E.2.B UPIC J1 Business Proposal Spreadsheet CLIN 0002.xlsx
XLSX spreadsheet 86 KB Posted
- Attached to
- Unified Program Integrity Contract (UPIC) Federal contract opportunity
- Solicitation number
- HHSM-500-2015-RFP-0122
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E.2.B UPIC J1 Business Proposal Spreadsheet CLIN 0002
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CLIN - 0002
| CLIN 0002 - Option Year 1 | |||||||||||||
| Tasks | Total FTEs | SLIN 0002AA - MIP | SLIN 0002AB - DRA | SLIN 0002AC - 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
Excellence award (at ____%)
Base Fee
TOTAL COSTS
&"Baskerville Old Face,Bold"&12CLIN 0002 Option Year 1 UPIC J1
HHSM-500-2015-RFP-0122
SLIN 0002AA - MIP
| Option Year 1 | |||||||||||||||||||||||||||||||||||||
| SLIN 0002AA - MIP | |||||||||||||||||||||||||||||||||||||
| 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 |
| Management |
| 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
Excellence award (at ___%)
Base Fee
TOTAL COSTS
&"Baskerville Old Face,Bold"&12 C&K01+000LIN 0002 Option Year 1 UPIC J1
HHSM-500-2015-RFP-0122
SLIN 0002AB - DRA
Option Year 1
| SLIN 0002AB-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 | Total FTEs | Vulnerabilities | Investigations | Lead Management | Data Analysis | Reserved | Support to Law Enforcement | Support to CMS | Reserved | 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 | Hours | Rates | Total | ||
| COST ELEMENTS |
| Direct Labor | ||
| Management | ||
| Jurisdiction Program Director | $0.00 | $0 |
| Medicare Operations Lead | $0.00 | $0 |
| Medicaid Operations Lead | $0.00 | $0 |
| PI Manager | $0.00 | $0 |
| Medical Review Manager | $0.00 | $0 |
| Medical Director | $0.00 | $0 |
| Data Manager | $0.00 | $0 |
| Chief Legal Counsel | $0.00 | $0 |
| Chief Statistician | $0.00 | $0 |
| Administrative Assistant | $0.00 | $0 |
| Reserved | $0.00 | $0 |
| Reserved | $0.00 | $0 |
| PI Analyst | $0.00 | $0 |
| A/B Lead | $0.00 | $0 |
| HH&H Lead | $0.00 | $0 |
| DME Lead | $0.00 | $0 |
| Lead Claims Review Analyst | $0.00 | $0 |
| Claims Analyst | $0.00 | $0 |
| Claims Review Analyst - Therapy | $0.00 | $0 |
| Coding Analyst | $0.00 | $0 |
| IT Support | $0.00 | $0 |
| Data Analyst | $0.00 | $0 |
| Clinical Information Specialist | $0.00 | $0 |
| Systems Adminstrator | $0.00 | $0 |
| Quality Manager | $0.00 | $0 |
| Systems Security Officer | $0.00 | $0 |
| Total FTE's | $0.00 | |
| Subtotal Direct Labor | $0 |
Fringe Benefits (at _____%) $ - 0
Total Direct Labor $0
| Travel (See separate schedule) | |
| SUBCONTRACTORS | |
| Subcontractor Name | $0.00 |
| Note: Subcontractors hours above | $0.00 |
| $0.00 | |
| Total Subcontractor | $0.00 |
| Total FTE's- Direct & Subcontract | |
| Other Direct Costs (See separate schedule) | $0 |
SUBTOTAL ALL DIRECT COSTS $0
Indirect Costs (at ______ %) $0
SUBTOTAL COSTS BEFORE FEE $0
Award Fee $0
Excellence award (at __%)
Base Fee $0
TOTAL COSTS $0
HHSM-500-2015-RFP-0122
SLIN 0002AC - Medi-Medi Option Year 1
| SLIN 0002AC-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 | Total FTEs | Vulnerabilities | Investigations | Lead Management | Data Analysis | Support to Law Enforcement | Reserved | Support to CMS | Quality Assurance | Appeals Support | Information Technology | 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 | ||
| COST ELEMENTS |
| Direct Labor |
| Management |
| 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 (at __%)
Excellence award (at ___%)
Base Fee (at ____%)
TOTAL COSTS
HHSM-500-2015-RFP-0122
ODCs & Travel
| ODCs and Travel |
| Option Year 1 |
| Materials/Other Direct Costs | |||||||||
| Contract Year | Item Description | Quantity | Unit Cost | Overhead | G&A | Other Indirect (Specify) | Fee | Total Cost | |
| SLIN 0002AA - MIP | Option Year 1 | ||||||||
| SLIN 0002AA - MIP | Option Year 1 | ||||||||
| SLIN 0002AA - MIP | Option Year 1 | ||||||||
| SLIN 0002AA - MIP | Option Year 1 | ||||||||
| SLIN 0002AA - MIP | Option Year 1 | ||||||||
| SLIN 0002AA - MIP | Option Year 1 | ||||||||
| SLIN 0002AA - MIP | Option Year 1 | ||||||||
| SLIN 0002AA - MIP | Option Year 1 | ||||||||
| SLIN 0002AA - MIP | Option Year 1 | ||||||||
| Total |
| DRA | Contract Year | Item Description | Quantity | Unit Cost | Overhead | G&A | Other Indirect (Specify) | Fee | Total Cost |
| SLIN 0002AB - DRA | Option Year 1 | ||||||||
| SLIN 0002AB - DRA | Option Year 1 | ||||||||
| SLIN 0002AB - DRA | Option Year 1 | ||||||||
| SLIN 0002AB - DRA | Option Year 1 | ||||||||
| SLIN 0002AB - DRA | Option Year 1 | ||||||||
| SLIN 0002AB - DRA | Option Year 1 | ||||||||
| SLIN 0002AB - DRA | Option Year 1 | ||||||||
| SLIN 0002AB - DRA | Option Year 1 | ||||||||
| SLIN 0002AB - DRA | Option Year 1 | ||||||||
| Total |
| Medi-Medi | Contract Year | Item Description | Quantity | Unit Cost | Overhead | G&A | Other Indirect (Specify) | Fee | Total Cost |
| SLIN 0002AC - Medi-Medi | Option Year 1 | ||||||||
| SLIN 0002AC - Medi-Medi | Option Year 1 | ||||||||
| SLIN 0002AC - Medi-Medi | Option Year 1 | ||||||||
| SLIN 0002AC - Medi-Medi | Option Year 1 | ||||||||
| SLIN 0002AC - Medi-Medi | Option Year 1 | ||||||||
| SLIN 0002AC - Medi-Medi | Option Year 1 | ||||||||
| SLIN 0002AC - Medi-Medi | Option Year 1 | ||||||||
| SLIN 0002AC - Medi-Medi | Option Year 1 | ||||||||
| SLIN 0002AC - Medi-Medi | Option Year 1 | ||||||||
| 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 0002AA - MIP | Option Year 1 | ||||||||||
| SLIN 0002AA - MIP | Option Year 1 | ||||||||||
| SLIN 0002AA - MIP | Option Year 1 | ||||||||||
| SLIN 0002AA - MIP | Option Year 1 | ||||||||||
| SLIN 0002AA - MIP | Option Year 1 | ||||||||||
| SLIN 0002AA - MIP | Option Year 1 | ||||||||||
| SLIN 0002AA - MIP | Option Year 1 | ||||||||||
| SLIN 0002AA - MIP | Option Year 1 | ||||||||||
| SLIN 0002AA - MIP | Option Year 1 | ||||||||||
| 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 0002AB - DRA | Option Year 1 | ||||||||||
| SLIN 0002AB - DRA | Option Year 1 | ||||||||||
| SLIN 0002AB - DRA | Option Year 1 | ||||||||||
| SLIN 0002AB - DRA | Option Year 1 | ||||||||||
| SLIN 0002AB - DRA | Option Year 1 | ||||||||||
| SLIN 0002AB - DRA | Option Year 1 | ||||||||||
| SLIN 0002AB - DRA | Option Year 1 | ||||||||||
| SLIN 0002AB - DRA | Option Year 1 | ||||||||||
| SLIN 0002AB - DRA | Option Year 1 | ||||||||||
| 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 0002AC - Medi-Medi | Option Year 1 | ||||||||||
| SLIN 0002AC - Medi-Medi | Option Year 1 | ||||||||||
| SLIN 0002AC - Medi-Medi | Option Year 1 | ||||||||||
| SLIN 0002AC - Medi-Medi | Option Year 1 | ||||||||||
| SLIN 0002AC - Medi-Medi | Option Year 1 | ||||||||||
| SLIN 0002AC - Medi-Medi | Option Year 1 | ||||||||||
| SLIN 0002AC - Medi-Medi | Option Year 1 | ||||||||||
| SLIN 0002AC - Medi-Medi | Option Year 1 | ||||||||||
| SLIN 0002AC - Medi-Medi | Option Year 1 | ||||||||||
| Total |
HHSM-500-2015-RFP-0122
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