E.2.F_Sample_Cost_Allocation_of_SOW_Tasks.docx

Exhibit E.2.F UPIC HHSM-500-2015-RFP-0122 Sample Cost Allocation of SOW Tasks The following cost structure shall serve as an example for cost allocation purposes and to show that some sub-tasks can be required to support multiple tasks. Offerors shall utilize the columns in the business proposal templates to reflect their proposed technical approach for meeting the requirements in the UPIC SOW. Offerors must ensure that all work identified in the UPIC SOW is reflected in the appropriate business proposal templates included in the solicitation.

CLIN 001-MIP

· Transition and Implementation (SOW 4.1)

· Kick off meeting* (SOW 7.1.1)

· Stakeholder education (SOW 5.11)

· Vulnerabilities (SOW 5.1)

· Support to CMS (SOW 5.8)-(e.g. working with CMS to develop/refine models in FPS)

· Contractor model development (SOW 5.2.4)

· Development of edits resulting from vulnerabilities (SOW 5.7)

· Investigations (SOW 5.4)

· Data analysis- data analysis in support of investigative development (SOW 5.2.4)

· Investigative activities-(e.g. interviews, onsite visits, drive bys, desk reviews, background checks (SOW 5.4)

· Medical Review (SOW 5.6)

· Edits related to an investigation (SOW 5.7)

· Provider education (5.11)

· Lead Management (SOW 5.3)

· Data Analysis (SOW 5.2)-analysis in support of model development

· Edits resulting from data analysis activities (SOW 5.7)

· Education as a result of data analysis findings (SOW 5.11)

· Support to Law Enforcement (SOW 5.10)

· Data-including data analysis and retrieval activities (SOW 5.10)

· Medical Review (SOW 5.6)

· Expert testimony (SOW 5.10)

· Support to CMS (SOW 5.8)-(e.g. HFPP support, command center activities and PI projects)

· Edit development (SOW 5.7)

· Quality Assurance (SOW 7.7)

· Information Technology (SOW 7.5)-(e.g. FPS, UCM, 1PI/IDR, FFS claims processing systems)

· Implementation of edits (SOW 5.7)

· Appeals Support (SOW 5.4.4)

· Claims appeals support (SOW 5.4.4)

· Revocation appeals support (SOW 5.4.4)

CLIN 002-DRA

· Transition and Implementation (SOW 4.1)

· Kick off meeting* (SOW 7.1.1)

· State/Stakeholder education (SOW 5.11)

· Vulnerabilities (SOW 5.1)

· Support to CMS- working with DASG to develop/refine models in FPS (SOW 5.8)

· Contractor model development (SOW 5.2.4)

· State Medicaid education (SOW 5.11)

· Recommendations for edits resulting from vulnerabilities (SOW 5.7)

· Support to states (SOW 5.9)

· Investigations (SOW 5.4)

· Data analysis- data analysis in support of investigative development

· Investigative activities-including but not limited to interviews, onsite visits, drive bys, desk reviews, background checks (SOW 5.4)

· Medical review (SOW 5.6)

· Edit recommendations resulting from an investigation (SOW 5.7)

· Cost report audits (SOW 5.5)

· Support to states (SOW 5.9)

· Provider education (SOW 5.11)

· Lead Management (SOW 5.3)

· Data Analysis (SOW 5.2)-analysis to support model development

· Education as a result of data analysis (SOW 5.11)

· Recommendation of edits as a result of data analysis (SOW 5.7)

· Support to Law Enforcement (SOW 5.10)

· Data-including all data analysis and retrieval activities (SOW 5.10)

· Expert testimony (SOW 5.10)

· Support to CMS (SOW 5.8)-(e.g. HFPP support, command center activities and PI projects)

· Edit recommendations (SOW 5.7)

· Quality Assurance (SOW 7.7)

· Information Technology (SOW 7.5)- (e.g. FPS, UCM, 1PI/IDR, FFS claims processing systems)

· Appeals Support (SOW 5.4.4)

CLIN 003-Medi-Medi

· Transition and Implementation (SOW 4.1)

· Kick off meeting* (SOW 7.1.1)

· Vulnerabilities (SOW 5.1)

· Support to CMS- working with CMS to develop/refine models in FPS (SOW 5.8)

· Contractor model development (5.2.4)

· Edits resulting from vulnerabilities (SOW 5.7)

· Support to states (SOW 5.9)

· Investigations (SOW 5.4)

· Data analysis- data analysis in support of investigative development (SOW 5.2)

· Investigative activities-(e.g. interviews, onsite visits, drive bys, desk reviews, background checks) (SOW 5.4)

· Medical Review (SOW 5.6)

· Support to states (SOW 5.9)

· Provider education (SOW 5.11)

· Lead Management (SOW 5.3)

· Data Analysis (SOW 5.2)-analysis in support of model development

· Identification/recommendation of edits associated with data analysis (SOW 5.7)

· Education as a result of data analysis (SOW 5.11)

· Support to Law Enforcement (SOW 5.10)

· Data-including all data analysis and retrieval activities (SOW 5.10)

· Expert testimony (SOW 5.10)

· Support to CMS (SOW 5.8)-(e.g. HFPP support, Command center activities and PI projects)

· Edit development (SOW 5.7)

· Quality Assurance (SOW 7.7)

· Information Technology (SOW 7.5)- (e.g. FPS, UCM, 1PI/IDR, FFS claims processing systems)

· Appeals Support (SOW 5.4.4)

· Medicare claims appeals support (SOW 5.4.4)

· Medicaid claims appeals support (SOW 5.4.4)

*Prorated across three CLINs