Questions_and_Answers_MPAPA-Amendment_000001.pdf

HHSM-500-2013-RFP-0030

Medicare Part A Provider Appeals (MPAPA) Request for Proposal Amendment 000001

Section J

Reference: Solicitation Section J, Attachment J.5 – NON-DISCLOSURE STATEMENT

Q1. Is the Non-Disclosure Statement meant to be included with the proposal or is it signed upon contract award?

Answer Q1. The Non-Disclosure Statement should be signed and included with the proposal.

Reference: Solicitation Section J, Attachment J.11 – REQUEST FOR PHYSICAL

ACCESS TO CMS FACILITIES – CMS FORM 730A

Q2. How and when should form CMS Form 730A be submitted in connection with this solicitation?

Answer Q2. Form 730A will only need to be submitted should your organization need access CMS buildings on a consistent basis. At this time, consistent access is not necessary.

Section K

Reference: Solicitation Section K.4 FAR 52.204-8 ANNUAL REPRESENTATIONS AND CERTIFICATIONS (p. 54 of 97)

Q3. If the Offeror is a small business, is currently registered in CCR (SAM) and has completed ORCA (SAM) electronically, what parts of Section K must be included in the proposal? For example, are subsections K1. through K.4. sufficient?

Answer Q3. All questions must be answered in Section K. If the question does not apply to you answer N/A.

Section L

Section L.1

Q4. Has an anticipated Contract Award Date been established?

Answer Q4. The contract will not be awarded prior to the end of this fiscal year, September 30, 2013.

Reference: Solicitation Section L.8 – GENERAL INSTRUCTIONS: H COMPACT DISCS (CDS)/DVDS (p. 76 of 97)

Request for Proposal Amendment 000001

Q5. The instructions read:

“1. Each CD/DVD shall clearly identify each volume, COPY # of , solicitation number, Offeror’s name, address and contact information.

2. If the material for a volume requires more than one CD/DVD, then that volume shall be labeled with the name and number of the volume and CD/DVD number (i.e., Technical Proposal, Part I,CD/DVD 1 of #). The original of each Volume shall be marked ORIGINAL and all other copies shall be marked COPY # of .”

We believe the reference to “Original” is meant for hard copy. Assuming that a volume can be contained on one CD, do the instructions mean that the Hard Copies should be labeled “Original” and “Copy 1 of 1,” while the CDs should be labeled “Copy 1 of 4” “Copy 2 of 4” “Copy 3 of 4” and “Copy 4 of 4”?

Answer Q5. Original is meant for the first copy of the hard (paper) copy and the first copy of the CD. Each ‘original’ is marked “Original”. Each copy after that is marked “Copy 1 of __.

Reference: Solicitation Section L.10, TAB F. Adequate Accounting System (p. 80 of 97)

Q6. Item c. references “DCAAP 7641.90, pp. 25.” However, the document included with the Solicitation is not numbered in that way. Rather, it uses chapter and then page within the chapter (e.g., “5-29”). Can CMS please provide the intended reference?

Answer Q6. A response will provided to this question in a later amendment.

Reference: Solicitation Section L.10.A. PROPOSAL ORGANIZATION – VOLUME I – BUSINESS PROPOSAL: Volume I, Section 2 – Business Proposal – TAB C. Business Proposal Spreadsheets (p.82 of 97)

Q7. The instruction for TAB B.1 – Exhibit E.1 ends with the clause “. . . and dependent upon the offeror’s accounting system.” Can you please advise if this is a typo, that is, are there extra or missing words?

Answer Q7.Tab B.1 has been revised to read Tab C.1. Please see revised Tab C.1.

Reference: Solicitation Section L.10.A. PROPOSAL ORGANIZATION – VOLUME I – BUSINESS PROPOSAL: Volume I, Section 2 – Business Proposal – TAB C. Business Proposal Spreadsheets (p. 82 of 97)

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Q8. The instructions under TAB C. Business Proposal Spreadsheets describe TAB B.1, TAB B.2, and TAB B.3. Can you please advise if this is a typo, that is, should the descriptions be for TAB C.1, TAB C. 2 and TAB C.3?

Answer Q8. Yes. The solicitation has been revised to reflect the changes.

Solicitation, Section L .10, Volume I, Section 2 – Business Proposal (page 82) Tab C.

Q9. There are three sub tabs under Tab C, but they are labeled Tab B.1, B.2 and B.3. Should they be labeled C.1, C.2 and C.3 when we submit the proposal?

Answer Q9. Please see response to question 8.

Reference: Solicitation Section L.10.B.1 PROPOSAL ORGANIZATION – VOLUME II – TECHNICAL PROPOSAL, TAB G. – Past Performance (p. 85 of 97)

Q10. The instructions permit “. . . Offerors having no organizational past performance record may provide references for proposed personnel.” The Past Performance Questionnaire (Attachment J.8) does not seem entirely appropriate for such personnel references. Is a letter of reference substantially covering the performance areas noted in the Past Performance Questionnaire acceptable?

Answer Q10. No. a letter of reference is not acceptable. This paragraph has been revised to correct and complete the sentence.

Section L.10, Subsection B.1, Tab G- Past Performance

Q11. This section states that the past performance questionnaires must be submitted directly to CMS by the references provided no later than one (1) week after the proposal due date. However, in the timeline provided in Section L.1- Procurement Timeline, the due date for the past performance questionnaires is indicated as 8/21/2013. Can you provide clarification around the due date for these questionnaires?

Answer Q11. Past Performance questionnaires must be submitted by September 13, 2013 which corresponds with the “no later than one week after the proposal due date”. The RFP is revised at Section L.1 to reflect the change.

Request for Proposal Amendment 000001

Business Proposal Cost Assumptions

Q12. Under the sampling for bidding purposes only caption we are to assume 150 group appeal requests are received during the year. On average how many providers should be assumed per group appeal.

Answer Q12. An average of 15 providers per group appeal should be used for bidding purposes.

Key Personnel

Q13.Will CMS consider accepting an individual as Program Director who possesses significant years of experience (i.e. over 25 years) in the field of Medicare Audit and Reimbursement, including Medicare Cost Report Appeal work, if that individual does not have a Bachelor’s degree?

Answer Q13. Yes, CMS will take into consideration an individual’s years of experience in the field of Medicare Audit & Reimbursement including Medicare cost report appeal work, if the individual does not have a Bachelor’s degree.

Reference: 3. Specific Requirements, Task 1: Appeal Activities – PRRB Individual and Group Appeal Activities (p.5)

Q14. The SOW, at 3.8.e.iii, requires: “Establish and maintain an electronic database of PRRB decisions. The database shall be available to CMS and MACs. The database shall also include Administrator decisions.” The CMS Web site already maintains this information (http://www.cms.gov/Regulations-and-Guidance/Review-Boards/PRRBReview/List-of-PRRB- Decisions.html). Please advise how this SOW requirement differs from the current CMS effort.

Answer Q14. The current CMS effort is a listing of decisions. The ASC will maintain a database of PRRB and Administrator decisions which will identify each specific issue decided in the decision so that the database can be used as a tool for contractors when conducting research. In addition, a future enhancement to the database will include following a case through the court system.

The Solicitation, Offer and Award document on Page 80 of 97 refers to Volume I, Section 2—Business Proposal—a. Cost Assumptions.

Please see sampling for bidding purposes only; not reflective of actual stats: “50 group cases were closed during the year; jurisdictional documents were submitted to the lead contractor”

Q15. Please clarify this item. Does “Closed” refer to there no longer being an active appeal or is this referring to ”Complete”, which means that the group case may move forward to

Request for Proposal Amendment 000001

Appeal?

Answer Q15. The term “closed” refers to group cases that were fully formed; all providers have been added to the group and Schedule G has been submitted to the PRRB and lead contractor.

Statement of Work

SOW, Section 3, Task 1 requirement 1

Q16. Who maintains the System Tracking for Audit & Reimbursement (STAR)

Answer Q16. Each contractor is responsible for maintaining STAR for its workload. The ASC will have the capability to enter data on some of the STAR screens and read-only capabilities on other screens.

SOW, Section 3, Task 1, requirement 3d

Q17. This requirement calls for the “Establish and maintain an electronic database.” Is this in

STAR?

Answer Q17. The jurisdictional electronic database is not included in STAR. Similar to Q14 above, the ASC will maintain a database of jurisdictional challenges and decisions that can be used as a tool for contractors when conducting research.

SOW, Section 3, Task 1, requirements 7

Q18. Is mediation included in this workload? If yes, is it combined with the 2,000 cases resolved, as noted in the Solicitation, Offer and Award document, Page 80 of 97? Please clarify “physically attend.” Does this mean the awarded contractor must physically attend all Appeal or Issue Resolution and Mediation sessions?

Answer Q18. Mediation is not a term officially used by CMS. For bidding purposes, resolution meetings between the MAC, provider and PRRB are not included in the sample.

Yes, the awarded contractor must physically attend all resolution meetings whenever a MAC, provider and PRRB are in physical attendance for such meeting.

SOW, Section 3, Task 1, requirement 8, PRRB Hearings Currently the ASC pays the expenses of the witness for live hearings. This expense is not listed in the proposal SOW.

Request for Proposal Amendment 000001

Q19. Is the contractor required to pay the expenses for MAC or other witnesses for a PRRB hearing?

Answer Q19. Yes, the contractor is required to pay the expenses for the MAC or other witnesses to attend a PRRB hearing when such presence is deemed necessary. Section 3, Task 1, Requirement 8b, has been revised to reflect this requirement.

The Solicitation SOW Task 2

Description states that the MPAPA will perform the following activities:

“2. Provide a hearing officer and coordinate Medicare Part A Cost Report individual appeals before a hearing officer.”

Q20. Please clarify this statement. Is the proposal referring to “Intermediary Appeals”?

Answer Q20. Yes, this statement refers to “Intermediary Appeals”.

SOW, Section 3, Task 4, requirement A.2

Q21. Can the key persons have multiple places of performance?

Answer Q21. Yes, key persons can have multiple places of performance.

SOW, Section 3, Task 4, requirement A.2

Q22. Can a home office be considered a place of performance?

Answer Q22. No, a home office is not considered a place of performance.

SOW, Section 3, Task 4, requirement A.2.a, bullet 4

Q23. Our small business reserves the authority to bind the company to contract modifications to a higher level executive than Program Director. Could this requirement be modified to either exclude the phrase “and binding the entity to contract modifications” OR insert the following phrase at the beginning “After consultation with next level senior management, has authority

Answer Q23. Section 3, Task 4, requirement A.2.a has been modified to include a separate bullet that states the Program Director shall “have the authority to bind the entity to contract modifications if not performed by a higher position.