E.2.E UPIC J1 Business Proposal Spreadsheet CLIN 0005.xlsx

XLSX spreadsheet 86 KB Posted

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.E UPIC J1 Business Proposal Spreadsheet CLIN 0005

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

CLIN - 0005

CLIN 0005 - Option Year 4
TasksTotal FTEsSLIN 0005AA - MIPSLIN 0005AB - DRASLIN 0005AC - Medi-MediGRAND TOTAL
HoursRatesTotalHoursRatesTotalHoursRatesTotalHoursRatesTotal
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 0005 Option Year 4 UPIC J1

HHSM-500-2015-RFP-0122

SLIN 0005AA - MIP

Option Year 4
SLIN 0005AA - MIPSLIN 0005AA - MIPSLIN 0005AB - DRASLIN 0005AC - Medi-Medi
C.5.1C.5.4C.5.3C.5.2C.5.10C.5.8C.7.7C.5.4.4C.7.5
TasksTotal FTEsVulnerabilitiesInvestigationsLead ManagementData AnalysisSupport to Law EnforcementReservedSupport to CMSQuality AssuranceAppeals SupportInformation TechnologyReservedGRAND TOTAL
HoursRatesTotalHoursRatesTotalHoursRatesTotalHoursRatesTotalHoursRatesTotalHoursRatesTotalHoursRatesTotalHoursRatesTotalHoursRatesTotalHoursRatesTotalHoursRatesTotalHoursRatesTotal
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 0005AB - DRA

Option Year 4
SLIN 0005AA - MIPSLIN 0005AB - DRASLIN 0005AC - Medi-Medi
SLIN 0005AB-DRAC.5.1C.5.4C.5.3C.5.2C.5.10C.5.8C.7.7C.5.4.4C.7.5
TasksTotal FTEsVulnerabilitiesInvestigationsLead ManagementData AnalysisReservedSupport to Law EnforcementSupport to CMSReservedQuality AssuranceAppeals SupportInformation TechnologyReservedGRAND TOTAL
HoursRatesTotalHoursRatesTotalHoursRatesTotalHoursRatesTotalHoursRatesTotalHoursRatesTotalHoursRatesTotalHoursRatesTotalHoursRatesTotalHoursRatesTotalHoursRatesTotalHoursRatesTotalHoursRatesTotal
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 0005AC - Medi-Medi

Option Year 4
SLIN 0005AA - MIPSLIN 0005AB - DRASLIN 0005AC - Medi-Medi
SLIN 0005AC-Medi-MediC.5.1C.5.4C.5.3C.5.2C.5.10C.5.8C.7.7C.5.4.4C.7.5
TasksTotal FTEsVulnerabilitiesInvestigationsLead ManagementData AnalysisSupport to Law EnforcementReservedSupport to CMSQuality AssuranceAppeals SupportInformation TechnologyGRAND TOTAL
HoursRatesTotalHoursRatesTotalHoursRatesTotalHoursRatesTotalHoursRatesTotalHoursRatesTotalHoursRatesTotalHoursRatesTotalHoursRatesTotalHoursRatesTotalHoursRatesTotal
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 4SLIN 0005AA - MIPSLIN 0005AB - DRASLIN 0005AC - Medi-Medi
Materials/Other Direct Costs
Contract YearItem DescriptionQuantityUnit CostOverheadG&AOther Indirect (Specify)FeeTotal Cost
SLIN 0005AA - MIPOption Year 4
SLIN 0005AA - MIPOption Year 4
SLIN 0005AA - MIPOption Year 4
SLIN 0005AA - MIPOption Year 4
SLIN 0005AA - MIPOption Year 4
SLIN 0005AA - MIPOption Year 4
SLIN 0005AA - MIPOption Year 4
SLIN 0005AA - MIPOption Year 4
SLIN 0005AA - MIPOption Year 4
Total
DRAContract YearItem DescriptionQuantityUnit CostOverheadG&AOther Indirect (Specify)FeeTotal Cost
SLIN 0005AB - DRAOption Year 4
SLIN 0005AB - DRAOption Year 4
SLIN 0005AB - DRAOption Year 4
SLIN 0005AB - DRAOption Year 4
SLIN 0005AB - DRAOption Year 4
SLIN 0005AB - DRAOption Year 4
SLIN 0005AB - DRAOption Year 4
SLIN 0005AB - DRAOption Year 4
SLIN 0005AB - DRAOption Year 4
Total
Medi-MediContract YearItem DescriptionQuantityUnit CostOverheadG&AOther Indirect (Specify)FeeTotal Cost
SLIN 0005AC - Medi-MediOption Year 4
SLIN 0005AC - Medi-MediOption Year 4
SLIN 0005AC - Medi-MediOption Year 4
SLIN 0005AC - Medi-MediOption Year 4
SLIN 0005AC - Medi-MediOption Year 4
SLIN 0005AC - Medi-MediOption Year 4
SLIN 0005AC - Medi-MediOption Year 4
SLIN 0005AC - Medi-MediOption Year 4
SLIN 0005AC - Medi-MediOption Year 4
Total
TravelPer Traveler
MIPContract YearReason for TripTrip (Departure/Arrival Locations)# of Trips (If more than one trip for same departure/arrival)# of Travelers# of DaysAirFareLodgingCar Rental / Mileage / ParkingPer DiemTotal Cost
SLIN 0005AA - MIPOption Year 4
SLIN 0005AA - MIPOption Year 4
SLIN 0005AA - MIPOption Year 4
SLIN 0005AA - MIPOption Year 4
SLIN 0005AA - MIPOption Year 4
SLIN 0005AA - MIPOption Year 4
SLIN 0005AA - MIPOption Year 4
SLIN 0005AA - MIPOption Year 4
SLIN 0005AA - MIPOption Year 4
Total
DRAContract YearReason for TripTrip (Departure/Arrival Locations)# of Trips (If more than one trip for same departure/arrival)# of Travelers# of DaysAirFareLodgingCar Rental / Mileage / ParkingPer DiemTotal Cost
SLIN 0005AB - DRAOption Year 4
SLIN 0005AB - DRAOption Year 4
SLIN 0005AB - DRAOption Year 4
SLIN 0005AB - DRAOption Year 4
SLIN 0005AB - DRAOption Year 4
SLIN 0005AB - DRAOption Year 4
SLIN 0005AB - DRAOption Year 4
SLIN 0005AB - DRAOption Year 4
SLIN 0005AB - DRAOption Year 4
Total
Medi-MediContract YearReason for TripTrip (Departure/Arrival Locations)# of Trips (If more than one trip for same departure/arrival)# of Travelers# of DaysAirFareLodgingCar Rental / Mileage / ParkingPer DiemTotal Cost
SLIN 0005AC - Medi-MediOption Year 4
SLIN 0005AC - Medi-MediOption Year 4
SLIN 0005AC - Medi-MediOption Year 4
SLIN 0005AC - Medi-MediOption Year 4
SLIN 0005AC - Medi-MediOption Year 4
SLIN 0005AC - Medi-MediOption Year 4
SLIN 0005AC - Medi-MediOption Year 4
SLIN 0005AC - Medi-MediOption Year 4
SLIN 0005AC - Medi-MediOption Year 4
Total

HHSM-500-2015-RFP-0122

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