to meet the Procuring Agency’s needs.

4. Review Section 5.0, “Pricing Structure and Price Sheet.” This section explains how to submit Bid pricing (which is critical because the Bid pricing will determine what Bidder(s) will be allowed to enter into a Contract with the State).

5. The remaining sections of the RFB describe the process you must follow and the way you must present your Bid to the State. It also describes the process the State will use to determine the winning Bidder. If you decide to Bid, be sure to review the “Bid Procedure and Instructions” section and the “Bid Acceptance and Award” section.

6. Please note, your Bid response must be complete and accurate. You must follow all instructions exactly as asked. DO NOT substitute your own materials in lieu of what is being asked in the RFB. DO NOT alter any of the forms or the price sheet. If you have questions, contact the Procurement Manager identified in the RFB.

7. Your RFB response must arrive at the proper location before the due date and time. Late Bids will be rejected.

Thank you for your interest in providing commodities and/or services to the State. We wish you success with this and future procurement opportunities.

TABLE OF CONTENTS

1.0 INTRODUCTION AND PURPOSE

1.1 DEFINITIONS

For the purposes of this Request for Bid and resulting Contract(s), the following definitions of terms shall apply, unless otherwise indicated.

1.2 PURPOSE AND SCOPE OF THE REQUEST FOR BID

The State of Wisconsin as represented by the Department of Administration, Bureau of State Risk Management requests Bids for Workers’ Compensation Center for Medicare Reporting Compliance Services (CMS Reporting Services), and intends to use the results of this process to award a Contract. The State does not guarantee it shall purchase any specific quantity or dollar amount. Bids that require a minimum number of commodities or services be ordered shall be rejected. There shall be no guarantee to purchase any specific quantity, or pay any minimum Contract price during the term of the Contract.

The State seeks a Contractor to assure the State of Wisconsin’s compliance with the Federal Government’s reporting requirements associated with changes to Section 111 of the Medicare, Medicaid and SCHIP Extension Act of 2007 (MMSEA) which added new mandatory requirements for workers’ compensation including self-insurance, no-fault insurance and liability insurance reporting. Under MMSEA and effective April 1, 2010, the State of Wisconsin is required to submit reports of payments on specific claims to the U.S. Department of Health and Human Services, Center for Medicare and Medicaid Services (CMS).

1.3 CURRENT OPERATIONS

The State of Wisconsin self-funds and administers the workers’ compensation, property and liability programs for all State and University employees and agencies. The program is managed by the Department of Administration (DOA), Division of Enterprise Operations, Bureau of State Risk Management (BSRM). BSRM delegates management of workers’ compensation claims for and to the University of Wisconsin System and directly manages claims for all other state agencies.

BSRM runs an adhoc report using specific criteria to pull out all claims to query with CMS. BSRM runs and submits this report to the Contractor daily. The Contractor in turn uploads the claims into the CMS site, monthly. CMS sends a return file back to the Contractor within 7-10 business days of submission. The Contractor will then review response file and send spreadsheet back to BSRM containing only claims that are matched in CMS and require additional information to be updated in CMS. BSRM then logs into the Contractors site directly and updates the claims with the additional information. The Contractor will submit these same claims again to CMS the following month.

Criteria used to identify claims to query: Date of Loss, Claim type is in the list of Lost Time, Hazardous Duty, Medical only, Total paid is over $750.00; State of Wisconsin will also use Contractors web portal to update termination dates and other claim information as requested by CMS.

1.4 CONTRACT TERM

This Contract shall run for an initial three (3) year period. BSRM and the Contractor, upon written mutual agreement, may renew the Contract for up to an additional two (2), one (1) year periods. The Contract shall be effective on the date it is executed by BSRM. If no formal Contract is executed, the effective date of the Contract is the date of the purchase order.

The RFB documents, the awarded Bidder’s response as accepted by BSRM and any purchase order related to this RFB shall become the Contract between the parties unless a separate Contract is executed.

1.5 MODIFICATIONS OF CONTRACT

The Contract shall not be used for purchasing commodities or services outside of the general scope and intent of the original Request for Bid. Any modifications made to the Contract shall fall within the scope of the Bid and be rendered in writing and signed by both parties or they shall be void.

1.6 ORDER OF PRECEDENCE

In the event of Contract award, the contents of this RFB (including all attachments), RFB addenda and revisions, the Bid response from the successful Bidder as accepted by BSRM, and any additional terms agreed to in writing by the parties shall be incorporated into the Contract. Failure of the successful Bidder to accept these elements into the Contract shall result in the cancellation of the Contract award.

In the event of conflict with the incorporated elements of the Contract, the following order of precedence shall prevail:

Final Signed Contract with clarifications included Official Purchase Order Bid Response as accepted by the State of Wisconsin Request for Bid

1.7 COOPERATIVE PURCHASING SERVICES

Commodities and services may be made available to Municipalities upon agreement of the Contractor. See Vendor Agreement-Wisconsin’s Cooperative Purchasing Services (DOA-3333), for definitions and other information on Municipalities. Municipalities shall be able to obtain the commodities and services procured under the Contract at the same rates agreed to by BSRM and the Contractor. The Contractor shall be responsible for confirming the status of potential Municipalities with BSRM and providing appropriate documentation and support and reporting Contract usage by Municipalities (see Vendor Agreement – Wisconsin’s Cooperative Purchasing Services, DOA-3333 attached to this RFB).

2.0 BIDDER QUALIFICATIONS & REQUIREMENTS

All Bidder qualifications in this section are mandatory. Failure to meet a qualification shall disqualify your Bid. However, BSRM reserves the right to waive any qualification if no Bidder is able to satisfy that qualification.

Before the award of any Contract, the Department shall be satisfied that the Bidder has sufficient qualified resources available for performing the work described in this Bid. It is the Bidder’s responsibility to acquaint the Department with these qualifications by submitting appropriate or supporting documentation.

2.1 Bidder shall have two (2) years’ experience in providing CMS reporting services to other Workers Compensation Carriers, self-insured or third party Workers Compensation Administrators.

3.0 MANDATORY REQUIRED SPECIFICATIONS OF BID

All requirements in this section are mandatory. The following requirements shall be met at no additional cost above the pricing provided in the Bid. All Specifications are defined as minimum mandatory requirements unless otherwise stated. Failure to meet any mandatory requirement shall result in rejection of the Bid. However, if no Bidder is able to meet an individual mandatory requirement, the State reserves the right to continue the review of Bids and to select the Bid that most closely meets the requirements specified in this RFB.

3.1 Pursuant to 2009 Wisconsin Act 136 [§16.705(1r), Wis. Stats.], the services outlined in RFB AD180727 shall be performed within the boundaries of the United States. The inability to perform services in the United States shall be grounds for disqualifying your Bid for this Contract.

3.2 Contractor shall assist BSRM in claims identification, isolating and reporting procedures and processes for the State’s self-funded Workers’ Compensation Program to be compliant with all regulations of the U.S. Department of Health and Human Services, Center for Medicare (CMS) reporting requirements within the provisions of Wisconsin’s Workers’ Compensation law.

3.3 Contractor shall perform data queries against CMS using data feeds specified and provided by BSRM.

3.4 Contractor shall have a Secured Web Based System which shall allow BSRM users with access to and ability to submit direct data entry into this system for claims previously queried and meeting the mandatory reporting thresholds set forth in MMSEA Section 111 Reporting.

3.5 Contractor shall submit Medicare eligible State Workers Compensation claim information reports to CMS on a quarterly basis.

3.6 Contractor shall supply all necessary administrative forms and one (1) copy of any administrative manual for each Workers’ Compensation employee of BSRM and University Wisconsin System (approximately 30), and supply additional manuals for new employees as needed. These reference materials shall include, but are not limited to, instructions for identifying potential CMS qualified claims, and mandatory fields required in the Contractor’s web based system and Contractor’s contact information.

3.7 Contractor shall interact with CMS to monitor federal government regulatory and non-regulatory changes and keep the State informed. Contractor shall change procedures and processes as needed for the State to remain fully compliant with CMS requirements.

3.8 Contractor shall be required to retain all claim records for seven (7) years from the date of each case review or interaction.

3.9 Contractor shall provide management reports, such as claims registered with CMS, and report formats as required by the State at the end of each quarter (see Attachment C – Quarterly Report Format).

3.10 Contractor shall provide hours of operation for telephone and email inquiries Monday through Friday 8:00 am CT through 5:00 pm. CT.

3.11 Contractor shall assist BSRM in identifying diagnostics codes and ICD-10/ICD-11 codes for CMS to minimize the rejection of claims.

3.12 Contractor shall respond to the State and CMS on all disputes originating from any sources regarding action the Contractor has taken to identify and report on claims submitted to CMS.

3.13 Contractor shall inform BSRM within 24 hours of Contractor’s knowledge of any failures in meeting CMS reporting requirements.

3.14 Contractor shall accept transferred State data from incumbent Contractor within thirty (30) of the contract expiration.

4.0 SPECIAL TERMS AND CONDITIONS OF BID

4.1 BACKGROUND CHECKS

Due to the nature of this solicitation BSRM reserves the right to conduct background checks on the organization, its officers and employees, and subcontractors, if applicable in order to determine whether any conviction exists that is substantially related to the solicited commodity or service, or if such conviction may otherwise adversely affect the Bidder’s ability to perform under the resulting Contract. The State is the sole determinant of whether the results of a background check(s) shall negatively impact the Contractor’s ability to meet contractual obligations and requirements.

4.2 PAYMENT TERMS

Payment shall not be made until the quarterly reports are determined to meet all Specifications, requirements and deliverables and have been accepted by BSRM.

4.3 CERTIFICATES OF INSURANCE

At the time that the Notice of Intent to Contract is issued, the winning Contractor shall be required to provide copies of applicable insurance certificates. The Agency shall evaluate all insurance certificates for compliance. Should the Contractor not provide the appropriate Certificates of Insurance within thirty (30) days of the State’s issuance of the Notice of Intent to Contract, the Contractor shall be given an additional seven (7) days to comply. Should the appropriate Certificates of Insurance not be received within that time, the State reserves the right to cancel the award or Contract and make another award.

4.4 DATA OWNERSHIP

The State of Wisconsin shall own the rights to all data/records produced as part of the Contract. Contractor shall deliver sufficient technical documentation with all data deliverables to permit the State to use the data as requested and/or at the completion of the Contract term.

4.5 HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA)

As a condition of receiving a Contract from the Department, the Contractor, and any Subcontractor(s) shall be required to comply and sign a Business Associate Agreement. A copy is attached on VendorNet for informational purposes. See Attachment D – Business Associate Agreement.

“Protected Health Information” (PHI) means any information, whether oral or recorded in any form or medium, that:

· Is created or received by a health care provider, health plan, public health authority, employer, life insurer, school or university, or health care clearinghouse; and

· Relates to the past, present, or future physical or mental health or condition of an individual, the provision of health care to an individual; or the past, present, or future payment for the provision of health care to an individual.

The Contractor, and any Subcontractor(s) shall comply with 42 U.S.C. Sections 1320d through 1320d-8, and shall implement regulations at 45 C.F.R. Section 164.502 (e) and Sections 164.504 (e) regarding disclosure of protected health information under the Health Insurance Portability and Accountability Act (HIPAA) of 1996. Protected Health Information (PHI) is information received by the Contractor from or on behalf of the State that meets the definition of PHI as defined by HIPAA and the regulations promulgated by the United States Department of Health and Human Services.

HIPAA compliance requires, at a minimum, that the Contractor:

· Shall not use or disclose PHI except as specifically required under the terms of this Contract, or as otherwise required under the HIPAA regulations or other applicable law.

· Shall use appropriate safeguards to protect against use or disclosure not provided for by this Contract.

· Shall promptly report to the State any knowledge of uses or disclosures of PHI that are not in accordance with this Contract or applicable law. In addition, the Contractor shall mitigate any adverse effects of such a breach to the extent possible.

· Shall ensure that all its Contracted Personnel that receive PHI from or on behalf of the Contractor and/or the State agree to the same restrictions and conditions that apply to Contractor with respect to the use or disclosure of PHI.

· Shall make available to the State such information as the State may require to fulfill its obligations to provide access to, provide a copy of, and account for disclosures with respect to PHI pursuant to HIPAA and related regulations.

· Shall make PHI available to the State in order for the State to fulfill its obligations pursuant to HIPAA to amend the information and shall, as directed by the State, incorporate any amendments into the information held by its Contracted Personnel.

· Shall make available its internal practices, books and records relating to the use and disclosure of PHI received from the State, or created and received by the Contractor on behalf of the State, to the State and to the Secretary of the U.S. Department of Health and Human Services for the purpose of determining the State’s compliance with HIPAA and the regulations promulgated by the United States Department of Health & Human Services and any amendment thereto. Shall, upon termination of this Contract, at the option of the State, return to the State, or destroy, all PHI in its possession, and keep no copies of the information except as requested by the State or required by law. If the Contractor’s Contracted Personnel destroy any PHI, then the Contractor shall provide the State with documentation evidencing such destruction. Any PHI maintained by the Contractor shall continue to be extended the same as required by HIPAA and the State for as long as it is maintained. In the event of a material breach of Contractor’s obligations under this Section, the State may at its option, terminate this Contract according to the termination provisions within this Contract.

4.6 CANCELLATION AND TERMINATION

4.6.1 TERMINATION FOR CAUSE

The State may terminate this Contract after providing the Contractor with thirty (30) calendar days written notice of the Contractor’s right to cure a failure of the Contractor to perform under the terms of this Contract.

The Contractor may terminate this Contract after providing the State one hundred and twenty (120) calendar days’ notice of the State’s right to cure a failure of the State to perform under the terms of this Contract.

Upon the termination of this Contract for any reason, or upon Contract expiration, each party shall be released from all obligations to the other party arising after the date of termination or expiration, except for those that by their terms survive such termination or expiration.

4.6.2 TERMINATION FOR CONVENIENCE

Either party may terminate this Contract at any time, without cause, by providing a written notice; the State by providing at least thirty (30) calendar days’ notice to the Contractor, and the Contractor providing at least one hundred and twenty (120) calendar days’ notice to the State in advance of the intended date of termination.

In the event of termination for convenience, the Contractor shall be entitled to receive compensation for any fees owed under the Contract. The Contractor shall also be compensated for partially completed Services. In this event, compensation for such partially completed Services shall be no more than the percentage of completion of the Services requested, at the sole discretion of the State, multiplied by the corresponding payment for completion of such Services as set forth in the Contract. Alternatively, at the sole discretion of the State, the Contractor may be compensated for the actual Service hours provided. The State shall be entitled to a refund for goods or services paid for but not received or implemented, such refund to be paid within 30 days of written notice to the Contractor requesting the refund.

4.6.3 CONTRACT CANCELLATION

The State reserves the right to cancel this Contract in whole or in part without penalty if the Contractor:

· Fails to perform any material obligation required under the Contract

· Files a petition in bankruptcy, becomes insolvent, or otherwise takes action to dissolve as a legal entity

· Allows any final judgment not to be satisfied or a lien not to be disputed after a legally-imposed, 30-day notice.

· Makes an assignment for the benefit of creditors

· Fails to follow the sales and use tax certification requirements of s. 77.66 of the Wisconsin Statutes

· Incurs a delinquent Wisconsin tax liability

· Fails to submit a non-discrimination or affirmative action plan as required in the Standard Terms and Conditions (DOA-3054)

· Fails to follow the non-discrimination or affirmative action requirements of subch. II, Chapter 111 of the Wisconsin Statutes (Wisconsin’s Fair Employment Law)

· Becomes a federally debarred Contractor

· Is excluded from federal procurement and non-procurement contracts

· Fails to maintain and keep in force all required insurance, permits and licenses as provided in this Contract

· Fails to maintain the confidentiality of the State’s information that is considered to be Confidential Information, proprietary, or containing Personally Identifiable Information

· Contractor performance threatens the health or safety of a State employee or State customer.

5.0 PRICING STRUCTURE & PRICE SHEET INSTRUCTIONS

5.1 METHOD OF BID

Bidder shall submit a net unit price and, if applicable, an extended net total for each item specified. Prices shall be in U.S. dollars unless otherwise indicated. In the event of errors in calculation, unit price shall prevail.

Bidder shall use Attachment A – Price Sheet to submit the Total Price Per Claim.

5.2 PRICE SHEET INSTRUCTIONS

Bidders shall complete the attached Price Sheet(s). Bidders shall not alter the Price Sheet in any manner unless instructions on the Price Sheet indicate otherwise. Alternate pricing formats shall not be accepted, and shall result in disqualification of the Bid.

5.3 REQUESTING PRICE ADJUSTMENTS

Prices shall be fixed for the duration of the initial three-year Contract. Price changes shall be considered at each renewal thereafter. Price changes shall be agreed to in writing by DOA. Price increase shall not exceed the change in Consumer Price Index – Urban (CIP-U) or 3%, whichever is lower.

6.0 BID PROCEDURE AND INSTRUCTIONS

6.1 CALENDAR OF EVENTS

Listed below are important dates and times by which actions related to this Request for Bid shall be completed. In the event that BSRM finds it necessary to change any of these dates and times (except estimated dates and times), it shall do so by posting an amendment to this RFB on VendorNet.

6.2 CORRESPONDENCE, CLARIFICATIONS AND QUESTIONS

Bidders are expected to raise any questions, exceptions, or additions they have concerning the RFB document by Monday, October 2, 2017, 2:00 p.m. CT. If at any time prior to the Bid due date, a Bidder discovers any significant ambiguity, error, conflict, discrepancy, omission, or other deficiency in this RFB, the Bidder shall immediately notify the Department of Administration representative named below of the issue in writing and request modification or clarification of the RFB document.

Email is the preferred method of written contact: Please email to Amber.Rademacher@wisconsin.gov.

All communication and/or questions on all matters regarding this Bid shall be made in writing and refer to Request for Bid # AD180727 and be directed to Amber Rademacher.

In the event that it becomes necessary to provide additional clarifying data or information, or to revise any part of this RFB, supplements or revisions shall be posted on VendorNet (https://vendornet.wi.gov/).

All contact or communication with any employee or officer of the State of Wisconsin concerning this RFB, except Amber Rademacher is strictly prohibited during the period from the date this RFB is released until the date the Notice of Intent to Contract is issued. Amber Rademacher may authorize in writing contact or communication with another state employee or officer as circumstances may dictate. Prospective Bidders who hold a current Contract with BSRM may continue to communicate with BSRM Contract Administrator regarding the performance of that current Contract only.

6.3 REASONABLE ACCOMMODATIONS

Upon request, the State shall provide reasonable accommodations, including the provision of informational material in an alternative format, for qualified individuals with a disability. If accommodations are needed at a Bid opening or Bidders’ Conference, please contact: Amber Rademacher at Amber.Rademacher@wisconsin.gov.

6.4 VENDORNET REGISTRATION

Registration on the State of Wisconsin’s VendorNet System (https://vendornet.wi.gov/) is available free of charge to all businesses and organizations that wish to sell commodities and services to the State. By registering on VendorNet, a Bidder may register for a Bidders list for any commodity or service the Bidder is interested in providing to the State. VendorNet also provides automatic email notification each time a Procuring State Agency, including University of Wisconsin System campuses, posts a Request for Bid with an estimated value over $50,000 in their designated commodity and or service area(s). Only registered Bidders with a valid email address at the time an RFB is posted shall receive email notifications of amendments. Bidders who obtain the RFB from a third party, through the State of Wisconsin Public Notices website or by any other means assume responsibility for checking for updates to the RFB.

6.5 SUBMITTING A BID

Bidders shall submit an original signed Bid, marked as stated below, and one (1) hard copies AND one (1) electronic of all materials required for acceptance of their Bid by the deadline shown on the Request for Bid (DOA-3070) form to:

All Bids shall be received and time-stamped at the above location no later than Wednesday, October 18, 2017, 2:00 p.m. CT

Bids not time-stamped shall be considered late and rejected. Receipt of a Bid by the State mail system does not constitute receipt of a Bid by the Purchasing Office.

All Bids shall be packaged, sealed in a box or envelope and clearly marked with the following information on the outside of the package:

BIDDER NAME AND ADDRESS

CMS Reporting

AD180727

October 18, 2017, 2:00 p.m. CT

Hand Delivered Bids The Department of Administration, at 101 E. Wilson St. in Madison, has building security policies and procedures. There is a security checkpoint at the first floor lobby. All visitors shall be required to provide current identification and sign in for a visitor’s pass. Security personnel shall call the intended procurement specialist prior to the visitor being allowed to proceed to their destination in the DOA building. This means Bidders shall have the procurement specialist’s name to allow the security guard to place a call to the procurement specialist. The Bidder shall allow ample time to clear security before reaching the Bureau of Procurement office to obtain the required Bid time-stamp.

The State is not responsible for deliveries that do not reach the Bureau of Procurement office by the required due date and time.

6.6 FAXED AND EMAILED BIDS

Faxed and email Bids shall not be accepted.

6.7 FORMAT OF BID RESPONSE

Bidders responding to this RFB shall comply with the following format requirements:

Tab 1 Signed Request for Bid Sheet:

Include the signed Request for Bid sheet (DOA-3070, front page of this document) with the Bid and those certifications required for submittal of a Bid. Bids submitted in response to this RFB shall be signed by the person in the vendor's organization who is responsible for the decision as to the prices being offered in the Bid or by a person who has been authorized in writing to act as agent for the person responsible for the decision on prices. DO NOT COPY AND RETURN THE ENTIRE BID DOCUMENT.

By submitting a signed Bid, the vendor's signatories certify that in connection with this procurement: (a) the vendor's organization or an agent of the vendor's organization has arrived at the prices in its Bid without consultation, communication or agreement with any other respondent or with any competitor for the purpose of restricting competition, (b) the prices quoted in the Bid have not been knowingly disclosed by the vendor's organization or by any agent of the vendor's organization and shall not be knowingly disclosed by same, directly or indirectly, to any other respondent or to any competitor, and (c) no attempt has been made or shall be made by the vendor's organization or by any agent of the vendor's organization to induce any other person or firm to submit or not to submit a Bid for the purpose of restricting competition.

Tab 2 Bid Response Qualifications and Requirements:

The Bidder shall include Attachment B – Bidder Checklist, included in this RFB. A response to each qualification and requirement listed shall be clearly checked and/or submitted as applicable and the sheet signed.

Tab 3 Additional Information:

Include the completed Vendor Information sheet (DOA-3477), Vendor Reference sheet (DOA-3478), and any other forms required in the Bid. Include all additional information that shall be essential to an understanding of the Bid. This might include diagrams, excerpts from manuals, or other explanatory documentation that would clarify and/or substantiate the Bid document.

Tab 4 Price Information:

Provide price information on the Price Sheet – Attachment A, included in this RFB, include one hard copy of the Price Sheet with the Bid response and one electronic copy in Excel format. All prices for furnishing the product(s) and/or service(s) included in the Bid in accordance with the terms and conditions in this RFB shall be included. No alternate price formats shall be accepted. Alternate price formats shall eliminate consideration for this Bid.

Tab 5 State of Wisconsin Standard Terms and Conditions (DOA-3054) and State of Wisconsin Supplemental Standard Terms and Conditions for Procurements for Services (DOA-3681) (herein after Terms and Conditions):

These Terms and Conditions shall govern this Bid and subsequent award. Vendors shall accept these Standard and Supplemental Terms and Conditions or submit point-by-point exceptions along with proposed alternate or additional language for each point. Submission of any standard vendor Contracts as a substitute for language in the Terms and Conditions is not a sufficient response to this requirement and may result in rejection of the vendor's Bid. The State reserves the right to negotiate contractual Terms and Conditions other than those in the State of Wisconsin Contract when it is in the best interest of the State to do so.

Any alteration of the Bid forms or Appendices is prohibited and shall result in rejection of the Bid.

6.8 MULTIPLE BIDS

Multiple Bids are permitted. However, each separate Bid shall conform fully to the requirements for a Bid submission. Each Bid shall be submitted separately and labeled as Bid #1, Bid #2, etc.; on each page included of the Bid response.

6.9 INCURRING COSTS

Neither the State of Wisconsin nor BSRM is liable for any costs incurred by the Bidder in responding to this RFB.

7.0 BID ACCEPTANCE AND AWARD

7.1 BID OPENING

A public Bid opening shall be held on Wednesday, October 18, 2017, 2:00 p.m. CT at 101 East Wilson Street, 6th Floor, Madison, WI. The names of all Bidders shall be read aloud at that time.

7.2 BID REVIEW

All Bids shall be reviewed by the Procurement Manager to ensure compliance with submittal requirements. The State shall be the sole judge as to Bidders’ compliance with the Bid instructions.

7.3 BID ACCEPTANCE

Bids that do not comply with Mandatory Requirements or Mandatory Specifications shall be rejected. Bids that do not comply with Special Terms and Conditions of Bid may be rejected. BSRM in its sole discretion retains the right to accept or reject any or all Bids, or accept or reject any part of a Bid, if deemed to be in the best interest of the State.

7.4 METHOD OF AWARD

The Bid Award shall be made on the basis of the lowest priced, responsive, responsible Bidder. Prices Bid shall be in US dollars unless otherwise indicated. Bids that require a specific quantity or dollar amount shall be disqualified. In the event of Bidder error in calculation, unit price shall prevail in award.

BSRM intends to award to one Bidder.

Award(s) shall be based on lowest Total Price Per Claim.

7.5 BIDDER REFERENCES

The Bid response shall include a completed Bidder Reference Form (DOA-3478) listing at least four (4) names or companies with whom the Bidder has done business similar in size and scope as required by this RFB within the last two (2) of years. For each organization listed, the Bidder shall include the company name, address, contact person, email address and telephone number along with a brief description of the product or service that formed the basis of the business relationship. BSRM shall determine which references to contact in order to assess the quality of the product or service.

7.6 USE OF SUBCONTRACTORS

The Contractor shall be responsible for the Contract performance of its subcontractors. The Contract shall be between the BSRM and the awardee. The Contractor shall be responsible for its subcontractors’ performance of the pertinent Contract obligations including related Specifications, insurance requirements and applicable regulations. The Bidder shall identify any potential subcontractor it intends to use to provide the product or service it shall provide if awarded the Contract. All subcontractors shall be approved in writing by BSRM. Any proposed substitution of an approved subcontractor shall be submitted in writing to the BSRM 30 days prior to implementation of the substitution, and include the substitute’s qualifications, the reason for the change, and the intended effective date of the substitution. Failure to notify the Department shall result in cancellation of the Contract without notice and without penalty to the State.

7.7 SUPPLIER DIVERSITY

7.7.1 MINORITY-OWNED BUSINESS ENTERPRISE

Minority-owned business enterprises (MBEs) are certified by the Wisconsin Department of Administration. This program can be found at: http://www.doa.wi.gov/Divisions/Enterprise-Operations/Supplier-Diversity-Program. The State of Wisconsin is committed to the promotion of MBEs in the State's purchasing program. Wisconsin statutes provide for a permissive 5% price preference for certified MBEs that compete for State Contracts. This means that State agencies may make an award to the MBE submitting the lowest qualified Bid when that qualified Bid is not more than 5% higher than the apparent low Bid. (A MBE Bidder preference shall not be considered on a printing or stationery procurement.) Policy provides that MBEs should have the maximum opportunity to participate in the performance of its Contracts. The Contractor is strongly urged to use due diligence to further this policy by awarding subcontracts to MBEs or by using such enterprises to provide commodities and services incidental to this agreement.

The Contractor shall furnish appropriate quarterly information about its efforts, including the identities of such businesses certified by the Wisconsin Supplier Diversity Program, their Contract amount, and spend for each period to BSRM.

A listing of certified MBEs, as well as the services and commodities they provide, is available at: https://wisdp.wi.gov/search.aspx.

7.7.2 VETERAN-OWNED BUSINESS

The State Bureau of Procurement encourages the participation of veteran-owned businesses (VBs) in the statewide purchasing program by inviting VBs to actively solicit public purchasing business and by reducing undue impediments to such participation. VBs are certified by the Department of Veterans Affairs (DVA). Applicants shall complete a Veteran-owned Business Request for Certification form (WDVA 1037). Contact the DVA at: http://dva.state.wi.us. There is no price preference for certified VBs that compete for State Contracts.

7.7.3 DISABLED VETERAN-OWNED BUSINESS

Disabled veteran-owned businesses (DVBs) are certified by the Wisconsin Department of Administration. This program can be found at: http://www.doa.wi.gov/Divisions/Enterprise-Operations/Supplier-Diversity-Program. The State of Wisconsin is committed to the promotion of DVBs in the State's purchasing program. Wisconsin statutes provide for a permissive 5% price preference for certified DVBs that compete for State Contracts. This means that State agencies may make an award to the DVB submitting the lowest qualified Bid when that qualified Bid is not more than 5% higher than the apparent low Bid. (A Bidder preference shall not be considered on a printing or stationery procurement.) Policy provides that DVBs should have the maximum opportunity to participate in the performance of its Contracts. The Supplier/Contractor is strongly urged to use due diligence to further this policy by awarding subcontracts to DVBs or by using such enterprises to provide commodities and services incidental to this agreement.

The Contractor shall furnish appropriate quarterly information about its efforts, including the identities of such businesses certified by the Supplier Diversity Program and their Contract amount.

A listing of certified DVBs, as well as the services and commodities they provide, is available at: https://wisdp.wi.gov/search.aspx.

7.7.4 WOMAN-OWNED BUSINESS ENTERPRISE

Woman-owned business enterprises (WBEs) are certified by the Wisconsin Department of Administration. This program can be found at: http://www.doa.wi.gov/Divisions/Enterprise-Operations/Supplier-Diversity-Program.

State certified WBEs are able to provide both governmental entities and private companies with a credible recognition of the business’ ownership. The WBE certification may serve as an additional marketing tool when seeking Contract opportunities with entities that place a value on having a diverse supplier base. There is no price preference for certified WBEs that compete for State Contracts.

A listing of certified WBEs, as well as the services and commodities they provide, is available at: https://wisdp.wi.gov/search.aspx.

7.8 DEBARMENT

Federal Executive Order (E.O.) 12549 “Debarment” requires that all contractors receiving individual awards, using federal funds, and all sub recipients certify that the organization and its principals are not debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded by any Federal department or Agency from doing business with the Federal Government. Information on debarment is available at the following websites: https://www.sam.gov/portal/SAM/ See Section 15.0 of the Standard Terms and Conditions (DOA-3054).

7.9 AWARD NOTIFICATION

All Bidders who respond to this RFB with a Bid shall be notified in writing of the Agency’s Intent to Contract.

7.10 PROTEST AND APPEALS PROCESS

7.10.1 PROTESTS

A Notice of Intent to protest a proposed Bid award and the actual protest shall be made in writing to the head of Procuring Agency (or his or her designee) as set forth below. The protest procedure applies to only those requests for Bids for services that are over $50,000.The protest shall be as specific as possible, and should identify statutes and Wisconsin Administrative Code provisions that are alleged to have been violated.

The Notice of Intent to Protest shall be filed with the individual listed below, and received by the head of Procure Agency (or designee) no later than five (5) business days after the Notice of Intent to Contract is issued.

The actual Protest also shall be filed with the individual listed below, and shall be received within ten (10) business days after the Notice of Intent to Contract is issued.

With a copy to: