ESRD_Questions_and_Responses.xlsx
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- 2016 End Stage Renal Disease (ESRD) Networks Federal contract opportunity
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- CMS-2016-ESRD-NETWORKS
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CMS-2016-ESRD-NETWORKS
| Number | SOW/SOD/Bus Prop/COI/Tech Prop/General | Section No./ Page # | Section Title | Question | CMS Response | |
| 1 | Amendment 000001 | Section L.14 Page 2 of the Amendment | Section L.14 Technical Proposal Instructions (Volume I) | Please clarify whether the techical approach is limited to 60 pages or whether the technical proposal, including the past performan and experience, management plan and staffing and personnel plan is limited to 60 pages. | Per Amendment 1, the technical proposal consists of Tabs 1 through 6. Tabs 2 through 5 are included in the page count. The page count is limited to 60 single-sided pages. | |
| 2 | Amendment 000001 | |||||
| Instructions | L.14 | |||||
| Pg. 2 | Technical Proposal Instructions (Volume I) | Section L.14 of Amendment 000001 states "The page limitation for the Technical Proposal is 60 single-sided or 30 double-sided pages." Would CMS allow Offerors to provide an acronym list in the appendix that is not included in the page count? | Yes | |||
| 3 | Amendment 000001 | |||||
| Instructions | L.14 | |||||
| pg. 5 | Description of Technical Proposal Contents, 2. Tab 2 | Section L.14 states "Tab 2 entitled, 'Technical Approach' shall utilize the table below to provide the following for each AIM and Domain:" However, a table is not provided for this bullet point. Would CMS please confirm the Offeror is to utilize the text provided below this statement? | Refer to Table 1 under Section L.14. | |||
| 4 | Amendment 000001 | |||||
| Instructions | L.14 | |||||
| pg. 5 | Description of Technical Proposal Contents, 2. Tab 2 | Section L.14 states "Tab 2 entitled, 'Technical Approach' shall utilize the table below to provide the following for each AIM and Domain:" Must the Offeror utilize a table to address each AIM/Domain/Sub-Domain, or can the Offeror provide narrative information for each AIM/Domain/Sub-Domain not in a tabular format? | Offeror may provide narrative information for each AIM/Domain/Sub-domain without using a table | |||
| 5 | Amendment 000001 | |||||
| Instructions | L.14 | |||||
| pg. 7 | b) Past Performance 2) Instructions a) | Section L.14 states " The Offeror and all its significant subcontractor(s) identified in the proposal are required to provide a summary to disclose all of the following for the past performance information with a period of performance end date within the last 3 years of the date of this solicitation..." Would CMS please clarify "end date within the last 3 years of this solicitation" for past performance information? This seems to restrict past performance information to contracts that have ended. May Offerors include current contracts, e.g., Network contracts whose end date will not be in the last 3 years, but in the coming months, in the past performance section? | The Offeror and all its significant subcontractor(s) identified in the proposal are required to provide a summary to disclose all relevant past performance information for current contracts and contracts with a period of performance end date within the last 3 years of the date of this solicitation. | |||
| 6 | Amendment 000001 | |||||
| Instructions | L.14 | |||||
| pg. 7 | b) Past Performance 2) Instructions a) | If CMS requires that all contracts/task orders ending within the last 3 years be included in the past performance section, would CMS consider allowing Offerors to include the contracts list in the appendix and not including the list in the page count? | No. The past performance is included in the page count limitation. Only include relevant contracts/task orders. | |||
| 7 | Amendment 000001 | |||||
| Instructions | L.14 | |||||
| pg. 7 | b) Past Performance 2) Instructions | Section L.14 states that the Offeror and subcontractor are required to submit the approximate total contract value. May subcontractors submit approximate total contract values directly to CMS, rather than to the prime contractor? | No. |
If subcontractor wants to submit sealed proposal, please include subcontractor proposal with the prime proposal submission.
| 8 | Amendment 000001 | |||||
| Instructions | L.14 | |||||
| pg. 9 | Description of Technical Proposal Contents, 6. Tab 6… | Section L.14 provides a list of items that should be included in the Appendix, but does not provide information on additional items. May Offerors include additional items such as work products in the appendix? | You may include additional items in the Appendix but keep in mind that the evaluation teams are not required to review any additional items in the Appendix. | |||
| 9 | Amendment 000002 | 3 | Business Proposal | Amendment 2 states that "The Offeror shall use business proposal spreadsheets and summarize total costs for the project using Form 719, in accordance with Attachment J.22....." Attachment J.22 states at the top of the Summary tab that it is CMS Form 685-G. Are we to complete this form then convert it into the format for Form 719 and submit both forms along with the break out of costs by major task listed in the SOW? | The title of the Form is 685. | |
| 10 | Amendment 000002 | L.13.a, page 2 | Volumes (Table) | The due dates in the table do not seem to be updated with the Cover Letter and L.12 submission time. Please confirm due date is 2:00 PM, July 28, 2015. | The due date and time is July 28, 2015 at 2:00 pm local time (Baltimore, MD) | |
| 11 | Attachment J-12 | Attachment J-12 - CROWNWeb Data Management Guidelines | Note: Page numbering is not correct in the J-12 attachment. • Are there plans to prioritize fixing the CROWNWeb reporting issues prior to the next contract cycle? (There are reports we are indicated should be run that are still not completely accurate or functioning as expected.) • States “Tier 3 CROWNWeb Data Managers support Tier 2 users by providing weekly Gap patient analysis reports”. What is this report? Is this in lieu of the CROWNWeb report? Which contractor will be providing this report? • How often will the CROWNWeb Data Management Guidelines be updated? (Although network staff provided comments and suggestions on this document previously, not all changes and suggestions were included.) | Enhancements and correction of CROWNWeb Reports have been placed on the CROWNWeb Product Backlog. Scopes for CROWNWeb releases prior to January 2016 have already been established and do not include the Report changes. |
The Network Report for Gap Patients is currently provided by the National Coordinating Center (NCC). The Report identifies patients not assigned to a dialysis facility in CROWNWeb. An annual review of the CROWNWeb Data Management Guidelines is anticipated or more frequently based on future scope releases of CROWNWeb that may alter key modules (patient/clinical/2744) or CROWNWeb Reports.
| 12 | Attachment J-12 | |
| CROWNWeb Data Management Guidelines | Attachment J-12 |
pg. 34 and
RFP SOW C.4.1.B.1
| pg. 39 | Complete CMS-2728 and CMS-2746 Forms Table/Frequency and | |||||
| Evaluate and Resolve Grievances | Attachment J-12 contains a table titled "Complete CMS-2728 and CMS-2746 Forms," which states that "Tier 2 CROWNWeb Data Managers submit initial CMS-2728 forms within 5 business days of notification." Does this statement only apply to Medicare-certified kidney transplantation and VHA facilities? | Yes. This statement only applies to Medicare-certified kidney transplant and VHA facilities. | ||||
| 13 | Attachment J-12 | |||||
| CROWNWeb Data Management Guidelines | Attachment J-12 | |||||
| pg. 36 | Resolve Gap Patients Table/Key Points | Attachment J-12 contains a table titled "Resolve Gap Patients," which states "For a Gap patient to be resolved, he/she must either be admitted to the proper facility, or the necessary death information must be entered in CROWNWeb." However, the Gap Report includes patients who have recovered, discontinued, are lost to follow up, transferred to hospital/hospice/nursing home/long-term care facility/rehab center, transplanted outside the US, involuntary discharge, and other. While these are valid discharge reasons, they do not meet the definition for being resolved. Do these valid discharge reasons need to be investigated and communicated to facilities on a weekly basis, as indicated in the Frequency section for Tier 2 CROWNWeb Data Managers? | No, not all discharges require investigation. The J-12 Attachment for Resolving Gap Patients only addresses patients requiring resolution when not assigned to a dialysis facility in CROWNWeb or death information has not been entered. These could include patients lost to follow up, system discharges, transfer outs without re-admission, or discontinued patients without death documentation. | |||
| 14 | Attachment J-17; SOW | J-17 throughout, pg. 1; RFP pg. 85, 154, 170 | RFP: G.20, L.9, F 4. | veterans owned VOSB percent of dollars narrative is correct throughout J-17 but missing in some SOW sections. Pg. 85 SOW says subcontracting with small disadvantaged businesses required if award is $700,00 or more; J-17 says (pgs. 1 and 8) $650,000 - this is not a material point as we assume each NW contract award will be higher than either of these amounts. If the contract awards are smaller than anticipated this dollar value should be corrected. While reference is made to SBA.gov for referrals and general information...we have regularly experienced breaks in links; outdated information for the SBA.gov site. Same problem with state sites. This makes it difficult to maintain / search for new entities to show our good faith effort in this program area. What improvements might we see in the future? | Per FAR 19.704 and FAR 52.219-9, the threshold is $650,000. |
SBA offers assistance when seeking small business subcontracting opportunities.
Attachment J-17 has been updated to fix a link on page 2.
| 15 | Attachment J-19 | J-19 | Compliance Program Attestation | In the original RFP, this attestation was required. That requirement appears to have been deleted in Amendment #1. Please confirm that this attestation is only submitted with Volume III COI. | The J-19 attestation is required to be included with the COI volume. |
| 16 | Business Proposal | Attachment J-22a, Appendix I, Page 19 of 19 | Annual Management Plan | Per Appendix I, "The Annual Management Plan contains information for direct labor and consultant costs." There is no place on the Annual Management Plan spreadsheet tab to include cost information. Please confirm no cost information is required to be entered on the Annual Management Plan. | There is no cost information for tab I, Management Plan, just hours and percentages of time per task. |
| 17 | Business Proposal | Attachment J-22a, I. Page 3 of 19; Attachment J-22a, II.1. Page 4 of 19; L.13.a. b.i, and b.iii Page 158 of 181; L.15.C. Page 167 of 181 | Method of Submission; Proposal Organization; Business Proposal Instructions | It is clear the business proposal submission shall be in Excel format on the CD and hardcopy (printed). Instructions for remaining submission requirements are inconsistent. |
Per J-22a I., "The cost information in the electronic version of your completed business proposal must be in Excel 2010 format. The narrative supporting information can be in Excel 2010 or Word 2010 format. Vouchers and price quotes are the only supporting documentation that can be submitted in pdf format."
Per J-22a II.1, "The CMS-provided electronic file and the specified Excel and Word versions are the only acceptable format for your cost proposal submission. Proposals received in any other format will be considered unacceptable."
Per L.13.a, "All PDF files sent electronically and included on the CD shall contain bookmarks indicating each indexed section."
Per L.13.b.i, "The files on each CD shall be compatible with Microsoft (MS) Office 2010."
Per L.13.b.iii, "All PDF files shall contain bookmarks indicating each indexed section. The indexed section shall coincide/match the hard copy sections."
Per L.15.C, "The business proposal shall be submitted in an electronic version of the spreadsheet on a CD using Excel. Offerors also need to provide a PDF version of the complete business proposal."
Please clarify the required format (Word, Excel, PDF) for the business proposal and all supporting documentation that is required to be submitted on CD and electronically. The business proposal shall consist of a narrative, supporting documentation and cost spreadsheet.
The cost portion of the business proposal shall be in Excel format. The Excel spreadsheet shall be fully functional./editable
The entire business proposal (including narrative, supporting documentation and spreadsheet) shall be included in 1 PDF file, if possible, with bookmarks for tabbed sections, i.e. the PDF bookmarks shall match the tabs in the hard copy.
The CD for the business proposal shall include the PDF of the entire business proposal and the funcational Excel spreadsheet.
The cost shall be included in the hard copy and the PDF of the business proposal. Do not simply state "see attached CD".
18 Business Proposal L.15.B, Page 166 of 181 and Page 167 of 181; L.15.F.3, Page 169 of 181 Business Proposal Instructions, Contract Form and Representation and Certifications L.15.B, Contract Form and Representation and Certifications, states, "… Section B, G and H of the RFP shall be completed where applicable." L.15.F.3, Section K, Representation and Certifications states, "... Sections B,G, H of the RFP shall be completed where applicable."
Section G only has two places to be completed, G.7 Key Personnel and G.8 Subcontract/Consultant Consent. Normally, CMS has to approve and list the key personnel and approved subcontract(s). Can these sections be completed at time of award? Or does CMS want the Offeror to fill in these sections and submit with the business proposal? If required to submit, do all sections of G need to be submitted or only G.7 and G.8?
| Section H only has one place to complete and it is H.16.F related to Special Innovation Projects, which are not applicable at this time. Does the Offeror need to submit section H in the business proposal? | Submit only the sections that need to be completed. If they are not applicable, submit with the text "not applicable". | |||||
| 19 | Business Proposal | L.15.C, Page 166 of 181 | Business Proposal Instructions | Section C references Attachment J-22 and the J-22a Business Proposal Form Instructions. Is Section C of the business proposal instructions where the J-22 forms and all supporting documentation is to be provided in the business proposal submission? | It is not required to have the J-22 form under Tab C but it is recommended. | |
| 20 | Business Proposal | L.15.C, Page 167 of 181 | Business Proposal Instructions | Per L.15.C, "The Offeror shall use the business proposal spreadsheets and summarize total costs for the project using Form 719, in accordance with Attachment J.22 in addition to breaking out costs by major task listed in the SOW or major activity or set of activities as described in the project plan." |
The CMS Forms 685 do not have a Form 719. The CMS Forms 685 are set-up to capture data by year and not by major cost task. Form 685, tab "I. Management Plan" does have a list of major tasks. However, per the business proposal instructions, the information entered on this tab is FTE, direct labor hours and percent of effort to each task listed. Is the CMS-Form 685, tab "I. Management Plan" the only required form to meet this requirement? Will CMS be providing any additional forms to capture cost by major task?
| Form 685 is the only form required. No additional forms will be provided. | |||||
| 21 | Business Proposal | L.15.D, Page 167 of 181 | Subcontract and Consulting | CMS stated in Section G.8, Subcontract/Consultant Consent, that consultants are considered subcontractors. In Section L.15.D., are items 1 through 6 (excluding 3, Excluded Parties verification) required to be submitted for consultants? It seems Item 7 covers the information required for consultants. | No. Only complete the sections that apply. |
| 22 | Business Proposal | L.15.D, Page 167 of 181 | Subcontract and Consulting | Section L.15.D, Item 6, states, "Certificate of Current Cost or Pricing Data; not required for IDIQ award." How does the IDIQ reference pertain to this procurement for a firm-fixed price award? | Language should read "Certificate of Current Cost or Pricing Data" |
| 23 | Business Proposal | L.15.F, Page 168 of 181 through Page 169 of 181 | Business Proposal Instructions, Other Administrative Data | Section F has two bullet points listed below related to Statement of Proposal Validity and Responsibility Determination. Then it has a subsection 1. Proposal Details followed by a. Labor Rates, b. Indirect Rates, c. Independent Research & Development (IR&D), d. Subcontract Costs, e. Uncompensated Overtime. The order of the business proposal submission is not clear. Is the business proposal (J-22 and supporting documentation) to be included as a subsection of Other Administrative Data section? Also, is uncompensated overtime part of the business proposal details or should this be part of Other Administrative Data? |
Under Administrative Data there are three other subsections: 2. Completed SF33, 3. Section K, Representations and Certifications, 4. Small Business Plan. Are these sections to be included in the Other Administrative Data section of the proposal? L.15.B requires Section K, Representation and Certifications to be executed; should it be included in this section or under the Administrative Data section?
| The order of the business proposal seems out of order in regard to similar type RFPs. Please clarify the order of the sections, along with section content, required to be submitted in the business proposal. | There is no required order of information for the business proposal submission; however, using Section L.15 as a guide is recommended. | ||||
| 24 | Business Proposal | L.15.F.1.b, Page 168 of 181 through Page 169 of 181; and Attachment J-22a, Appendix F, Page 15 of 19 | Business Proposal Instructions, Other Administrative Data; Appendix F General and Administrative (G&A) / Overhead | Section L.15.F.1.b, states, 1) "An Offeror with current government approved indirect rates agreement should provide a copy of the forward pricing rate agreement with the proposal. 2) An Offeror without a current forward pricing rate agreement needs to provide the following ..." Per J-22a, "If the Offeror has an approved provisional indirect rate, then you are permitted to use this rate and not compute the G&A line items above." |
| If the Offeror has an approved provisional rate, but not a forward pricing agreement, can it submit that to support the indirect rates and meet the requirement in L.15.F.1.b? Or does the other information in L.15.F.1.b.2 (i & ii) need to be submitted since the Offeror doesn't have a forward pricing rate agreement? | Submit documentation supporting the rate being used. | |||||
| 25 | Business Proposal/SOW | Attachment J-22a, Appendix I, Page 19 of 19; C.3, Page 15 of 181 through Page 34 of 181 | Annual Management Plan; General Requirements | Appendix I, Annual Management Plan, does not have a column to record the efforts needed to fulfill the SOW, Section C.3, General Requirements. All other columns can be cross-walked to the SOW activities. How is the Offeror to allocate hours required for those efforts to the tasks listed in Appendix I, Annual Management Plan? | Attachment J-22 has been revised. | |
| 26 | COI | G.8/Page 76 & L.16, Page 171 | Conflict of Interest Instructions | Please confirm that the only COI information to be submitted by a proposed subcontractor is Tab A, Summary List of Contracts (page 172) – unless the subcontract has a value in excess of $5 million per FAR 52.203-13 (page 173). Since G.8 says consultants are considered to be subcontractors, is there a dollar threshold that applies to when the Summary List of Contracts is to be submitted? | Yes, Tab A is only requirement for subcontractors for COI submission. Consultants do not need to submit a summary list of contracts. | |
| 27 | COI | H, Pg. 94 | Post-Award Annual Audit | audit (includes financial and some program requirements) for calendar year 2015 may be required (due June 30, 2016 and/or annually thereafter)/arrangements and payment for audit responsiblity of contract holder if hold multiple CMS contracts - how is this correlated between current contract holders (who may have not received 2016 - 2020 award) and those who do receive award | CMS would like to provide further clarification concerning the new Post-Award Annual Audit language that has been added to the Conflict of Interest provision in Section H of the solicitation. |
CMS made a determination for the need of routine annual audits performed by every CMS contractor if there is not an approved mitigation plan which resolves an existing OCI. Both the mitigation plan and audit would be negotiating points prior to the issuance of any contract; however, the language is being included in the contract for the possibility that an OCI may arise during the period of performance. Since the frequency of how often an audit would be performed is unclear at this time, the audit requirements language will not specify any dates.
If there is not any potential for an OCI at pre-award of a contract, no audit would be routinely required. If one does arise requiring a mitigation plan, then as part of the process of approving the plan, the audit component will be included.
28 COI Instructions L.14/Amendment 000001 Page 7 b) Past Performance 2) Instructions a) & b) Would CMS please confirm that "All CMS contracts/task orders greater than the simplified acquisition" and "All relevant contracts/orders entered into with...." refer to contracts related to the SOW and that Offerors are not required to include all of their contracts in the past performance section? This question appears to discuss 2 different topics.
1. The COI submission shall include ALL current contracts.
2. The past performance section of the technical proposal shall include a summary to disclose all relevant past performance information for current contracts and contracts with a period of performance end date within the last 3 years of the date of this solicitation.
| 29 | COI Instructions | L.16 | |
| pg. 171 | A Tab A: Organizational Conflict of interest - Summary List of Contracts | Section L.16 states, "The Offerors or Contractors must disclose all contracts, both government currently held with CMS, other government health care agencies, or with non-government entities..." May subcontractors submit the summary list of contracts directly to CMS? | No. |
If subcontractor wants to submit sealed proposal, please include subcontractor proposal with the prime proposal submission.
| 30 | COI Instructions | L.16 | |
| pg. 171 | A Tab A: Organizational Conflict of interest - Summary List of Contracts | Section L.16 states, "The Offerors or Contractors must disclose all contracts, both government currently held with CMS, other government health care agencies, or with non-government entities..." If subcontractors must submit their list of contracts to the prime contractors, may they submit a version without contract values to the prime and submit the contract values directly to CMS? | No. |
If subcontractor wants to submit sealed proposal, please include subcontractor proposal with the prime proposal submission.
| 31 | General | 86 | G22 A133 audits | G22 on page 86 explains that there shall be an A-133 audit for nonprofit organizations. In previous years, CMS determined that A133 audits were not applicable for fixed price ESRD Network contracts. (See copy of letter attached.) A133 audits are considerably more expensive, and we estimate that CMS can save about $500,000 - $1 million nationally in this contract cycle if A133 audits are not required. Is it possible that Networks might not have to have A133 audits done during this 5-year contract? It will be helpful to get this question clarified so that appropriate cost estimates can be included in business proposals. | At this time these provisions will remain in the solicitation; however, CMS is still seeking additional clarification. Pending any new developments, a future amendment could to be issued. |
| 32 | General | Amendment 0002 | Questions and Responses | The following appeared in Amendment 2: "Which applicants are required to submit a transition plan as referenced in L-14 [Technical Proposal Instructions] in the RFP?” CMS Response: “Bidders who do not currently hold ESRD contracts should propose transition costs for the period of December 1 – December 31.” |
Follow-up questions:
1) From this response, we are interpreting that incumbent bidders (those currently holding a contract with CMS for the ESRD Network on which they are bidding) do not have to submit a transition plan in any of the volumes of their proposal. Please confirm the accuracy of this statement. If wrong, please provide specific instruction by volume.
2) From this response, we are interpreting that non-incumbent bidders (those not currently holding a contract with CMS for the ESRD Network on which they are bidding) only have to submit transition costs for the period of December 1 - December 31 in their Business Proposal, and no other information related to transition, i.e., no transition plan in the Technical Proposal.
1) A current Network bidding on the same Network (incumbent) does not need to propose transition costs for that network.
2) Those not currently holding the contract on a network on which they intend to propose shall include transition costs for that network. The transition will be included in the business proposal and the technical proposal. See technical instructions under section L.14.
| 33 | General | B,E,G, K | Certifications | Fixed price contract: why is there any reference to Cost Accounting? | Cost accounting standards take into consideration the overall dollar value and is not dependend on the contract type. |
| 34 | General | FARs | Small business subcontracting plan | How will a previous Prime Contractor's reporting be different as a subcontractor other than marking eSRS that we are now a subcontractor vs. prime contract holder? Seems reasonable that the same data would apply as there are no other tiers below us. Reading of FAR left me a wee bit uncertain. | Unclear as to which FAR reference you are referring. |
A large business prime contractor is responsible for the small business subcontracting plan and reporting. This is a new contract. Your status under a previous contract has no bearing.
35 General FARs small business identification majority of references state small business can provide their own documentation stating their type of small disadvantaged business designation; one reference indicates (for HUBZone) that we must got to SAM.gov to confirm. Does this apply to existing business relationships that are disadvantaged business enterprise HUBZone and service disabled veterans? Unclear as to which FAR reference you are referring.
If a prime offeror is declaring to be a small business or any specific small business designation, then CMS can confirm that information by searching the offeror's DUNS number at www.sam.gov. This is a full and open competition so proof of small business designation is not required to be eligible for award.
| 36 | General | FARs | cost accounting standards | lots of references to cost accounting but we are fixed price. Are the cost accounting principles applicable? | Yes. Cost accounting standards take into consideration the overall dollar value and is not dependent on the contract type. |
| 37 | General | FARs | employment eligibility verification | employees assigned to contract means they are hired after Nov. 6, 1986. With subcontractor status (transitioning from a Prime Contractor for ESRD Networks), will we be considered new hires and be required to go through e-Verify? | Please follow the regulations under FAR 52.222-54. If a contractor needs to enroll in the e-verify program, according to FAR 52.222-54, more information and instructions can be found at http://www.dhs.gov/how-do-i/verify-employment-eligibility-e-verify. |
| 38 | General | FARs | employment eligibility verification | Do major subcontractors need to register for e-verify within the 30 days of contract award? Are the following requirements applicable to the major subcontracts: individual employee verifications are due within 90 days after enrollment in e-Verify or within 30 days of EE's assignment to the contract, whichever date is later; new employees must be verified within 3 days of hire; etc. | Please follow the regulations under FAR 52.222-54. If a contractor needs to enroll in the e-verify program, according to FAR 52.222-54, more information and instructions can be found at http://www.dhs.gov/how-do-i/verify-employment-eligibility-e-verify. |
| 39 | General | FARs | Small business subcontracting plan | eSRS: close out 2015 (Nov of Dec) as Prime contractor and then Dec-Mar or Jan-Mar as subcontractor for March 31st report due. Can you provide clarification on actual due dates? | Refer to RFP Section G.20. |
The dates for this contract are referenced under Section G.20. Any current contracts are reported separately from this contract.
| 40 | General | G.22, page 86; G.23, page 86 | A-133 INTERIM AUDITS (FOR NON-PROFIT ORGANIZATIONS ONLY); CLOSEOUT AUDIT FOR PROFIT AND NON-PROFIT ORGANIZATIONS | Why or how would two different types of audits be necessary for non-profits (A-133 for new awards and A-122 for close out). Brief overview of these indicates A-122 is not applicable as it refers to cost reporting vs. fixed firm priced contract types. Current contract holders who typically have independent audits performed annually and intend to have one performed regarding January - December 31st may wish to reconsider since an audit of some kind may likely be required. Cost saving consideration. | At this time these provisions will remain in the solicitation; however, CMS is still seeking additional clarification. Pending any new developments, a future amendment could to be issued. | |
| 41 | General | M.4 / 179 | Evaluation Methodology | Please identify the criteria you will be using in evaluating each volume of the proposal, specifically the weighting and factors. | Refer to Section M of the RFP. | |
| 42 | General | OIG pre-award audits | Can CMS share its plans for OIG pre-award audits? Will OIG pre-award audits be requied? If yes, will OIG audits be required for all 18 Network contracts? | There will be no OIG pre-award audits. | ||
| 43 | General | Pre-proposal conference call slides | Can CMS please provide the slides used durig the pre-proposal conference call? | Slides will not be provided. The pertinent information from the slides was included in Amendment 2. | ||
| 44 | General | General | Is there a maximum number of networks that a bidder/contractor can win as a prime and/or sub? Or a maximum number of beneficiaries that a single organization/contractor can represent? | No. There is no limit. | ||
| 45 | General | There are 30 days in November, not 31. | This will be adjusted at time of award. | |||
| 46 | General/ | |||||
| Attachment J-14 | G.8/Page 76 | Subcontract/Consultant Consent | G.8 says consultants are considered subcontractors, and to facilitate the review of a proposed subcontract the Contractor shall submit the information required by FAR 52.244-2 and -5. We read FAR 52.244-2 to say that in a fixed-price type contract consent is required only on unpriced contract actions, and then only if it’s cost-reimbursement, time-and-materials or labor-hour type, or fixed price over the simplified acquisition threshold ($150,000) or 5% of the total cost of the contract. Please clarify when the J-14, Consent to Subcontract, is to be completed. Networks may have small business consultants providing very limited, but important, services. | Section G.8 has been updated as part of this amendment. | ||
| 47 | SOD #20 | pg 7 | Patients for NCC PE-LAN | SOW states in one place (pg 38, first paragraph that this deliverable is due by the end of the first quarter of each contract year. Later on page 38, in bullet one, the SOW indicates that this deliverable is due within 45 days of contract award. The SOD indicates that this deliverable is due within 45 days of contract award (February 15 each year). Please clarify the correct date. | February 15th is the accurate date. A correction has been made to the SOW. | |
| 48 | SOD #26 | pg 8 | BSI QIA | SOD states deliverable is due on 3/31 for the base year, attachment J-9 indicates a 1/31 due date for the base year. Please clarify the correct date. | March 31st is the accurate date. The J-9 Attachment will be updated to change 1/31 to 3/31. | |
| 49 | SOD #28 and #39 | Are these two deliverables requiring the same information? Please clarify. | Yes deliverables 28 and 39 are requiring the same information. Deliverable 28 will be removed. The SOD has been revised and some deliverables have been renumbered. | |||
| 50 | SOD #7 | pg 3 | Semi Annual Cost Report | The SOW states that the OY4 cost report is due by the last day of November, the SOD indicates 12/31/20. Please clarify the correct date. | November 30th is the accurate date. Deliverable #10 will be updated to reflect the November 30th. | |
| 51 | SOD;SOW | SOD pg. 3, 10, 11; RFP pg. 7, 23, 68 | SOD: Period of Performance; RFP: B.4, C.3.7., F.2. | Will Cost Reports be due November 30th or December 31st of OY4? Note period of performance dates: i.e., December 1, 2015 thru November 30, 2016 and following; some places December 1-31, 2015 "transition" | November 30th is the accurate date. Deliverable #10 will be updated to reflect the November 30th. The SOW will be updated to provide a period of performance December 1, 2015 - November 30, 2016. | |
| 52 | SOD;SOW | SOD pg. 8; RFP pg. 15 | SOD: C.4.1.A-D; RFP: Table 2.QIAs | Will QIAs be due November 30th or December 31st of OY4? | OY4 will mark the end of this contract cycle and no QIAs for future cycles will be due. At the conclusion of the Base and OY1 -OY3 Revisions to QIA participants will be due November 30th. Page 15 C.2.2.B of SOW will be updated. | |
| 53 | SOW | 15 | Network Activities | 1st paragraph states that "During 4th quarter…achieved success." While on pg This is contradicted on pg. 48 in the first partial paragraph last sentence where it states that "In the third quarter…QIA facilities to continue or replace…." Please clarify the timing of QIA facility adjustments. | Pg. 15 November 30th QIA submission applies only to those QIAs that do not have other timeframe specifications. Page 48 "in the third quarter…" language is accurate as it specifically applies to the BSI QIA. | |
| 54 | SOW | 26 | Emergency and Disaster Responsibilities of the Network: | C.3.13 States “Network will submit an emergency/disaster plan to its COR.” Do we need to use the CEMP template? | Offeror may choose to utilize any template (or none) to submit this plan. | |
| 55 | SOW | 29 | Security Review and Verification | States: “The Network shall provide annual certification in accordance with SA&A methodology that certifies it has examined the management, operational, and technical controls for its systems supporting the Network contract function and considers these controls adequate to meet CMS’ security standards and requirements.” This is a new requirement. Is it possible to get a preliminary view of the template? | The template is not currently available. It will be provided as soon as it becomes available. | |
| 56 | SOW | 37 | Involve Patients, Family Members, and Caregivers in CMS Meetings | Increases the required number of patients/Family/Caregivers for CMS meetings from 1 to 2. Also, 2 or more – is this per quarter or per meeting? | 2 Patient SMEs are required to attend 2 meetings per quarter. The same patients do not have to attend both meetings. | |
| 57 | SOW | 45 | Patient Safety: Healthcare- Associated Infections LAN | In the first paragraph letter c : it ask Networks to reduce HAI rates among ESRD patients receiving dialysis care in both in-center and home settings. NSHN does not currently track BSI (or other Dialysis Events- DE) for home patients. Is it the intent that Networks collect this data from facilities or use billing data? Is it expected that a modification is coming to NHSN to allow for DE for home patients? | The Offeror will only need to use the data that is available in NHSN. If home dialysis data is unavailable in NHSN it will not be required. | |
| 58 | SOW | 48 | Vaccinations | Last paragraph states that faciliies that achieve 60% vaccination rate for each measure will be replaced. Admitting that CrownWeb data is currently not representative of actual vaccination rates and that those patients that are naturally immune or immune due to previous exposure are not captured in CrownWeb, sample facilities are reporting 80% vaccination rates. Please provide direction if the Network does not have 10% their facilities below the 60% rate | Network will work with the lowest performing 10% even if those facilities are at or above 60%. | |
| 59 | SOW | 56 | Project A2 | In both letters f and g, should not the referrence be to letter e not d? | Yes the reference in F and G should be the E. Page 59 of the SOW will be updated to make the correction. | |
| 60 | SOW | 59 | Support the ESRD QIP, et al | Should bullet five be five business days? | Yes Bullet 5 will be changed to 5 business days. | |
| 61 | SOW | 60 | Select ESRD QIP Outcome Measures | Under #1. During the base year of the contract the Network shall work on the topic of Hypercalcemia performance. When evaluating current results, the percentage of the current hemodialysis population with an uncorrected serum calcium greater than 10.2 mg/dL was below 3%. Is the intent of this base year to work with such a small percentage of our population? | The requirement is that the Network work with the 10 lowest performing facilities regardless of their values. | |
| 62 | SOW | 64 | Provide Technical Assistance …. | Considering that the current scope of work has Networks performing NHSN data checks monthly, is it necessary to review the entire 2015 years data in March as according to bullet 2. | Yes | |
| 63 | SOW | 16; 115-116 | Board of Directors | States “The BOD must comply with Section H.20 of this contract”. Just want to verify this is correct. H.20 is “Open Government Proactive Pre-DisclosureNotification”. H.21 is “Governance and Compliance Requirements”. (pg 16; 115-116) | This reference has been corrected to indicate H.21. | |
| 64 | SOW | 35; 38 | Attachment J-4 Reporting Requirements | K. States “Submit Facility Attestations”, however in the CROWNWeb Data Management Guidelines, this is listed as a “Tier 1” activity. What is the expectation here? How does CMS expect these to be “resolved” and what should be used as the number? Same question for PART verification and Manage Clinical. | Section K of the J-4 Attachment for Reporting Requirements will be modified to indicate “Monitor Facility Attestations”. Submission of attestations is a Tier 1 activity. The number would represent all facilities within the Network. |
Section K of the J-4 Attachment for Reporting Requirements will be modified to indicate “Monitor Monthly PART Verifications”. PART verification is a Tier 1 activity. The number would represent total number of facilities within the Network.
Section K of the J-4 Attachment for Reporting Requirements will be modified to indicate “Monitor Monthly Clinical Compliance”. Clinical data submission is a Tier 1 activity. The number would represent all facilities within the Network.
65 SOW C.2.1
pg. 11-12;
C.4.1.A
pg. 35-38; and C.4.B
| pg.39-43 | Domains / Table 1: AIMs, Domains; Foster Patient and Family Engagement at the Facility Level; and Patient Experience of Care | While the AIMS, Domains, and Sub-Domains table presented in section C.2.1 provides a summary list of the AIMs, Domains, and Sub-Domains to be addressed in an Offeror’s proposal submission, the Offeror is reliant on the detailed Domain/Sub-Domain requirements presented in Section C.4 to construct responses. Sections C.4.1.A, C.4.1.A.2, and C.4.1.A.3 present the Sub-Domain performance requirements associated with the Patient and Family Engagement Domain in the same order listed within the table provided in Section C.2.1. However, it does not appear that Section C.4.1.B Patient Experience of Care uses the same approach to present the Sub-Domain requirements. Would CMS consider providing the requirements associated with the Conduct QIA to Improve Facility Grievance Process, Address Issues Identified through Data Analysis, and Recommend Sanctions Sub-Domains? | Offeror should utilize the SOW and all applicable RFP attachments to submit a proposal. |
| 66 | SOW | C.2.2.B | |
| pg. 14-15 | Network Activities | Section C.2.2.B states "… QIAs shall be based on achievement of results by September of the contract period." Please clarify if the three AIMs evaluation are to be based on September data, which become available in October or November, or on the most recent data available at the end of September. | The evaluations will be based on the October DIF. Page 15 of the SOW will be updated to reflect this. |
| 67 | SOW | C.2.2.B |
pg.14-15 and C.4.1.D.3
| pg. 47-48 | Network Activities and Reduce Rates of Dialysis Events | Please clarify the timeframe relationship between the evaluations of the three AIMS requirement stated on pg.14 (Sept of the contract period) vs. the pg. 48 requirement that "The Network shall demonstrate a 5% or greater relative reduction in the pooled mean at re-measurement compared to the previous year (1st/2nd quarter 2016)? | The evaluations will be based on the October DIF. Page 15 of the SOW will be updated to reflect this. | |||
| 68 | SOW | C.2.2.B./pg15 | Network Activities | The direction seems to indicate that QIAs may run over multiple years, please confirm. | Yes. Networks are expected to update QIAs annually, as directed by the SOW . | |
| 69 | SOW | C.2.2/p.10 | A Role of Network | Does "Sharing information to promote care coordination for ESRD patients (NQS Principle 8)" incorporate the responsibility to continue to respond to selected inquiries from CMS-approved Medicare Advantage Organizations (MCOs)? The responsibility is not listed specifically, however under CROWN MEMO 13-0756-CO, this has been a continued requirement, with the numbers to be reported monthly under 'Additional Information'. | Yes. This is a continued requirement. | |
| 70 | SOW | C.3.18./29 | Internal Quality Improvement Program | In the current SOW, the IQI reports are to go to the BOD, the requirement in the 2016 SOW is to send the reports to the MRB. Is this correct, or should this be the BOD? | The IQI should go to the BOD. Page 29 of the SOW will be updated with the current information. | |
| 71 | SOW | C.3.4./20 | Communication Requirements | The SOW states "Materials shall be appropriately translated for non-English speakers, as applicable." Could you please provide additional guidance; does this mean that the Network will translate for any request, based on a % of population, or?? Is there a requirement for the Network to use a certified translator or is a native speaker acceptable? | The Network should make reasonable efforts to ensure that the needs of the patients of the Network service area are being met. Certified translators are preferred. | |
| 72 | SOW | C.3.8. | ||||
| pg. 24 | Meetings | Section C.3.8 states that "Networks shall receive CMS approval for all in-person meetings (e.g. LAN Meetings) prior to January 1 of the year in which the meeting will occur." At what time should the Networks submit approval requests for in-person meetings occurring within the base year? | Networks should request approval for any known in person meetings upon award of the contract. | |||
| 73 | SOW | C.4.1.A.2 | ||||
| pg. 37 | Involve Patients, Family Members, and Caregivers in CMS meetings | Section C.4.1.A.2 states "In at least two of the monthly COR monitoring meetings held during each quarter, two or more Patient SMEs and/or family members or caregivers shall participate." Please clarify if this statement requires the Offeror to provide two total SMEs/family members/caregivers for both meetings (one per meeting), or two SMEs/family members/caregivers per meeting (four total)? | 2 Patient SMEs are required to attend 2 meetings per quarter. The same patients do not have to attend both meetings | |||
| 74 | SOW | C.4.1.A.2/p. 37 | Involve Patients, Family Members and Caregivers in CMS Meetings | Patients and family members are to be included in "at least two of the monthly COR monitoring meetings held during each quarter." Does this mean that patients need to be on at least 2 of 3 calls per quarter (a total of 8 calls)? | 2 Patient SMEs are required to attend 2 meetings per quarter. The same patients do not have to attend both meetings. | |
| 75 | SOW | C.4.1.A.3 | ||||
| pg. 37-38 | Support the ESRD NCC Patient /Family Engagement LAN | Section C.4.1.A.3 states that "The Network shall support the N-PFE LAN by enlisting the participation of 5 of the 15 selected patient SMEs and/or family members or caregivers to serve as representatives on the N-PFE LAN by the end of the first quarter of each contract year." However the first bullet on the same page states "Within 45 days of contract award, recruit five (5) Patient SMEs and/or family members or caregivers (from the group of 15 Patient SMEs) to participate on the N-PFE LAN throughout the contract year, 3 of whom must be eligible patients on the transplant waitlist." Will the time period for selection of SMEs for the N-PFE be different for the base year? If yes, what will it be? | No the time period will be the same. February 15th is the accurate date. | |||
| 76 | SOW | C.4.1.A.3./38 | Support the ESRD NCC PE-LAN | The SOW states that 3 of the 5 patient SME volunteers who will support the NCC PE-LAN shall be eligible on the transplant waiting list. This ratio seems to be unfairly weighted. Would CMS re-consider to allow more patients that are not eligible or not interested in transplantation to participate on the national level? | No. CMS requires the recruitment of patients who are on the transplant waitlist. | |
| 77 | SOW | C.4.1.B.4./42 | Promote the use of ICH-CAHPS | In paragraph 2, the SOW states that "the Network shall assist qualified facilities with interpretation of results and development of an action plan…" Please provide the criteria for "qualified facilities." | Qualified facilities for the purposes of C.4.1.B.4 are those eligible for ICH-CAHPS | |
| 78 | SOW | C.4.1.B.4./43 | Promote the use of ICH-CAHPS | How will the Network receive the ICH-CAHPS data? Will CMS provide the data directly by way of the vendors or will Networks be expected to reach out to every dialysis facility to retrieve the data. These two methods require very different levels of effort. | The NCC will provide ICH-CAHPS data | |
| 79 | SOW | C.4.1.C.1 | ||||
| pg. 43 | Reduce Catheter Rates for Prevalent Patients | Section C.4.1.C.1 states the Network "…shall target a Network reduction in the rate of long-term catheter use among prevalent patients by at least 2 percent in dialysis facilities that have a >10% rate of long term catheter use in prevalent patients at baseline." Would CMS consider excluding newly certified facilities, which may contain a low number of patients, or establish criteria for low census facilities? Due to the low denominator, data obtained from these facilities may be inaccurate. | No. Networks are to work with the facilities with LTC rates >10%. | |||
| 80 | SOW | C.4.1.C.1/p. 43 | Reduce Catheter Rates for Prevalent Patients | The 2% reduction goal is noted, but no formal due date is provided in the SOD. Will this be added? | Networks are to report activities on the COR monthly report. Final evaluation of this measure will be based on the October DIF. | |
| 81 | SOW | C.4.1.C.1/p. 43 | Reduce Catheter Rates for Prevalent Patients | No exclusion criteria are noted for facilities included in the LTC group. Will low volume facilities be added to the exclusion list given the significant impact one patient can have on the rates of these facilities and the Network averages as a whole? | No exclusion criteria is anticipated at this time. | |
| 82 | SOW | C.4.1.C.4 | ||||
| pg. 44 | Provide Technical Support in the Area of Vascular Access | In section C.4.1.C.4, the last bullet states "The Network shall propose the intervention(s) that it plans to use in achieving the AV fistula-in-use goal ..." What is the AV fistula-in-use goal? It does not appear to be provided in the SOW. | AV fistula-in-use-goal is not accurate. Page 44 of the SOW will be updated to change AV fistula-in-use-goal to LTC-in-use-goal | |||
| 83 | SOW | C.4.1.C.4/p. 44 | Provide Technical Support in the Area of Vascular Access | The 7th bullet indicates that "The Network shall propose the intervention(s) that it plans to use in achieving the AV fistula-in-use goal…" This performance goal is no longer specified in the SOW or SOD. Is there a designated goal moving into this SOW? Will this be changed to a performance metric or is the ongoing goal to continue to increase AVF without a set metric? | AV fistula-in-use-goal is not accurate. Page 44 of the SOW will be updated to change AV fistula-in-use-goal to LTC-in-use-goal | |
| 84 | SOW | C.4.1.D.3/48 | Reduce Rates of Dialysis Events | Facilities are only required to enter data in NHSN quarterly. Are NWs permitted to contradict those deadlines by asking for monthly data? | Networks are to provide monthly updates to the DIF using the quarterly updates provided by NHSN | |
| 85 | SOW | C.4.1.D.3/48 | Reduce Rates of Dialysis Events | Last paragraph of section is confusing with timing of project. If baseline period is 1st and 2nd quarters of 2015 and remeasurement is 1st and 2nd quarters of 2016, when will the work and interventions be done? Implies late 2015 but contract does not begin until 2016. In addition, 6 months of intervention is probably not sufficient to realize a 5% decrease in BSI. | Networks should be working their interventions as quickly as possible. | |
| 86 | SOW | C.4.1.D.3/pp. 47-48 | Reduce Rates of Dialysis Events | The last paragraph in this section states "Networks shall monitor the BSI rate for QIA facilities and report monthly results..." At this time facilities are not required to report these results monthly, but rather by the end of the quarter when data closes in NHSN. Will this timing change to ensure that data can be accurately reported on the DIF, since we can only change up to the previous 2 months of data at this time in the DIF? | Networks are to provide monthly updates to the DIF using the quarterly updates provided by NHSN | |
| 87 | SOW | C.4.1.D.3/pp. 47-48 | Reduce Rates of Dialysis Events | This section notes reduction of BSI/Sepsis. Since sepsis can be from other sources, are we to evaluate only access related-BSI/sepsis. If so, where are we obtaining the data showing the sepsis since NHSN only reflects the BSI/dialysis event, not the sepsis? | For this QIA, Networks will utilize NHSN data only. | |
| 88 | SOW | C.4.1.D.4 |
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