Attachment 4 - Cost Report Locations.xlsx

XLSX spreadsheet 19 KB Posted Sep 3, 2024

Attached to: Medicare Cost Reporting Services Federal contract opportunity
Solicitation number: 75H70424R00011
Issued by: Department of Health and Human Services Indian Health Service

About this file

Written by GovTribe AI · Sep 3, 2024

This document is a combined synopsis/solicitation for a Request for Proposal (RFP) issued by the Indian Health Service (IHS) for Medicare Cost Reporting Services. IHS is seeking one contractor to provide these services in assistance of the IHS Office of Resource Access and Partnerships. The solicitation is a total small business set-aside under NAICS code 541219 with a $25M size standard. The contract will be a Hybrid Fixed Price Purchase Order with Cost Reimbursement, with a one-year Base Period and four one-year Option Periods. Proposals are due by 5:00 PM EST on September 19, 2024 and must be valid for 30 days. The evaluation factors are Technical Capability, Relevant Past Performance, and Price, with Technical being more important than Price. Travel costs are estimated at $65,000 per Period of Performance. The performance location is remote/off-site at the vendor's facility.

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Other files for this federal contract opportunity

Other files attached to Medicare Cost Reporting Services, newest first.
File	Type	Posted
Attachment 3 - Pricing Sheet - RFP 75H70424R00011.pdf	PDF	Sep 3, 2024
Attachment 2 - SF1449 - 75H70424R00011.pdf	PDF	Sep 3, 2024
Attachment 7 - Medicare Cost Reporting Services - PWS.pdf	PDF	Sep 3, 2024
Attachment 6 - Cost Report Locations - YRTC.xlsx	XLSX spreadsheet	Sep 3, 2024
Attachment 5 - Cost Report Locations - UIO.xlsx	XLSX spreadsheet	Sep 3, 2024
Attachment 1 - Past Performance Survey.pdf	PDF	Sep 3, 2024
RFP Document - 75H70424R00011.pdf	PDF	Sep 3, 2024

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Sheet1 Attachment A - Cost Report Contract

	AREA	LOCATION/TASK	FED/ TRIBAL	2023 CCN	MAC	SPECIFIC TYPE	FED/ TRIBAL	DUE DATE
1	Alaska	ALASKA NATIVE MEDICAL CENTER	TRIBAL	020026	Novitas	FACILITY	TRIBAL	JUNE 3OTH
2	Alaska	YUKON-KUSKOKWIM DELTA REGIONAL HOSPITAL	TRIBAL	020018	Novitas	FACILITY	TRIBAL	JUNE 3OTH
3	Alaska	SOUTHCENTRAL FOUNDATION	TRIBAL	N/A	Novitas	FACILITY	TRIBAL	JUNE 3OTH
4	Alaska	SAMUEL SIMMONDS MEMORIAL HOSPITAL	TRIBAL	021312	Novitas	FACILITY-CAH	TRIBAL	FEBRUARY 28TH
5	Alaska	KANAKANAK HOSPITAL	TRIBAL	021309	Novitas	FACILITY-CAH	TRIBAL	FEBRUARY 28TH
6	Alaska	MANIILAQ HEALTH CENTER	TRIBAL	021310	Novitas	FACILITY-CAH	TRIBAL	FEBRUARY 28TH
7	Alaska	MOUNT EDGECUMBE HOSPITAL	TRIBAL	021314	Novitas	FACILITY-CAH	TRIBAL	FEBRUARY 28TH
8	Alaska	ALASKA AREA OFFICE	FEDERAL	HO9729	Novitas	HOME OFFICE-CAH	FEDERAL	FEBRUARY 28TH
9	Alaska	ALASKA NATIVE TRIBAL HEALTH CONSORTIUM	TRIBAL	HO9413	Novitas	HOME OFFICE-CAH	TRIBAL	FEBRUARY 28TH
10	Albuquerque	SANTA FE INDIAN HOSPITAL	FEDERAL	320057	Novitas	FACILITY	FEDERAL	JUNE 3OTH
11	Albuquerque	ZUNI COMPREHENSIVE HEALTH CENTER	FEDERAL	320060	Novitas	FACILITY	FEDERAL	JUNE 3OTH
12	Albuquerque	ALBUQUERQUE AREA OFFICE	FEDERAL	HB0740	Novitas	HOME OFFICE	FEDERAL	JUNE 3OTH
13	Bemidji	RED LAKE HOSPITAL	FEDERAL	240206	Novitas	FACILITY	FEDERAL	JUNE 3OTH
14	Bemidji	CASS LAKE HOSPITAL	FEDERAL	241358	Novitas	FACILITY-CAH	FEDERAL	FEBRUARY 28TH
15	Bemidji	BEMIDJI AREA OFFICE	FEDERAL	HB0048	Novitas	HOME OFFICE-CAH	FEDERAL	FEBRUARY 28TH
16	Billings	BLACKFEET COMMUNITY HOSPITAL	FEDERAL	270074	Novitas	FACILITY	FEDERAL	JUNE 3OTH
17	Billings	CROW/NORTHERN CHEYENNE INDIAN HOSPITAL	FEDERAL	271339	Novitas	FACILITY-CAH	FEDERAL	FEBRUARY 28TH
18	Billings	FORT BELKNAP HEALTH CENTER	FEDERAL	271315	Novitas	FACILITY-CAH	FEDERAL	FEBRUARY 28TH
19	Billings	BILLINGS AREA OFFICE	FEDERAL	HO9726	Novitas	HOME OFFICE-CAH	FEDERAL	FEBRUARY 28TH
20	Great Plains	QUENTIN N BURDICK MEMORIAL HOSPITAL	FEDERAL	350063	Novitas	FACILITY	FEDERAL	JUNE 3OTH
21	Great Plains	PINE RIDGE HOSPITAL	FEDERAL	430098	Novitas	FACILITY	FEDERAL	JUNE 3OTH
22	Great Plains	ROSEBUD COMPREHENSIVE HEALTH CARE FACILITY	FEDERAL	430084	Novitas	FACILITY	FEDERAL	JUNE 3OTH
23	Great Plains	CHEYENNE RIVER HEALTH CENTER	FEDERAL	431383	Novitas	FACILITY-CAH	FEDERAL	FEBRUARY 28TH
24	Great Plains	STANDING ROCK IHS HOSPITAL	FEDERAL	351364	Novitas	FACILITY-CAH	FEDERAL	FEBRUARY 28TH
25	Great Plains	GREAT PLAINS AREA OFFICE	FEDERAL	HO9730	Novitas	HOME OFFICE-CAH	FEDERAL	FEBRUARY 28TH
26	Headquarters	HEADQUARTERS	FEDERAL	HB0109	Novitas	HOME OFFICE-CAH	FEDERAL	FEBRUARY 28TH
27	Nashville	CHEROKEE INDIAN HOSPITAL	TRIBAL	340156	Novitas	FACILITY	TRIBAL	JUNE 3OTH
28	Nashville	CHOCTAW HEALTH CENTER	TRIBAL	250127	Novitas	FACILITY	TRIBAL	JUNE 3OTH
29	Nashville	NASHVILLE AREA OFFICE	FEDERAL	HB0742	Novitas	HOME OFFICE	FEDERAL	JUNE 3OTH
30	Navajo	CHINLE COMPREHENSIVE HEALTH CARE FACILITY	FEDERAL	030084	Novitas	FACILITY	FEDERAL	JUNE 3OTH
31	Navajo	CROWNPOINT HEALTH CARE FACILITY	FEDERAL	320062	Novitas	FACILITY	FEDERAL	JUNE 3OTH
32	Navajo	TSEHOOTSOOI MEDICAL CENTER	TRIBAL	030071	Novitas	FACILITY	TRIBAL	JUNE 3OTH
33	Navajo	GALLUP INDIAN MEDICAL CENTER	FEDERAL	320061	Novitas	FACILITY	FEDERAL	JUNE 3OTH
34	Navajo	NORTHERN NAVAJO MEDICAL CENTER	FEDERAL	320059	Novitas	FACILITY	FEDERAL	JUNE 3OTH
35	Navajo	TUBA CITY REGIONAL HEALTH CARE	TRIBAL	030073	Novitas	FACILITY	TRIBAL	JUNE 3OTH
36	Navajo	NAVAJO AREA OFFICE	FEDERAL	HB0049	Novitas	HOME OFFICE-CAH	FEDERAL	FEBRUARY 28TH
37	Oklahoma	CHICKASAW NATION MEDICAL CENTER	TRIBAL	370180	Novitas	FACILITY	TRIBAL	JUNE 3OTH
38	Oklahoma	CHOCTAW NATION HEALTH CARE CENTER	TRIBAL	370172	Novitas	FACILITY	TRIBAL	JUNE 3OTH
39	Oklahoma	CLAREMORE INDIAN HOSPITAL	FEDERAL	370173	Novitas	FACILITY	FEDERAL	JUNE 3OTH
40	Oklahoma	LAWTON INDIAN HOSPITAL	FEDERAL	370170	Novitas	FACILITY	FEDERAL	JUNE 3OTH
41	Oklahoma	CHEROKEE NATION WW HASTINGS HOSPITAL	TRIBAL	370171	Novitas	FACILITY	TRIBAL	JUNE 3OTH
42	Oklahoma	OKLAHOMA CITY AREA OFFICE	FEDERAL	HB0076	Novitas	HOME OFFICE-CAH	FEDERAL	FEBRUARY 28TH
43	Phoenix	PHOENIX INDIAN MEDICAL CENTER	FEDERAL	030078	Novitas	FACILITY	FEDERAL	JUNE 3OTH
44	Phoenix	SAN CARLOS APACHE HEALTHCARE	TRIBAL	031320	Novitas	FACILITY-CAH	TRIBAL	FEBRUARY 28TH
45	Phoenix	WHITERIVER INDIAN HOSPITAL	FEDERAL	030113	Novitas	FACILITY	FEDERAL	JUNE 3OTH
46	Phoenix	HU HU KAM MEMORIAL HOSPITAL	TRIBAL	031308	Novitas	FACILITY-CAH	TRIBAL	FEBRUARY 28TH
47	Phoenix	HOPI HEALTH CARE CENTER	FEDERAL	031305	Novitas	FACILITY-CAH	FEDERAL	FEBRUARY 28TH
48	Phoenix	PARKER INDIAN HEALTH CENTER	FEDERAL	031307	Novitas	FACILITY-CAH	FEDERAL	FEBRUARY 28TH
49	Phoenix	PHOENIX AREA OFFICE	FEDERAL	HO9722	Novitas	HOME OFFICE-CAH	FEDERAL	FEBRUARY 28TH
50	Tucson	TON SELLS HOSPITAL	TRIBAL	030074	Novitas	FACILITY	TRIBAL	JUNE 3OTH
51	Tucson	TUCSON AREA OFFICE	FEDERAL	HB0741	Novitas	HOME OFFICE	FEDERAL	JUNE 3OTH
52	Miscellaneous	As identified by the COR			Novitas	FACILITY	TBD	JUNE 3OTH
53	Miscellaneous	As identified by the COR			Novitas	FACILITY-CAH	TBD	FEBRUARY 28TH

Sheet2

LOCATION/TASK	FYE	CCN	CLIENT	MAC	ABBR
CHEYENNE RIVER HEALTH CENTER	9/30/23	431383	IHS	Novitas	EAG	ABR	FACILITY-CAH
STANDING ROCK IHS HOSPITAL	9/30/23	351364	IHS	Novitas	FTY	ABR	FACILITY-CAH
KANAKANAK HOSPITAL	9/30/23	021309	IHS	Novitas	DIL	AKA	FACILITY-CAH
MANIILAQ HEALTH CENTER	9/30/23	021310	IHS	Novitas	KOT	AKA	FACILITY-CAH
MOUNT EDGECUMBE HOSPITAL	9/30/23	021314	IHS	Novitas	SIT	AKA	FACILITY-CAH
SAMUEL SIMMONDS MEMORIAL HOSPITAL	9/30/23	021312	IHS	Novitas	BAR	AKA	FACILITY-CAH
CASS LAKE HOSPITAL	9/30/23	241358	IHS	Novitas	CAS	BEM	FACILITY-CAH
CROW/NORTHERN CHEYENNE INDIAN HOSPITAL	9/30/23	271339	IHS	Novitas	CRO	BIL	FACILITY-CAH
FORT BELKNAP HEALTH CENTER	9/30/23	271315	IHS	Novitas	FTB	BIL	FACILITY-CAH
HOPI HEALTH CARE CENTER	9/30/23	031305	IHS	Novitas	HOP	PHX	FACILITY-CAH
HU HU KAM MEMORIAL HOSPITAL	9/30/23	031308	IHS	Novitas	GIL	PHX	FACILITY-CAH
PARKER INDIAN HEALTH CENTER	9/30/23	031307	IHS	Novitas	PAR	PHX	FACILITY-CAH
SAN CARLOS APACHE HEALTHCARE	9/30/23	031320	IHS	Novitas	SCA	PHX	FACILITY-CAH
SANTA FE INDIAN HOSPITAL	9/30/23	320057	IHS	Novitas	SFE	ABQ	FACILITY
ZUNI COMPREHENSIVE HEALTH CENTER	9/30/23	320060	IHS	Novitas	ZNI	ABQ	FACILITY
PINE RIDGE HOSPITAL	9/30/23	430098	IHS	Novitas	PIN	ABR	FACILITY
QUENTIN N BURDICK MEMORIAL HOSPITAL	9/30/23	350063	IHS	Novitas	BEL	ABR	FACILITY
ROSEBUD COMPREHENSIVE HEALTH CARE FACILITY	9/30/23	430084	IHS	Novitas	ROS	ABR	FACILITY
ALASKA NATIVE MEDICAL CENTER	9/30/23	020026	IHS	Novitas	ANC	AKA	FACILITY
SOUTHCENTRAL FOUNDATION	9/30/23	N/A	IHS	Novitas	SCF	AKA	FACILITY
YUKON-KUSKOKWIM DELTA REGIONAL HOSPITAL	9/30/23	020018	IHS	Novitas	BET	AKA	FACILITY
RED LAKE HOSPITAL	9/30/23	240206	IHS	Novitas	RED	BEM	FACILITY
BLACKFEET COMMUNITY HOSPITAL	9/30/23	270074	IHS	Novitas	BRO	BIL	FACILITY
CHEROKEE INDIAN HOSPITAL	9/30/23	340156	IHS	Novitas	CHE	NAS	FACILITY
CHOCTAW HEALTH CENTER	9/30/23	250127	IHS	Novitas	PHI	NAS	FACILITY
CHINLE COMPREHENSIVE HEALTH CARE FACILITY	9/30/23	030084	IHS	Novitas	CHI	NAV	FACILITY
CROWNPOINT HEALTH CARE FACILITY	9/30/23	320062	IHS	Novitas	CPT	NAV	FACILITY
GALLUP INDIAN MEDICAL CENTER	9/30/23	320061	IHS	Novitas	GAL	NAV	FACILITY
NORTHERN NAVAJO MEDICAL CENTER	9/30/23	320059	IHS	Novitas	SHI	NAV	FACILITY
TSEHOOTSOOI MEDICAL CENTER	9/30/23	030071	IHS	Novitas	FTD	NAV	FACILITY
TUBA CITY REGIONAL HEALTH CARE	9/30/23	030073	IHS	Novitas	TUB	NAV	FACILITY
CHEROKEE NATION WW HASTINGS HOSPITAL	9/30/23	370171	IHS	Novitas	TAH	OKC	FACILITY
CHICKASAW NATION MEDICAL CENTER	9/30/23	370180	IHS	Novitas	ADA	OKC	FACILITY
CHOCTAW NATION HEALTH CARE CENTER	9/30/23	370172	IHS	Novitas	CHO	OKC	FACILITY
CLAREMORE INDIAN HOSPITAL	9/30/23	370173	IHS	Novitas	CLA	OKC	FACILITY
LAWTON INDIAN HOSPITAL	9/30/23	370170	IHS	Novitas	LAW	OKC	FACILITY
PHOENIX INDIAN MEDICAL CENTER	9/30/23	030078	IHS	Novitas	PIM	PHX	FACILITY
WHITERIVER INDIAN HOSPITAL	9/30/23	030113	IHS	Novitas	WHI	PHX	FACILITY
TON SELLS HOSPITAL	9/30/23	030074	IHS	Novitas	SEL	TUC	FACILITY
SIT - Wrangell	9/30/23	021305	OTHER	Novitas	SITWMC	AKA	FACILITY-CAH
GREAT PLAINS AREA OFFICE	9/30/23	HO9730	IHS	Novitas	ABR	ABR	HOME OFFICE-CAH
ALASKA AREA OFFICE	9/30/23	HO9729	IHS	Novitas	AKA	AKA	HOME OFFICE-CAH
ALASKA NATIVE TRIBAL HEALTH CONSORTIUM	9/30/23	HO9413	IHS	Novitas	ANT	AKA	HOME OFFICE-CAH
BEMIDJI AREA OFFICE	9/30/23	HB0048	IHS	Novitas	BEM	BEM	HOME OFFICE-CAH
BILLINGS AREA OFFICE	9/30/23	HO9726	IHS	Novitas	BIL	BIL	HOME OFFICE-CAH
HEADQUARTERS	9/30/23	HB0109	IHS	Novitas	HQE	HQE	HOME OFFICE-CAH
NAVAJO AREA OFFICE	9/30/23	HB0049	IHS	Novitas	NAV	NAV	HOME OFFICE-CAH
OKLAHOMA CITY AREA OFFICE	9/30/23	HB0076	IHS	Novitas	OKC	OKC	HOME OFFICE-CAH
PHOENIX AREA OFFICE	9/30/23	HO9722	IHS	Novitas	PHX	PHX	HOME OFFICE-CAH
ALBUQUERQUE AREA OFFICE	9/30/23	HB0740	IHS	Novitas	ABQ	ABQ	HOME OFFICE
NASHVILLE AREA OFFICE	9/30/23	HB0742	IHS	Novitas	NAS	NAS	HOME OFFICE
TUCSON AREA OFFICE	9/30/23	HB0741	IHS	Novitas	TUC	TUC	HOME OFFICE
						0
DSH/MEDICAID ELIGIBILITY ANALYSIS	9/30/23	N/A	IHS	Novitas	N/A	1
EQUIPMENT DEPRECIATION SCHEDULES	9/30/23	N/A	IHS	Novitas	N/A	1
SAMUEL SIMMONDS MEMORIAL HOSPITAL	9/30/23	021312	IHS	Novitas	N/A	1
DSH/MEDICAID ELIGIBILITY ANALYSIS	9/30/23	N/A	IHS	Novitas	N/A	1
EQUIPMENT DEPRECIATION SCHEDULES	9/30/23	N/A	IHS	Novitas	N/A	1
CAH ANALYSIS	9/30/23	N/A	IHS	Novitas	N/A	1
EQUIPMENT DEPRECIATION SCHEDULES	9/30/23	N/A	IHS	Novitas	N/A	1
RATE CALCULATION/NEGOTIATION	9/30/23	N/A	IHS	Novitas	N/A	1
REVIEW/ANALYSIS/PREP/AUDIT SUPPORT/MISC/SQ FT	9/30/23	N/A	IHS	Novitas	N/A	1
						0
CBN	9/30/23	321964	OTHER	Novitas	CBN	0
CHESNF	9/30/23	345475	OTHER	Palmetto	CHESNF	0
CSK	9/30/23	271810	OTHER	Noridian	CSK	0
KOT - SNF	9/30/23	025035	OTHER	Novitas	KOTSNF	0
LEE	6/30/23	241818	OTHER	NGS	LEE	0
SIT - AICS	9/30/23	021845	OTHER	Novitas	SITAIC	0
SIT - SNF	9/30/23	025032	OTHER	Novitas	SITSNF	0
WZZ	9/30/23	371917	OTHER	Novitas	WZZ	0
GRAND GI & ENDOSCOPY GROUP INC	12/31/23	050801	OTHER	Noridian	GEC	0
UIT	12/31/23	451914	OTHER	NGS	UIT 12/31	0
PALO VERDE HOSPITAL	6/30/23		OTHER		PVH	0

File details come from the government source that posted it. Updated Sep 3, 2024.