HHSM-500-2015-RFP-0113_signed_amendment_3.pdf

(x)

HHSM-500-2015-RFP-0113

x x copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted ; or (c) By separate letter or telegram which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGEMENT TO BE RECEIVED AT

THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted , such change may be made by telegram or letter, provided each telegram or letter makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

x

AGG/EB

Contract Specialist Eisha Banks

ASG - DPIFMC

BALTIMORE MD 21244-1850

7500 SECURITY BLVD., MS: B3-30-03

CMS,OAGM,ASG,DPIFMC

06/08/2015000003

13. THIS ITEM ONLY APPLIES TO MODIFICATION OF CONTRACTS/ORDERS. IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

12. ACCOUNTING AND APPROPRIATION DATA (If required) is not extended.is extended, Items 8 and 15, and returning

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended , by one of the following methods: (a) By completing

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

FACILITY CODE CODE

10B. DATED (SEE ITEM 13)

10A. MODIFICATION OF CONTRACT/ORDER NO.

9B. DATED (SEE ITEM 11)

9A. AMENDMENT OF SOLICITATION NO.

CODE

8. NAME AND ADDRESS OF CONTRACTOR (No., street, county, State and ZIP Code)

7. ADMINISTERED BY (If other than Item 6)CODE 6. ISSUED BY

PAGE OF PAGES

4. REQUISITION/PURCHASE REQ. NO.3. EFFECTIVE DATE2. AMENDMENT/MODIFICATION NO. 5. PROJECT NO. (If applicable)

1. CONTRACT ID CODE

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

05/06/2015

CHECK ONE A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER (Specify type of modification and authority) appropriation date, etc.) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

E. IMPORTANT: Contractor is not, is required to sign this document and return __________________ copies to the issuing office.

ORDER NO. IN ITEM 10A.

14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

A. This amendment revises versions of the following:

1. Incorporates Questions and Answers;

2. Revises versions of the following Statement of Work (SOW) documents;

3. Revises the solicitation as Section J and Section L

Period of Performance: 09/15/2015 to 09/14/2020

16A. NAME AND TITLE OF CONTRACTING OFFICER (Type or print)15A. NAME AND TITLE OF SIGNER (Type or print)

15C. DATE SIGNED 16B. UNITED STATES OF AMERICA 15B. CONTRACTOR/OFFEROR 16C. DATE SIGNED

(Signature of person authorized to sign) (Signature of Contracting Officer)

THERESA A. SCHULTZ

STANDARD FORM 30 (REV. 10-83)

Prescribed by GSA

FAR (48 CFR) 53.243

NSN 7540-01-152-8070

Previous edition unusable

Except as provided herein, all terms and conditions of the document referenced in Item 9 A or 10A, as heretofore changed, remains unchanged and in full force and effect .

HHSM-500-2015-RFP-0113 Medical Claims Review for Managed Care Organizations Amendment 000003

4) This amendment revises versions of the SOW documents as follows:

a. SOW – Medical Review Contractor (MRC) (Revisions in redline)

b. Appendix B – Sampling and Extrapolation Guidance (Only change was to make name of MRC consistent).

c. Appendix D - Extrapolation Template (Only change was to make name of MRC consistent).

d. Appendix H – Overall Review Timeline (Revisions in redline)

e. Appendix I – Medical Review Steps (Revisions in redline)

f. Appendix J – Cost Plan Contract List (This is a new document)

g. Appendix K – MCOs to be Reviewed (This is a new document)

5) This amendment revises the following solicitation sections:

a. Section J – List of Exhibits, at Appendix J, Appendix K and Attachment E.3 are revised and attached hereto. The solicitation questions and answers are hereby provided as Attachment E.4 to this amendment.

PART III – LIST OF DOCUMENTS, EXHIBITS, AND OTHER

ATTACHMENTS

SECTION J - LIST OF ATTACHMENTS

J.1 Medical Claims Review of Managed Care Organizations (MCOs) Statement of Work (SOW) J.1.a Appendix A Schedule of Deliverables J.1.b Appendix B Sampl & Extrap Guidance J.1.c Appendix C MCO Standard Sampling Plan J.1.d Appendix D Extrapolation Template J.1.e Appendix E Cost Report Instructions 2013 J.1.f Appendix F Final Cost Report 2013 J.1.g Appendix G Overall Review Timeline J.1.h Appendix H Medical Coding Review Steps J.1.i Appendix I Medical Review Steps J.1.j Appendix J Cost Plan Contract List (This is a new document) J.1.k Appendix K MCOs to be Reviewed (This is a new document)

J.2 Wage Determination (To be included at award) J.3 Subcontract Checklist J.4 Virus Detection Certification J.5 Responsibility Questionnaire J.6 Past Performance Questionnaire

SECTION J – LIST OF EXHIBITS

E.1 Prime Proposal Checklist E.2 Subcontractor Proposal Checklist E.3 Business Proposal Spreadsheet (Updated spreadsheet) E.4 Medical Review of MCO Questions Template

6) This amendment revises Section L.1, Procurement Timeline as follows:

L.1 Procurement Timeline:

Request for Proposal (RFP) Issued May 6, 2015 Questions Due May 18, 2015 Questions Answered June 3, 2015 Notice of Intent to Submit Proposals June 9, 2015 Proposals Due June 19, 2015 Award of Contract September 15, 2015

7) This amendment revises Section L.8, General Instructions, (f) as follows:

L.8 General Instructions:

(f) When/Where/How Many Proposals to Submit:

One (1) original hard copy of the proposal, signed by an official authorized to bind your organization, plus three (3) electronic CD copies shall be received by Eisha Banks, Contract Specialist, no later than 11:30am local prevailing time on June 19, 2015.

Below provides the address the Offeror shall submit their proposal:

Centers for Medicare and Medicaid Services (MAILING ADDRESS) OAGM/Division of Program Integrity and Financial Management Attn: Eisha Banks M/S: B3-30-03 7500 Security Boulevard Baltimore, MD 21244-1850

Centers for Medicare and Medicaid Services (PHYSICAL LOCATION)

OAGM/ASG/DPIFMC

Attn: Eisha Banks, Contract Specialist 7111 Security Boulevard Baltimore, MD 21244-1850 410-786-5145 Cube: B3-30-03

Alternate Point of contact:

Theresa Schultz Contacting Officer 410-786-8496

NOTE: Offerors are hereby advised that the place for submission of proposals (CMS at 7111 Security Boulevard, Baltimore (Woodlawn, Maryland), is a secure building.

Please be advised that CMS Security Guards will not accept proposals for CMS staff.

Proposal delivery must be made to the exact location stated in this RFP on or before the date and time specified. The proposal is not considered to be delivered until it is in the hands of the Contract Specialist.

If planning to send a proposal via mail, Offerors are advised that all mail addressed to the CMS Contracting Office is delivered to the CMS mail room (including overnight mail) located at the main CMS complex (7500 Security Boulevard). When utilizing overnight mail carriers you are cautioned that overnight carriers do not deliver to the 7111 Security Boulevard location. Therefore, if using an overnight carrier, the date of proposal receipt will be the date the overnight package was signed for by CMS at the CMS mailroom. When using regular first class mail, the date of proposal receipt will be the date the proposal is received by the Contracting Officer. Offerors are cautioned that it may take several days for mail to be delivered to the Contracting Officer from the CMS mailroom.

Proposals delivered by a mail carrier service other than the U.S. Postal Service are not accepted in the CMS mailroom and therefore, Offerors’ proposals may not be delivered timely to the location and person specified in this RFP solicitation. Offerors are advised to take that possibility into consideration in determining when and how a proposal must be received at the specified location to meet the date and time requirements. Offerors are also advised to make sure that the proposal is clearly marked as to:

• The RFP number,

• The date and time for receipt,

• The intended room/cube location,

• The intended recipient, and

• The telephone number of the intended recipient.

This RFP does not commit the Government to pay any cost for the preparation and submission of a proposal. In addition, the Contracting Officer is the only individual who can legally commit the Government to the expenditures of public funds in connection with the proposed procurement.

8) This amendment revises Section L.9(c) - Proposal Organization, to allow less than 12-point font for charts, graphs and tables.

L.9 Proposal Organization

(c) Paper Size, Type, Spacing and Page Numbering

Paper size shall be 8.5 by 11 inches. Fold-outs will count as two pages. The pages shall be numbered and printed on both sides if possible. Type size shall not be less than a 12-point font with a space and a half between lines. Charts, graphs, and tables may be no less than 9-point font Times New Roman. The number of pages for the proposal is limited to 27 pages, except for résumés of personnel, which are limited to three (3) pages each, and any other section specifically noted.

9) This amendment revises Section L.10(B) , Volume I - Technical Proposal Instructions, to correct the page limit for resumes to 3 pages:

L.10 Volume I - Technical Proposal Instructions

B. Key Personnel and Other Essential Personnel/Staffing (limited to 3 pages) (Resumes limited to 3 pages and Organizational Chart limited to 1 page – neither will be counted in the overall page count)

End of Amendment