E.2.A UPIC J1 Business Proposal Spreadsheet CLIN 0001.xlsx
XLSX spreadsheet 83 KB Posted
- Attached to
- Unified Program Integrity Contract (UPIC)
- Solicitation number
- HHSM-500-2015-RFP-0122
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E.2.A UPIC J1 Business Proposal Spreadsheet CLIN 0001
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CLIN - 0001
| CLIN 0001-Base Year | |||||||||||||
| Tasks | Total FTEs | SLIN 0001AA - MIP | SLIN 0001AB - DRA | SLIN 0001AC - Medi-Medi | GRAND TOTAL | ||||||||
| Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | ||
| COST ELEMENTS |
Direct Labor
| Jurisdiction Program Director |
| Medicare Operations Lead |
| Medicaid Operations Lead |
| PI Manager |
| Medical Review Manager |
| Medical Director |
| Data Manager |
| Chief Legal Counsel |
| Chief Statistician |
| Total FTE's |
| Subtotal Direct Labor |
Fringe Benefits (at _____%)
Total Direct Labor
| Travel (See separate schedule) |
| SUBCONTRACTORS |
| Subcontractor Name |
| Note: Subcontractors hours above |
| Total Subcontractor |
| Total FTE's- Direct & Subcontract |
| Other Direct Costs (See separate schedule) |
SUBTOTAL ALL DIRECT COSTS
Indirect Costs (at ______ %)
SUBTOTAL COSTS BEFORE FEE
Award Fee
Base Fee
TOTAL COSTS
&"Baskerville Old Face,Bold"&12CLIN 0001 Base Year UPIC J1
HHSM-500-2015-RFP-0122
SLIN 0001AA - MIP
| SLIN 0001AA - MIP | |||||||||||||||||||||||||||||||||||||
| Base Year | C.5.1 | C.5.4 | C.5.3 | C.5.2 | C.5.10 | C.5.8 | C.7.7 | C.5.4.4 | C.7.5 | ||||||||||||||||||||||||||||
| Tasks | Total FTEs | Vulnerabilities | Investigations | Lead Management | Data Analysis | Support to Law Enforcement | Reserved | Support to CMS | Quality Assurance | Appeals Support | Information Technology | Reserved | GRAND TOTAL | ||||||||||||||||||||||||
| Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | ||
| COST ELEMENTS |
Direct Labor
| Jurisdiction Program Director |
| Medicare Operations Lead |
| Medicaid Operations Lead |
| PI Manager |
| Medical Review Manager |
| Medical Director |
| Data Manager |
| Chief Legal Counsel |
| Chief Statistician |
| Total FTE's |
| Subtotal Direct Labor |
Fringe Benefits (at _____%)
Total Direct Labor
| Travel (See separate schedule) |
| SUBCONTRACTORS |
| Subcontractor Name |
| Note: Subcontractors hours above |
| Total Subcontractor |
| Total FTE's- Direct & Subcontract |
| Other Direct Costs (See separate schedule) |
SUBTOTAL ALL DIRECT COSTS
Indirect Costs (at ______ %)
SUBTOTAL COSTS BEFORE FEE
Award Fee
Base Fee
TOTAL COSTS
HHSM-500-2015-RFP-0122
SLIN 0001AB - DRA
| Base Year | ||||||||||||||||||||||||||||||||||||||||
| SLIN 0001AB-DRA | C.5.1 | C.5.4 | C.5.3 | C.5.2 | C.5.10 | C.5.8 | C.7.7 | C.5.4.4 | C.7.5 | |||||||||||||||||||||||||||||||
| Tasks | Vulnerabilities | Investigations | Lead Management | Data Analysis | Reserved | Support to Law Enforcement | Support to CMS | Reserved | Quality Assurance | Appeals Support | Information Technology | Reserved | GRAND TOTAL | |||||||||||||||||||||||||||
| 1880 | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | |
| COST ELEMENTS |
Direct Labor
| Jurisdiction Program Director |
| Medicare Operations Lead |
| Medicaid Operations Lead |
| PI Manager |
| Medical Review Manager |
| Medical Director |
| Data Manager |
| Chief Legal Counsel |
| Chief Statistician |
| Total FTE's |
| Subtotal Direct Labor |
Fringe Benefits (at _____%)
Total Direct Labor
| Travel (See separate schedule) |
| SUBCONTRACTORS |
| Subcontractor Name |
| Note: Subcontractors hours above |
| Total Subcontractor |
| Total FTE's- Direct & Subcontract |
| Other Direct Costs (See separate schedule) |
SUBTOTAL ALL DIRECT COSTS
Indirect Costs (at ______ %)
SUBTOTAL COSTS BEFORE FEE
Award Fee
Base Fee
TOTAL COSTS
HHSM-500-2015-RFP-0122
SLIN 0001AC - Medi-Medi
| Base Year | ||||||||||||||||||||||||||||||||||
| SLIN 0001AC-Medi-Medi | C.5.1 | C.5.4 | C.5.3 | C.5.2 | C.5.10 | C.5.8 | C.7.7 | C.5.4.4 | C.7.5 | |||||||||||||||||||||||||
| Tasks | Vulnerabilities | Investigations | Lead Management | Data Analysis | Support to Law Enforcement | Reserved | Support to CMS | Quality Assurance | Appeals Support | Information Technology | GRAND TOTAL | |||||||||||||||||||||||
| 1880 | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | |
| COST ELEMENTS |
Direct Labor
| Jurisdiction Program Director |
| Medicare Operations Lead |
| Medicaid Operations Lead |
| PI Manager |
| Medical Review Manager |
| Medical Director |
| Data Manager |
| Chief Legal Counsel |
| Chief Statistician |
| Total FTE's |
| Subtotal Direct Labor |
Fringe Benefits (at _____%)
Total Direct Labor
| Travel (See separate schedule) |
| SUBCONTRACTORS |
| Subcontractor Name |
| Note: Subcontractors hours above |
| Total Subcontractor |
| Total FTE's- Direct & Subcontract |
| Other Direct Costs (See separate schedule) |
SUBTOTAL ALL DIRECT COSTS
Indirect Costs (at ______ %)
SUBTOTAL COSTS BEFORE FEE
Award Fee
Base Fee
TOTAL COSTS
HHSM-500-2015-RFP-0122
ODCs & Travel
| ODCs and Travel |
| Base Year |
| MIP | Contract Year | Item Description | Quantity | Unit Cost | Overhead | G&A | Other Indirect (Specify) | Fee | Total Cost |
| SLIN 0001AA - MIP | BaseYear | ||||||||
| SLIN 0001AA - MIP | BaseYear | ||||||||
| SLIN 0001AA - MIP | BaseYear | ||||||||
| SLIN 0001AA - MIP | BaseYear | ||||||||
| SLIN 0001AA - MIP | BaseYear | ||||||||
| SLIN 0001AA - MIP | BaseYear | ||||||||
| SLIN 0001AA - MIP | BaseYear | ||||||||
| SLIN 0001AA - MIP | BaseYear | ||||||||
| SLIN 0001AA - MIP | BaseYear | ||||||||
| Total |
| DRA | Contract Year | Item Description | Quantity | Unit Cost | Overhead | G&A | Other Indirect (Specify) | Fee | Total Cost |
| SLIN 0001AB - DRA | BaseYear | ||||||||
| SLIN 0001AB - DRA | BaseYear | ||||||||
| SLIN 0001AB - DRA | BaseYear | ||||||||
| SLIN 0001AB - DRA | BaseYear | ||||||||
| SLIN 0001AB - DRA | BaseYear | ||||||||
| SLIN 0001AB - DRA | BaseYear | ||||||||
| SLIN 0001AB - DRA | BaseYear | ||||||||
| SLIN 0001AB - DRA | BaseYear | ||||||||
| SLIN 0001AB - DRA | BaseYear | ||||||||
| Total |
| Medi-Medi | Contract Year | Item Description | Quantity | Unit Cost | Overhead | G&A | Other Indirect (Specify) | Fee | Total Cost |
| SLIN 0001AC - Medi-Medi | BaseYear | ||||||||
| SLIN 0001AC - Medi-Medi | BaseYear | ||||||||
| SLIN 0001AC - Medi-Medi | BaseYear | ||||||||
| SLIN 0001AC - Medi-Medi | BaseYear | ||||||||
| SLIN 0001AC - Medi-Medi | BaseYear | ||||||||
| SLIN 0001AC - Medi-Medi | BaseYear | ||||||||
| SLIN 0001AC - Medi-Medi | BaseYear | ||||||||
| SLIN 0001AC - Medi-Medi | BaseYear | ||||||||
| SLIN 0001AC - Medi-Medi | BaseYear | ||||||||
| Total |
| Travel | Per Traveler | ||||||||||
| MIP | Contract Year | Reason for Trip | Trip (Departure/Arrival Locations) | # of Trips (If more than one trip for same departure/arrival) | # of Travelers | # of Days | AirFare | Lodging | Car Rental / Mileage / Parking | Per Diem | Total Cost |
| SLIN 0001AA - MIP | BaseYear | ||||||||||
| SLIN 0001AA - MIP | BaseYear | ||||||||||
| SLIN 0001AA - MIP | BaseYear | ||||||||||
| SLIN 0001AA - MIP | BaseYear | ||||||||||
| SLIN 0001AA - MIP | BaseYear | ||||||||||
| SLIN 0001AA - MIP | BaseYear | ||||||||||
| SLIN 0001AA - MIP | BaseYear | ||||||||||
| SLIN 0001AA - MIP | BaseYear | ||||||||||
| SLIN 0001AA - MIP | BaseYear | ||||||||||
| Total |
| DRA | Contract Year | Reason for Trip | Trip (Departure/Arrival Locations) | # of Trips (If more than one trip for same departure/arrival) | # of Travelers | # of Days | AirFare | Lodging | Car Rental / Mileage / Parking | Per Diem | Total Cost |
| SLIN 0001AB - DRA | BaseYear | ||||||||||
| SLIN 0001AB - DRA | BaseYear | ||||||||||
| SLIN 0001AB - DRA | BaseYear | ||||||||||
| SLIN 0001AB - DRA | BaseYear | ||||||||||
| SLIN 0001AB - DRA | BaseYear | ||||||||||
| SLIN 0001AB - DRA | BaseYear | ||||||||||
| SLIN 0001AB - DRA | BaseYear | ||||||||||
| SLIN 0001AB - DRA | BaseYear | ||||||||||
| SLIN 0001AB - DRA | BaseYear | ||||||||||
| Total |
| Medi-Medi | Contract Year | Reason for Trip | Trip (Departure/Arrival Locations) | # of Trips (If more than one trip for same departure/arrival) | # of Travelers | # of Days | AirFare | Lodging | Car Rental / Mileage / Parking | Per Diem | Total Cost |
| SLIN 0001AC - Medi-Medi | BaseYear | ||||||||||
| SLIN 0001AC - Medi-Medi | BaseYear | ||||||||||
| SLIN 0001AC - Medi-Medi | Base Year | ||||||||||
| SLIN 0001AC - Medi-Medi | BaseYear | ||||||||||
| SLIN 0001AC - Medi-Medi | BaseYear | ||||||||||
| SLIN 0001AC - Medi-Medi | BaseYear | ||||||||||
| SLIN 0001AC - Medi-Medi | BaseYear | ||||||||||
| SLIN 0001AC - Medi-Medi | BaseYear | ||||||||||
| SLIN 0001AC - Medi-Medi | BaseYear |
HHSM-500-2015-RFP-0122
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