BFCC-QIO_Amendment_3_Additional_Industry_Questions_CMS_Responses.doc

BFCC-QIO Amendment Number 3 Industry Questions CMS Responses January 9, 2014

1. Immediate Advocacy is included as part of the 37% non-review costs.

2. Do not specifically budget for intensified reviews. These reviews are already included in the other case review volumes.

3. CMS assumes that the 37% non-review budget assumptions will cover any costs associated with assistant at cataract reviews.

4. The Fraud and Abuse reviews are assumed under the Referred Quality of Care (QOC) – Referral Cases.

BFCC Sup Sch Yr 1: F. Other Direct Costs (row 54). ODC costs map from the QIO ODC sheet. The mapping in Cell E54 should reference QIO ODC E44, not F44. This error is duplicated in all columns except Non-Review Activities, IT and Transition costs.

BFCC Sup Sch Yr 2, 3, 4 ,5:

F. Other Direct Costs (row 54). ODC costs map from the QIO ODC sheet. The mapping in Cell E54 should reference QIO ODC E44, not F44. This error is duplicated in all columns except Non-Review Activities, IT and Transition costs.

F. Other Direct Costs (row 54). In addition to the column errors mentioned above, the row reference to the QIO ODC sheet is incorrectly pulling row 44 instead of the correct Year 2 row (row 77). Note the error begins in cell C54 and all subsequent columns. Please correct these links.

Travel Detail: The total formula is referencing the incorrect mileage rate cell for years 2-5. Please correct those cell references.

BFCC Suppl Sch: Columns U, W & AA (Non-Rev, IT & Transition) row 60 (Fee). The formula adds each of the year sheets and divides by 5. The formula should not divide the fee by 5 in these columns. Please remove the “5” from the formula.

Quality of Care Reviews: 0.84 hours

EMTALA 5-day: 1.13 hours

EMTALA 60 day: 1.35 hours

BIPA: 0.34 hours

Grijalva: 0.4 hours

Weichardt: 0.25 hours

HWDRG: 0.06 hours

QOC Referrals: 0.26 hours

Pre-Admission and Admission HINNs: 0.45 hours

Sanctions: 5.7 hours

Please report these hours on the physician review/consultant lines on the Business Proposal Forms.

This statement appears in the discussion of responsibility. Since, responsibility and financial resources required to perform a contract depend on the specific offeror and the approach utilized by the offeror, and because the responsibility determination is not a technical requirement of the RFP, will CMS change the language of the proposal instruction to say that offerors with such net worth will be deemed to have financial capability but financial capability to perform the contract can be shown by other means?

Otherwise, will CMS confirm that non-profit offerors do not have to demonstrate a net worth in excess of 10% of the annual total cost-plus-fee” to be eligible to receive a BFCC-QIO contract award?

If CMS will not change the net worth language, how will CMS measure or evaluate the “net worth” of a non-profit organization that is an offeror?

Also, please provide, for each region, the “annual total cost-plus-fee” for the BFCC-QIO contract that will be used for purposes of determining a whether an organization’s net worth exceeds 10% of the annual cost-pus-fee.

Under L.14.D. Tab 10, the 2nd paragraph is revised to read as follows: “Offeror’s Financial Capability: In accordance with FAR 9.104-3, your proposal must indicate whether you have the necessary financial capacity, working capital, and other resources to perform the contract without assistance from any outside source (If not, indicate the amount required and the anticipated source).

The next paragraph that begins with “At a minimum,” in the RFP is hereby deleted; therefore, removing the 10% requirement.