J.1.a_Appendix_A_-_Schedule_of_Deliverables.pdf

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Medical Claims Review of Cost-Based Medicare Managed Care Organizations (MCO)
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HHSM-500-2015-RFP-0113
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J.1.a Appendix A - Schedule of Deliverables

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Appendix A – Schedule of Deliverables, Milestones and Conferences

The Contractor shall submit all required reports and deliverables in accordance with the following schedule. Reports and/or deliverables submitted under this contract shall be in accordance with the Statement of Work. All deliverables shall be submitted via email to the assigned Contracting Officer’s Representative (COR) and/or Servicing Auditor) or as indicated otherwise below.

Deliverable/ Conference Type

Due Date Recipient

Required Claims Database Fields (SOW – Section IV.G.b.)

15 calendar days after contract award CAC, copying COR

Planning Meeting - With each Cost Audit Contractor (CAC) (SOW – Section IV.G.a.)

15 calendar days after contract award Between MRC and

CAC

Planning Meeting Minutes (SOW

– Section IV.G.a.)

3 calendar days after planning meeting COR

Kick-off Meeting Agenda (SOW

– Section IV.A.d.)

2 business days prior to the kick-off meeting COR

Kick-off Meeting with CMS (SOW – Section IV.A.d.)

20 calendar days after contract award COR and Servicing Auditors

Kick-off Meeting Minutes (SOW

– Section IV.A.d.)

3 business days after Kick-off Meeting COR

Security and Tracking Plan – Draft (SOW – Section IV.A.f.)

20 calendar days after contract award COR

Project Management Plan (PMP) – Draft (SOW – Section IV.A.e.)

20 calendar days after contract award COR

PMP and Security and Tracking Plan – Final (SOW – Section IV.A.e.)

5 calendar days after approval of draft COR

Memo of Understanding Template (SOW – Section IV.C.a)

30 calendar days after contract award COR

Biweekly Status Report (SOW – Section V.F.)

1 calendar days prior to the biweekly call COR and Servicing

Biweekly Status Call (SOW – Section V.F.)

Biweekly – to be coordinated with the COR COR and Servicing

Monthly Status Report (SOW – 20 calendar days following the close of the COR and Servicing

Section V.G.) reported month

Entrance Conference (SOW Section IV.G.c.)

Within 120 days of contract award To be coordinated with the CAC. CMS COR to attend.

Sampling Plan – Separate for each MCO to be reviewed (SOW

– Section IV.B.b.)

Within 2 weeks of receiving the reconciled database.

COR, CAC and to each MCO Servicing Auditor

Sample Selection sent to MCO (SOW – Section IV.B.c.)

10 calendar days after the sampling plan is approved.

MCO

Mid-Contract Presentation (SOW

– Section V.H.)

As coordinated with CMS, within 7 months after contract award. Materials to be submitted 5 calendar days prior to the presentation.

COR, in-person presentation

Preliminary List of Exceptions sent to MCO and Preliminary Exit Conference to occur (SOW – Section IV.C.c.)

60 calendar days after the samples submitted to the MCO (60 calendar days after entrance conference)

MCO, copy COR

Draft Report (SOW – Section V.D.) 30 calendar days after the medical record submission window is complete (60 calendar days after preliminary Exit Conference)

COR, Servicing Auditor, CAC

Final List of Exceptions (SOW – Section IV.C.c.)

30 calendar days after the medical record submission window is complete (60 calendar days after preliminary Exit Conference)

MCO, copy COR

Final Exit Conference to occur (SOW Section IV.G.c.)

Within 120 days of Preliminary Exit Conference

Final Report (SOW – Section V.E.)

5 calendar days after CMS approval of the draft report

COR, Servicing Auditor and CAC

Formal Reply to Plan Disagreements to Findings (SOW – Section IV.G.b.)

Within 1 week of receiving disagreements. CAC, Servicing Auditor and COR

Error Rate and Adjustment Summary Report (SOW – Section V.I.)

15 calendar days after the Final Reports for all MCOs have been submitted to CMS

COR

Self-Assessment/ Lessons Learned Report (SOW – Section V.J.)

15 calendar days after the end of the contract year

COR

Round Table Discussion and Materials (SOW – Section V.K.)

As coordinated by CMS, towards the end of the Period of Performance. Any materials to be presented are due at least 5 calendar days

COR, in-person presentation prior to the round-table discussion.

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