E.2.D UPIC J1 Business Proposal Spreadsheet CLIN 0004.xlsx

XLSX spreadsheet 86 KB Posted Jul 17, 2015

Attached to: Unified Program Integrity Contract (UPIC) Federal contract opportunity
Solicitation number: HHSM-500-2015-RFP-0122
Issued by: Department of Health and Human Services Centers for Medicare and Medicaid Services

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E.2.D UPIC J1 Business Proposal Spreadsheet CLIN 0004

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Other files for this federal contract opportunity

Other files attached to Unified Program Integrity Contract (UPIC), newest first.
File	Type	Posted
Amendment_000005_Revised_UPIC_Solicitation.doc	DOC document	Aug 14, 2015
E.2.F_Sample_Cost_Allocation_of_SOW_Tasks.docx	DOCX document	Aug 14, 2015
Amendment_000005_HHSM-500-2015-RFP-0122.pdf	PDF	Aug 14, 2015
Amendment_0004_HHSM-500-2015-RFP-0122.pdf	PDF	Aug 11, 2015
Amendment_000003_HHSM-500-2015-RFP-0122_UPIC_Final.pdf	PDF	Aug 6, 2015
Amendment 000002 E.2.D UPIC J1 Business Proposal Spreadsheet CLIN 0004.xlsx	XLSX spreadsheet	Aug 5, 2015
Amendment 000002 Revised UPIC Solicitation.doc	DOC document	Aug 5, 2015
Amendment 000002 E.2.E UPIC J1 Business Proposal Spreadsheet CLIN 0005.xlsx	XLSX spreadsheet	Aug 5, 2015
Amendment 000002 E.1.A UPIC Subcontractor Proposal Checklist.doc	DOC document	Aug 5, 2015
HHSM-500-2015-RFP-0122 Amendment 000002 UPIC.pdf	PDF	Aug 5, 2015
Amendment 000002 J.8 Business Ethics Conflict of Interest and Compliance Submission by Offeror-Contractor.docx	DOCX document	Aug 5, 2015
Amendment 000002 E.9 UPIC Questions and Responses.xlsx	XLSX spreadsheet	Aug 5, 2015
Amendment 000002 J.6.B UPIC_J1_Task_Order_SOW.doc	DOC document	Aug 5, 2015
Amendment 000002 J.2 Unified_Program_Integrity_Contract_USOW_Appendices.doc	DOC document	Aug 5, 2015
Amendment 000002 J.1 Unified_Program_Integrity_Contract_USOW.docx	DOCX document	Aug 5, 2015
Amendment 000002 E.2.B UPIC J1 Business Proposal Spreadsheet CLIN 0002.xlsx	XLSX spreadsheet	Aug 5, 2015
Amendment 000002 E.2.C UPIC J1 Business Proposal Spreadsheet CLIN 0003.xlsx	XLSX spreadsheet	Aug 5, 2015
HHSM-500-2015-RFP-0122_Amendment_000001.pdf	PDF	Jul 24, 2015
E.3_UPIC_Questions_Template_Amendment_000001.xlsx	XLSX spreadsheet	Jul 24, 2015
J.3.E UPIC Freedom of Information Request Log.docx	DOCX document	Jul 17, 2015
J.1 Unified Program Integrity Contract USOW.docx	DOCX document	Jul 17, 2015
E.2.E UPIC J1 Business Proposal Spreadsheet CLIN 0005.xlsx	XLSX spreadsheet	Jul 17, 2015
J.9 Personal Conflicts of Interest Financial Disclosure.docx	DOCX document	Jul 17, 2015
J.15 UPIC Award Fee Plan.docx	DOCX document	Jul 17, 2015
J.4_UPIC_IDIQ_Ordering_Guide.docx	DOCX document	Jul 17, 2015
J.6.D_Small_Business_Subcontracting_Plan.docx	DOCX document	Jul 17, 2015
J.7 UPIC Technical Evaluation Scenarios.docx	DOCX document	Jul 17, 2015
E.6 Draft PIM Chapter 4.docx	DOCX document	Jul 17, 2015
E.1.A UPIC Subcontractor Proposal Checklist.doc	DOC document	Jul 17, 2015
J.8 Business Ethics Conflict of Interest and Compliance Submission by Offeror-Contractor.docx	DOCX document	Jul 17, 2015
J.3.K UPIC State Education Report.docx	DOCX document	Jul 17, 2015
E.3 UPIC Questions Template.xlsx	XLSX spreadsheet	Jul 17, 2015
J.12 Virus Detection Certification.doc	DOC document	Jul 17, 2015
E.2.C UPIC J1 Business Proposal Spreadsheet CLIN 0003.xlsx	XLSX spreadsheet	Jul 17, 2015
J.3.A UPIC Analytic Findings Report.docx	DOCX document	Jul 17, 2015
J.6.B_UPIC_J1_Task_Order_SOW.doc	DOC document	Jul 17, 2015
E.2.B UPIC J1 Business Proposal Spreadsheet CLIN 0002.xlsx	XLSX spreadsheet	Jul 17, 2015
J.14 UPIC Map of Jurisdictions.pdf	PDF	Jul 17, 2015
J.10_Past_Performance_Questionnaire.docx	DOCX document	Jul 17, 2015
J.3.D UPIC FOIA Log.xls	XLS spreadsheet	Jul 17, 2015
E.1 UPIC Prime Proposal Checklist.doc	DOC document	Jul 17, 2015
E.5 Draft UCM Functional Requirements Document.docx	DOCX document	Jul 17, 2015
E.8 Draft PIM Chapter 16.docx	DOCX document	Jul 17, 2015
J.3.I UPIC Risk Management Plan.docx	DOCX document	Jul 17, 2015
E.2.A UPIC J1 Business Proposal Spreadsheet CLIN 0001.xlsx	XLSX spreadsheet	Jul 17, 2015
J.3.C UPIC Data Matching Protocol.docx	DOCX document	Jul 17, 2015
J.13 Subcontract Checklist - Consent to Subcontract.doc	DOC document	Jul 17, 2015
J.6.A_UPIC_J1_Task_Order_RFP.doc	DOC document	Jul 17, 2015
J.3.J UPIC RO FOIA Form.xls	XLS spreadsheet	Jul 17, 2015
J.6.C_UPIC_J1_Task_Order_SOW_Attachment_A.docx	DOCX document	Jul 17, 2015

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CLIN - 0004

CLIN 0004 - Option Year 3

Tasks

Total FTEs

SLIN 0004AA - MIP

SLIN 0004AB - DRA

SLIN 0004AC - 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 0004 Option Year 3 UPIC J1

HHSM-500-2015-RFP-0122

SLIN 0004AA - MIP

Option Year 3

SLIN 0004AA - 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

HHSM-500-2015-RFP-0122

SLIN 0004AB - DRA

Option Year 3

SLIN 0004AB-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 0004AC - Medi-Medi Option Year 3

SLIN 0004AC-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 3

Materials/Other Direct Costs
	Contract Year	Item Description	Quantity	Unit Cost	Overhead	G&A	Other Indirect (Specify)	Fee	Total Cost
SLIN 0004AA - MIP	Option Year 3
SLIN 0004AA - MIP	Option Year 3
SLIN 0004AA - MIP	Option Year 3
SLIN 0004AA - MIP	Option Year 3
SLIN 0004AA - MIP	Option Year 3
SLIN 0004AA - MIP	Option Year 3
SLIN 0004AA - MIP	Option Year 3
SLIN 0004AA - MIP	Option Year 3
SLIN 0004AA - MIP	Option Year 3
Total

DRA	Contract Year	Item Description	Quantity	Unit Cost	Overhead	G&A	Other Indirect (Specify)	Fee	Total Cost
SLIN 0004AB - DRA	Option Year 3
SLIN 0004AB - DRA	Option Year 3
SLIN 0004AB - DRA	Option Year 3
SLIN 0004AB - DRA	Option Year 3
SLIN 0004AB - DRA	Option Year 3
SLIN 0004AB - DRA	Option Year 3
SLIN 0004AB - DRA	Option Year 3
SLIN 0004AB - DRA	Option Year 3
SLIN 0004AB - DRA	Option Year 3
Total

Medi-Medi	Contract Year	Item Description	Quantity	Unit Cost	Overhead	G&A	Other Indirect (Specify)	Fee	Total Cost
SLIN 0004AC - Medi-Medi	Option Year 3
SLIN 0004AC - Medi-Medi	Option Year 3
SLIN 0004AC - Medi-Medi	Option Year 3
SLIN 0004AC - Medi-Medi	Option Year 3
SLIN 0004AC - Medi-Medi	Option Year 3
SLIN 0004AC - Medi-Medi	Option Year 3
SLIN 0004AC - Medi-Medi	Option Year 3
SLIN 0004AC - Medi-Medi	Option Year 3
SLIN 0004AC - Medi-Medi	Option Year 3
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 0004AA - MIP	Option Year 3
SLIN 0004AA - MIP	Option Year 3
SLIN 0004AA - MIP	Option Year 3
SLIN 0004AA - MIP	Option Year 3
SLIN 0004AA - MIP	Option Year 3
SLIN 0004AA - MIP	Option Year 3
SLIN 0004AA - MIP	Option Year 3
SLIN 0004AA - MIP	Option Year 3
SLIN 0004AA - MIP	Option Year 3
	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 0004AB - DRA	Option Year 3
SLIN 0004AB - DRA	Option Year 3
SLIN 0004AB - DRA	Option Year 3
SLIN 0004AB - DRA	Option Year 3
SLIN 0004AB - DRA	Option Year 3
SLIN 0004AB - DRA	Option Year 3
SLIN 0004AB - DRA	Option Year 3
SLIN 0004AB - DRA	Option Year 3
SLIN 0004AB - DRA	Option Year 3
	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 0004AC - Medi-Medi	Option Year 3
SLIN 0004AC - Medi-Medi	Option Year 3
SLIN 0004AC - Medi-Medi	Option Year 3
SLIN 0004AC - Medi-Medi	Option Year 3
SLIN 0004AC - Medi-Medi	Option Year 3
SLIN 0004AC - Medi-Medi	Option Year 3
SLIN 0004AC - Medi-Medi	Option Year 3
SLIN 0004AC - Medi-Medi	Option Year 3
SLIN 0004AC - Medi-Medi	Option Year 3
	Total

HHSM-500-2015-RFP-0122

File details come from the government source that posted it. Updated Nov 14, 2017.