ESBD_489206_1770832940044_Scope of Work (SOW)_Cost Report Review Project_RFP.pdf

Rider 101-Scope of Work

Project Title:

Cost Report Review Project

Background / Purpose:

MD Anderson Cancer Center (MD Anderson) seeks a qualified consultant to perform an independent review of the FY 2025 filed Medicare Cost Report (CMS-2552-10).

Project Objective:

The purpose of this engagement is to:

• Validate the cost report calculations and support documentation against current cost reporting rules and regulations.

• Identify and quantify reimbursement enhancement opportunities (short-term actions and strategic long-term improvements).

• Provide implementable recommendations supported by transparent calculation and assumption.

• Develop an actionable plan to support feasible implementation by MD Anderson’s

Reimbursement Department.

Scope of Services / Tasks:

Document Access and Intake MD Anderson will facilitate access to the FY 2025 cost report package and related support.

Consultants’ responsibilities include requesting, indexing and validating completeness of documentation for analysis.

Included Materials

• Medicare Cost Report – FY 2025 filed version

• Revenue and Expense details supporting the cost report

• Statistics and allocation bases (square footage, FTE’s, patient days, meals, etc.)

• Medicare Paid Logs

• Prior audit adjustments, Notice of Program Reimbursement (NPR), and settlement history available on request.

• Any additional documentation not previously stated but needed to complete the engagement.

Access Method & Security All documentation will be provided through a secure OneDrive site in a designated folder structure. Some materials may contain PHI (bad debt detail) and/or sensitive workforce compensation information (physician employment information and employee salaries).

Consultants must comply with all applicable privacy, security and confidentiality requirements under the governing agreement.

Stakeholder Coordination and Communication The Consultant will collaborate closely with MD Anderson stakeholders to ensure timely data exchanges, efficient issue resolution, and transparent communication throughout the engagement.

• Participate in a project kickoff meeting to confirm the scope, schedule, deliverables, and data requirements.

• Conduct weekly project status and working meetings to review progress, address questions, and identify any emerging issues.

• Maintain a target turnaround time of 1-2 business days for data requested from MD Anderson, unless otherwise mutually agreed upon.

Cost Report Review The Consultant will perform an independent review to assess accuracy, compliance and compliant revenue optimization opportunities within the cost report. At a minimum, analyses should address the areas listed below, and may include additional relevant areas identified during the review:

• Cost report allocations, reclassification, and adjustments

• Bad debt

• Graduate Medical Education (GME) components

• Worksheet D-6 and related items

• Other cost report elements impacting reimbursement settlement outcomes and future filings.

In addition, the Consultant will include the following as part of the analytical review.

• Regulatory considerations: Identify any pending or newly issued regulatory changes that may impact MD Anderson reimbursement. Provide summarized relevance and potential implications.

Findings and Recommendations Consultant will develop findings and recommendations that are data-supported and compliant with current rules and regulations. Recommendation should include both short-term actions and strategic long-term improvements.

Develop an implementation plan for recommendations.

Consultant will develop an implementation plan to support the adoption of approved recommendations by MD Anderson’s Reimbursement Department.

• Include a prioritization approach (impact x effort x risk)

Timeline:

Estimated completion: June 30, 2026

Roles and Responsibilities:

MD Anderson’s Responsibilities

• Provide input and access to all documentation and additional requests in a timely manner.

• Will be available for scheduled meetings and reviews.

• Provide directions, review deliverables, resolve any issues that arise, approve final findings.

Consulting Firm Responsibilities

• Perform a thorough, independent review of the FY 2025 filed Medicare Cost Report.

• Identify and quantify appropriate reimbursement enhancement opportunities.

• Provide timely updates through scheduled meetings.

• Adhere to all appliable client policies and legal/regulatory requirements governing confidential information, PHI, and sensitive employee data.

Deliverables:

• Project plan, initial data request list, and communication plan.

• Draft findings and preliminary recommendations.

• Final report describing findings, recommendations, quantified impacts, risk and full calculation support.

• Presentation summarizing approach, key findings, recommendations and prioritized opportunities.

Invoicing and Payment Supplier to invoice MDA in accordance with Rider 116 Invoice Payment requirements upon MD Anderson acceptance of final report.