MQIDTA_(QPP-SURS)_RFP_Q A_Final.pdf

Question Number

Question Source Page # Question Answer

1 B.1 - Description of Services 6 How many practices can be in the small group 14 or up to 15. In Section B.1 Description of Services it indicates that a small group practice of 15 or fewer are to be assisted. In section J.3 Table 4 and 4a it indicates practices of <15. Should it be less than or equal to 15?

Less than or equal to 15. ALL small practices and practices in Health Professional Shortage Areas of eligible providers may include individual or small group practices of 15 or fewer, focusing on those practicing in historically under resourced areas including rural areas, health professional service areas (HPSA), and medically underserved areas (MUA).

2 B.1 - Description of Services 7 If there are multiple MQIDTAs in a proposed geographic region, how will CMS expect the different groups to work together?

CMS does not expect more than one MQIDTA contractor to work in any given state (or combination of states). CMS intends to award one area per contractor based on a best value/ tradeoff determination.

3 B.1 - Description of Services The focus stated is to provide resources to rural and underserved areas. Is this limited to just those practices in those areas or can the assistance be provided to others as well?

CMS expects to cover all eligible clinicians meeting the target population requirements designated in the statute that need assistance across the country.

The target population includes practices with 15 or fewer clinicians, with preference given to practices in medically underserved and rural areas.

4 B.1 - Description of Services What does 'serve ALL clinicians' mean? Any clinician who needs help in our area we are required to serve?

Yes. Each proposal should include a clear and precise plan on how you will provide technical assistance at the right level of need to ALL small practices of 15 or fewer clinicians with priority given to those practicing in historically under resourced areas including rural areas, health professional shortage areas (HPSA), and medically underserved areas (MUA).

5 B.2 - Type Of Contract Are these grants or contracts? These are contracts, not grants.

6 B.2 - Type Of Contract 7 Please explain what is meant by the following excerpt from Section

B.2: "The services of this contract will be severable."

The performance of severable services is based on funding type. The funding for the base year and each option year may not exceed one year.

7 B.3 - Estimated Cost Plus Fixed Fee (CPFF) Can funds be used to hire new staff in order to execute this work? Yes, new staff may be hired in accordance with your government approved accounting system.

8 B.3 - Estimated Cost Plus Fixed Fee (CPFF) It has been customary for CMS to indicate both min and max award levels for each prime award within the total program, esp in this area of practice transformation. This helps applicants determine their scope of work and territory coverage and thus resource requirements that CMS has in mind for the award. Is this info forthcoming?

No. Multiple awards are anticipated and offerors must propose on the performance of the work of their proposed state(s). This amount will vary from contractor to contractor.

9 B.3 - Estimated Cost Plus Fixed Fee (CPFF) 7 This dollar amounts in this entire section are listed as TBD. Please clarify these amounts.

These are the contract award amounts and will be filled in upon contract award.

10 B.3 - Estimated Cost Plus Fixed Fee (CPFF) What is the total funding available and what is the maximum of total funding anticipated for each award?

CMS is not releasing funding information for this procurement. The dollar amounts released in the press release are not indicative of the budget for this procurement and was more general information for MACRA program as a whole.

11 B.5 - Transition Services Is there an incumbent? If so, who is/are the incumbent(s)? No. This is new work based upon new legislation.

12 B.5 - Transition Services 10 Section B.5 states that “…Contractor will participate in transition activities and submit a transition business and technical proposal when requested. Refer to Section H.14 and Section C.8 of the SOW for guidance” however, Section H.14 refers to FOIA guidance, not transition guidance. Please confirm that RFP should reference H.13 instead.

Refer to Amendment for correction

13 G.11 - Government Furnished/Contractor Acquired Property

22 If the contractor is a Quality Innovation Network organization, may they use any CMS provided Health Care Quality Information System information technology resources for the MQIDTA contract?

QIN-QIO contractors have access to specific data (e.g. QualityNet) by virtue of the statutory authority invested in them by Congress and may use this data as part of their proposed solution.

14 G.11 - Government Furnished/Contractor Acquired Property

23 Includes the statement that CMS will determine each Contractors initial Hardware/Software configuration. CMS will initiate an order for such hardware/software with the CMS contractor. CMS will inform the contractor of the CMS determined configuration. Can CMS provide information on the IT infrastructure?

CMS is not furnishing equipment, but expects awardees to have at a minimum systems that have secure internet access. CMS expects to provide further clarification on hardware/software capability after award.

15 G.11 - Government Furnished/Contractor Acquired Property

22 States that the Government will furnish for performance of the work required herein a list of property, which is provided under Attachment J.9 and is hereby made part of this contract. The J.9 Attachment is simply a blank HHS-565 form. Can the government provide a listing of the equipment that will be provided to do this work?

The Government does not anticipate providing property/equipment but allows the contractor to purchase equipment to perform this work as part of the contract. HHS- 565 form should be completed by the contractor maintaining any equipment provided by the government or contractor acquired during the contract.

16 G.7 - Subcontract/Consultant Consent 21 Is Attachment J.4 Consent to Subcontract due with the proposal? Yes

17 General Can a contractor who submits a proposal as a prime also be part of a second proposal submission as a subcontractor?

Yes. As stated in the RFP, CMS will only evaluate one proposal per organization.

However, there are no restrictions on proposing as a subcontractor on multiple MQIDTA efforts.

18 General Can CMS please clarify how many of the original 62 RECs remain functioning organizations providing technical assistance to eligible providers?

Approximately 90% of RECs are continuing to operate in providing a variety of practice transformation and/or health IT services.

19 General Does CMS anticipate making additional data available (e.g., Medicare FFS claims data) at the clinician level to facilitate contractor TA activities for engaged clinicians in the contractor's contiguous states?

Please review the revised J.3 Attachment. CMS has provided an estimate of eligible clinician in dataset. This data was an analysis of 2014 Physician Quality Reporting (PQRS) from eligible providers by State and Provider Type, eligible providers in Small Practices (< 15 Providers), excluding Low Volume Providers. Please refer to Attachment J.3 Table 4 A

20 General Does CMS prefer states to join together for this work and if so, what does CMS deem as optimal size?

CMS is not restricting a minimum or maximum amount of states proposed by one offeror.

21 General Even though MIPS is not for hospitals, are the providers billing Part B within the hospital setting (ex: ED) part of MIPs as they are in

PQRS?

Yes. Per the propoposed rule, the following providers are considered "eligible professionals" for purposes of measurement and payment adjustment under the MIPS program:

For the first two years of MIPS, the following Medicare Part B providers are deemed eligible professionals:

• Physicians

• Physician assistants

• Nurse practitioners

• Clinical nurse specialists

• Nurse anesthetists

For the third and succeeding years, the following providers also become MIPS-eligible:

• Physical or occupational therapists

• Speech-language pathologists

• Audiologists

• Nurse midwives

• Clinical social workers

• Clinical psychologists

• Dietitians or nutrition professionals

Please refer to the 2016 Medicare Physician Fee Schedule (PFS) Proposed Rule and subsequent Final Rule when released.

22 General Has CMS obtained OMB/PRA clearance for MQIDTA contractors to survey ECs regarding their satisfaction with our services?

Please see Amendmemt

23 General How did you calculate Table 4 and identify that participations numbers that were 15 or less?

CMS has provided an estimate of eligible clinician in dataset (Attachment J.3). This data was an analysis of 2014 Physician Quality Reporting (PQRS) from eligible providers by State and Provider Type, eligible providers in Small Practices (< 15 Providers), excluding Low Volume Providers. Please refer to Attachment J.3 Table 4 A

24 General 107 If the Offeror plans to contract with a subcontractor using a Firm Fixed Price agreement type, please advise if the subcontractor is required to prepare the cost detail required under B.1.i?

A breakdown of the firm fixed price costs should include labor, travel, ODCs and the indirect rate, but supporting documentation and detail is not required

25 General Is it the intent of CMS to have coverage of the entire US and Territories as a result of this acquisition? If so, then how will CMS address coverage of states and territories that do not have an acceptable proposal submitted?

Yes, please refer to section L.11 of the RFP.

26 General Is there a directory of the target providers CMS will make every effort to provide eligible clinicians/practice(s) level data available upon contract award.

27 General Is there any way for potential subcontractors to be put in touch with organizations that are applying to serve as prime contractor?

Please refer to amendment 2 and list of pre-proposal conference attendees

28 General May a bidder bid as a prime on one bid and as a subcontractor on another?

Yes. As stated in the RFP, CMS will only evaluate one proposal per organization.

However, there are no restrictions on proposing as a subcontractor on multiple MQIDTA efforts.

29 General Our organization covers several regions. Do we identify a specific area that has providers that meet the criteria?

Offerors are not restricted by the number of states that make up a proposed geographic area (no minimum or maximum); however, Offerors are required to propose contiguous states. But are required to propose its most optimal combination of states and provide rationale and identify efficiencies for selecting the geographic area.

30 General Please clarify if being a prime under this opportunity precludes an organization from also bidding to become one of the national support contractors.

Yes, being a prime contractor under the QPP-SURS procludes an organziation from also bidding to become a national support contractor.

31 General Please clarify the distinction between the two terms used, "Engagement" vs "Enrollment". Do they equal the same thing, and if not, what is the difference?

Engagement is defined as an established connection with the clinician with the understanding that assistance will be provided based on clinician/practice needs.

Enrollment is defined as actively participating in the MIPS/APM Programs.

32 General SF33 shows the last option end date as 11/30/2021, while in other parts of the RFP it is listed as 11/29/2021. Can you please clarify which is the correct date?

Please see the Amendment for the correct date

33 General Since Meaningful Use support is part of Advancing Care Information, is Direct Technical Assistance support available to Medicaid providers in small practices that may elect to participate in the Medicaid EHR Incentive Program versus MIPS? Many providers who work in underserved communities are also eligible for the Medicaid EHR Incentive program, but still serve Medicare patients at this time.

No. No. Offerors need to support ALL clinicians eligible to participate in the Quality Payment Program as defined in the 2016 Medicare Physician Fee Schedule (PFS) Proposed Rule and subsequent Final Rule.

34 General 104 The SF33 appears to be between the prime contractor and CMS.

As such, is an SF33 needed from subcontractors?

No. The subcontractor needs to submit their proposal as part of the Prime Contractors proposal.

35 General What can the funds not be used for? Refer to FAR part 31.201-6 for a discussion of unallowable costs

36 General What level of detail will CMS be able to supply to contractors in order to identify and locate eligible clinicians?

Please review the revised J.3 Attachment. CMS has provided an estimate of eligible clinician in dataset. This data was an analysis of 2014 Physician Quality Reporting (PQRS) from eligible providers by State and Provider Type, eligible providers in Small Practices (< 15 Providers), excluding Low Volume Providers. Please refer to Attachment J.3 Table 4 A

37 General Will CMS hold this project until the rule is finalized? No. Offerors Technical Approach should demonstrate the ability to begin outreaching efforts immediately upon award. The finalized MACRA regulation is anticipated to be completed late Fall '16 and the first performance period MIPS starting Jan 1, 2017 and run through December 31, 2017.

38 General Will CMS provide MQIDTA contractors with a list of eligible clinicians and practices, similar to the list provided to Regional Extension Center contractors?

CMS will make every effort to provide eligible clinicians/practice(s) level data available upon contract award.

39 General Will the contractor need to obtain any kind of participation agreement from ECs that seek/obtain technical assistance?

CMS does not require participation agreements; it is up to the offeror to determine the best approach to managing the provision of assistance

40 General Will the contractors be assigned exclusive territories like the REC's were or allow for contractor competition in a given area?

It is the intent to cover all states and U.S. territories. Offerors are not restricted by the number of states that make up a proposed geographic area. Offerors are required to propose contiguous states. Offerors can submit proposals on any state/territory as part of this competition. Awards will be made based on best value determination and service areas will be established upon award. There will only be one MQIDTA contractor per state awarded.

41 General Will the threshold of 100 or $10,000 in payments ever change, since costs do increase as well as participants in Medicare?

Contractors will be held to supporting eligible clinicians as defined under the final rule.

42 H.1 - Business Ethics, Conflict of Interest and Compliance

36 If the contractor submits a mitigation plan that requires an independent external audit of the mitigation strategy, can the cost of the audit be charged directly to the contract?

If the audit is a requirement of this contract only and benefits no other contract, the costs may be direct. If other contracts will benefit, it must be indirect.

43 H.1 - Business Ethics, Conflict of Interest and Compliance

32 It states, “ 2. Proposed Restraint on Future Contractor Activities:

CMS is proposing to restrain current and future Contractor activities as follows: CMS considers it a conflict for a MQIDTA Contractor to simultaneously be a Medicare Administrative Contractor (MAC), Recovery Audit Contractor (RAC), Zone Program Integrity Contractor (ZPIC), Unified Program Integrity Contractor (UPIC), or a Beneficiary and Family-Centered Care Quality Improvement Organization (BCFF-QIO) Contractor in the same geographic region.”

Does the Proposed Restraint on Future Contractor Activities also apply to the MACRA Contractor’s parent or affiliates?

Generally yes. However, COI analysis is so fact dependent it is nearly impossible to provide guidance without more details. Therefore, some steps should be taken as early as possible to address potential unfair competitive advantage and/or impaired objectivity at the parent/affiliate BEFORE the new requirement is published.

44 H.1 - Business Ethics, Conflict of Interest and Compliance

32 It states, “ 2. Proposed Restraint on Future Contractor Activities:

CMS is proposing to restrain current and future Contractor activities as follows: CMS considers it a conflict for a MQIDTA Contractor to simultaneously be a Medicare Administrative Contractor (MAC), Recovery Audit Contractor (RAC), Zone Program Integrity Contractor (ZPIC), Unified Program Integrity Contractor (UPIC), or a Beneficiary and Family-Centered Care Quality Improvement Organization (BCFF-QIO) Contractor in the same geographic region.”

Will the proposed Restraint on Future Contractor Activities apply to a MQIDTA subcontractor's parent or affiliates?

Usually, CMS is only concerned with direct ownership affiliations, not business relationships not involving ownership and control. Thus, subcontracts not owned or controlled by the parent/affiliate may not be affected by this restraint. But again, COI analysis is fact dependent - see response above.

45 H.1 - Business Ethics, Conflict of Interest and Compliance

36 Please confirm our understanding that a COI independent audit would only be required if CMS determines a Mitigation Plan/Mitigation Strategy is required of the Contractor or its subcontractors. In other words, the fact that a Contractor has identified various mitigation approaches/strategies as a means to alleviate or remove potential conflict, doesn't in of itself, trigger the need for an independent audit - correct?

An independent audit is required after the first year of performance on any mitigation plan accepted by the Contracting Officer. Thereafter, it is CO discretion whether further audits are required.

46 H.1 - Business Ethics, Conflict of Interest and Compliance

Would the QIN-QIO & TCPI contractors have a conflict of interest issue?

QIN-QIO or TCPI contractors are not precluded from becoming a MQIDTA contractor.

However, COI analysis is fact dependent, and offeror's should present a mitigation strategy as part of their proposal.

47 H.5 - CMS Security Clause 44 Will any employees of the contractor need sufficient access to a CMS information system to require PIV badge access as described in section H.5 CMS Security Clause?

Yes, and contractors should provide corporate experience that indicates service delivery processes that successfully used interventions to assist providers in addressing quality improvement interventions for Medicare beneficiaries and quality measurement reporting in Medicare programs.

48 I.11 - Electronic and Information technology Accessibility

What does 508 compliance mean? Section 508 requires Federal agencies to ensure that persons with disabilities (both employees and members of the public) have comparable access to and use of electronic information technology. Information about Section 508 is available at http://www.hhs.gov/web/508

49 I.2 - Department of Health and Human Services Acquisition Regulations (HHSAR) Clauses Incorporated by Reference

64 HHSAR 352.231-70 Salary Rate Limitation (Dec 2015). The HHSAR specifies the pay tables on the Office of Personnel Management website. Can CMS provide the specific table name that is being referenced since there are several Executive Schedules available on the OPM website? Is it Salary Table No. 2016-EX?

Yes, the reference is made to the Salary Table No. 2016-EX, Rates of Basic Pay for the Executive Schedule (EX).

50 J.1 - MQIDTA SOW The RFP indicates the contractor is required to utilize a CMS approved knowledge management system. In addition, the Statement of Deliverables (SOD) specifies the contractor will use several CMS TBD reporting mechanisms and business intelligence tools. What additional information can you provide about these tools and contractor requirements as this likely represents both added cost as well as cost savings potential for the contractors and providers?

CMS will not be providing an information technology solution for knowledge management. However, the offeror should include strategies to manage education and outreach as stated in the statement of work (See amendment under Section C.1.5.2.) in the proposal which may include technological solutions.

51 J.10 - Information Security Attestation Attachment J-10 is provided. In which volume are we to submit the completed/signed J-10?

Please refer to the amendment

52 J.11 - Past Performance Questionnaire Are there Instructions for completion and submission of the Past Performance Questionnaires? Specifically, how many completed Questionnaires are required? Must questionnaires be for relevant work only? Is there a standard letter that the Offeror should send out along with the Questionnaire to the company that will be rating the Offeror? Should companies completing the Questionnaire/evaluation return the forms directly to CMS or should they be sent back to the Offeror to include with their proposal? If returned to the Offeror, where should the Questionnaires be included in the proposal - as an Appendix to Volume III?

Please refer to the amendment.

53 J.11 - Past Performance Questionnaire Attachment J-11 is provided; however, no instructions related to J- 11 are included in RFP Sections L and/or M. Please clarify whether we are we to ask our clients to submit J-11 PP Questionnaires? If yes, how many max, and when would they be due to CMS?

Please refer to the Amendment, which updates the J-11 with instructions/cover letter.

54 J.11 - Past Performance Questionnaire Does the two page limit specified on page 97 apply to each past performance or all past performances in total?

The 2 page limit on page 97 refers to the past performance summary (including chart from page 103) and is the page limit in total for Volume III. Past performance questionnaires are submitted separately directly from the contact completing the questionnaire and is not counted towards the page limit.

55 J.11 - Past Performance Questionnaire Is a description/write up of the past performance, scope, relevance, size, and summary required or CMS is only requesting that the table on page 103 of the SOW be completed?

The past performance submission should include the past performance summary including the chart from page 103 and should only include those contracts whose scope, relevance, and size are appropriately related to this SOW.

56 J.11 - Past Performance Questionnaire Is there a maximum number of past performances for the prime, sub, and combined?

There is no minimum number of Past Performance questionnaires that can submitted. Prime Contractors can submit no more than three (3) Past Performance Questionnaires and Subcontractors can submit no more than three (3) Past Performance Questionnaires. Please see amendment.

57 J.11 - Past Performance Questionnaire Will the Past Performance Questionnaire be submitted directly to CMS or will it be submitted as part of the proposal.

Past Performance shall be sent directly to CMS in the MQIDTA@cms.hhs.gov mailbox.

Please see the amendment for full instructions.

58 J.3 - Estimated Eligible Clinician Data Set Can you provide estimates of the number of HPSA providers per state?

Please review the revised J.3 Attachment. CMS has provided an estimate of eligible clinician in dataset. This data was an analysis of 2014 Physician Quality Reporting (PQRS) from eligible providers by State and Provider Type, eligible providers in Small Practices (< 15 Providers), excluding Low Volume Providers. Please refer to Attachment J.3 Table 4 A

59 J.3 - Estimated Eligible Clinician Data Set Which table should be used to estimate the target population for technical assistance for a given state?

Please review the revised J.3 Attachment. CMS has provided an estimate of eligible clinician in dataset. This data was an analysis of 2014 Physician Quality Reporting (PQRS) from eligible providers by State and Provider Type, eligible providers in Small Practices (< 15 Providers), excluding Low Volume Providers. Please refer to Attachment J.3 Table 4 A

60 J.5 - Small Business Subcontracting Plan 7 Are all HPSA providers included in Table 4? Does "all eligible clinicians" include both Tables 4 and 4A?

Please review the revised J.3 Attachment. CMS has provided an estimate of eligible clinician in dataset. This data was an analysis of 2014 Physician Quality Reporting (PQRS) from eligible providers by State and Provider Type, eligible providers in Small Practices (< 15 Providers), excluding Low Volume Providers. Please refer to Attachment J.3 Table 4 A

61 J.5 - Small Business Subcontracting Plan 69-80 We are a small non-profit organization with less than 20 employees. Are we required to complete and submit a Small Business plan?

No, small businesses do not need to submit small business subcontracting plans, however please note that non-profit organizations are considered large businesses regardless of size per SBA.

62 J.6 - Contractor Business Ethics COI and Compliance Program Requirements

2 Please clarify what information CMS is looking for in the Offerors response - Compliance Officer attestation the he/she has analyzed each PCI Financial Disclosure or a summary of each analysis?

Due to PII security concerns, CMS does not want any personal COI information disclosed to the agency. As a result, CMS is relying on the offeror to observe the honor system when collecting and analyzing board member and employee potential personal conflicts. This requires the offeror to exercise some discretion while providing CMS with adequate information for it to have a level of comfort that the offeror is and will be protecting (this is on-going during POP) the Government’s interests.

63 J.6 - Contractor Business Ethics COI and Compliance Program Requirements

1 tab 2. B. 2nd bullet states to provide "Level of Need for each customer segment". Please define what is meant by "customer segment".

CMS expects to cover all eligible clinicians meeting the target population requirements designated in the statute that need assistance across the country.

The target population includes practices with 15 or fewer clinicians, with preference given to practices in medically underserved and rural areas.

64 K.6 - Certification Regarding Responsibility Matters

69-80 Should these certification be submitted with the proposal? And if so with what Volume?

Yes. In Volume IV

65 L.10 - Proposal Organization 96 "All PDF files sent electronically shall contain bookmarks indicating each indexed section". Does CMS expect each Volume to be its own pdf file, or does the preceding statement mean some or all should be combined?

Each Volume should be its own file. Within a pdf file, different sections of the document should be bookmarked.

66 L.10 - Proposal Organization 97 CMS asks offerors to bookmark the PDF files "indicating each indexed/tabbed section." Does CMS require section-level tabs;

e.g., Section A, Section B? Or does CMS require bookmarks down to the subsection level; e.g. A.1, A.2, B.1, B.2, etc.?

Section level tabs are sufficient.

67 L.10 - Proposal Organization Does "technical volume" mean volumes I, II and III? Volumes I, II, and III encompass the full technical proposal.

68 L.10 - Proposal Organization 97 L.10.d.1 indicates files must be compatible with Microsoft Office 2010 or later versions. L.10.d.2 says PDFs shall contain bookmarks. Does this mean the proposal may be submitted as a Word document or a PDF?

Yes.

69 L.10 - Proposal Organization 97 Must the business proposal be page numbered? Must the COI volume be page numbered?

Yes.

70 L.10 - Proposal Organization 96 Please clarify: Volume IV & V have no page limits. If so, what is the document size you are allowed to accept via email?

Correct. You may submit more than one email if the proposal does not fit within one email.

71 L.10 - Proposal Organization 97 Please confirm or correct that an electronic signature is acceptable since the submission method is exclusively by email.

Yes

72 L.10 - Proposal Organization 96 Please confirm or correct the time of delivery is 11 AM EDT. Yes. Please refer to the Amendment.

73 L.10 - Proposal Organization 97 Please confirm that the technical proposal is to be single-spaced. Yes

74 L.10 - Proposal Organization 97 This Volume is limited to two (2) pages. Offeror and significant subcontractors are required to complete a table providing a summary of relevant past performance information. Please advise what should be done If the relevant past performance information exceeds two pages when the table is completed. Should some contracts be deleted from the table, should descriptions of services be significantly shortened, or what other acceptable steps should be taken to keep within page limits?

The table should only include recent contracts (within the last 3 years) and be similar in size, scope and complexity to this contract. If the table exceeds 2 pages, the table should be shortened to just the most pertinent contracts. Description of services should be brief.

75 L.11 - Technical Proposal Instructions Can vendors bid on more than one contiguous group of states within one proposal?

No. Primes offerors must proposal one contiguous state grouping. Alternate proposals will not be accepted.

76 L.11 - Technical Proposal Instructions 98 Can you confirm our understanding that if CMS causes an Offeror's states to become noncontiguous, such Offeror's bid remains competitive?

Correct.

77 L.11 - Technical Proposal Instructions Can you please clarify how large a "contiguous area" is intended to be? Smaller than a State, as large as a State, multi-state?

At minimum, offerors must cover an entire state. Offerors can propose multiple states and the state clusters that is proposed must be contiguous (defined as bordering) states.

78 L.11 - Technical Proposal Instructions 98 CMS asks that offerors "provide a PDF version of the complete technical proposal." Does this mean a PDF containing all of the content in Volume I, or a PDF containing Volumes I, II and III?

One PDF per Volume.

79 L.11 - Technical Proposal Instructions Do all eligible clinicians in a state need to be assisted, or can proposals be confined to defined area that is a section of the state

Contractors need to cover an entire state.

80 L.11 - Technical Proposal Instructions Do contractors need to cover an entire state (as opposed to a specific part of a state)?

Yes, contractors need to cover an entire state. Per the RFP, "Offerors shall propose an approach to provide customized direct technical assistance tailored to provider needs to help ALL eligible providers within a contiguous state boundary."

81 L.11 - Technical Proposal Instructions 98 Do the appendices have a page limit? Should all appendices be provided in a single, bookmarked PDF file, or separately?

Appendices do not have page limits but should be limited to reasonable page counts.

Appendices can be provided in a single bookmarked PDF file for each respective Volume.

82 L.11 - Technical Proposal Instructions Do you prefer state based proposals over regional ones? would you accept a multistate regional proposal?

The Offeror shall propose its most optimal combination of states and provide rationale and identify efficiencies for selecting the geographic area.

83 L.11 - Technical Proposal Instructions How large are the regions CMS intends each contractor to serve? CMS has not established regions and there is no minimum or maximum for the number of states that an offeror can propose.

84 L.11 - Technical Proposal Instructions Our organization currently services providers in the State of California and the State of Hawaii. Would we submit a separate proposal for each State or would we submit one proposal for both the State of Hawaii and State of California.

One proposal should encompass any and all states in your proposed area.

85 L.11 - Technical Proposal Instructions 98 If an organization plans to submit for two regions of contiguous states, is it necessary to submit two proposals?

Prime offerors may only submit one proposal and they must be for one contiguous state grouping.

86 L.11 - Technical Proposal Instructions 98 The RFP states that, "Offerors are required to propose contiguous states." Is a potential contractor allowed to submit more than one prime bid to address the contiguous states requirement? For example, states A, B, and C are contiguous and states X and Y are contiguous (but A, B, C are not contiguous with X,Y), is a potential contractor allowed to submit bid #1 for states A, B, and C and bid #2 for states X and Y?

CMS shall only evaluate one proposal per organization as a prime contractor.

Organizations may serve as a subcontractor on other proposals. CMS encourages industry contacts to team with one another in putting forth their best solution under one proposal to the Government. CMS encourages teaming arrangements between qualified organizations with experience and documented performance on quality improvement efforts and encourages Offerors to leverage the collective quality improvement expertise that exists in the field while crafting their proposals.

87 L.11 - Technical Proposal Instructions 98 This section states that past performance should be provided in an appendix, which does not count against page limitation; however, there is a Past Performance-specific Volume, which is limited to two pages. Please clarify which is correct.

Past Performance volume is two pages. The Past Performance Questionnaires are part of the appendix.

88 L.11 - Technical Proposal Instructions What do you mean by contiguous states? Are we to bid for only one state or should bordering states be included in a proposal?

Offerors are required to propose contiguous (defined as bordering) states. States or territories outside of the continental U.S. do not have bordering states and therefore may be proposed by any Offeror as part of their proposed state based geographic area. The Offeror shall propose its most optimal combination of states and provide rationale and identify efficiencies for selecting the state clusters.

89 L.11 - Technical Proposal Instructions 98 Will CMS accept and review additional appendices that we believe to be germane to our proposal?

Yes but CMS is not obligated to review items included in appendices that have not been requested in the RFP.

90 L.12 - Technical Approach and Targeted Outcomes

99 "Include how the need and solution will be prioritized for those eligible providers who fall in more than one of following categories" If the proposed approach utilizes a different categorization of providers by need, can that approach be described in lieu of these categories?

Yes. Offerors should describe methodology to determine the right level of technical assistance at the right time with the least amount of intervention and expenditure of resources, progressing if necessary will be determined.

91 L.12 - Technical Approach and Targeted Outcomes

99 "Propose, at a minimum, the total % of providers in a proposed area of contiguous states/territories that meet the MIPS/APM enrollment requirements as stated in the legislation, that the [missing word] will successfully enroll and describe the approach and methodology to reach and/or engage the providers."

(1) Is the missing word "Offeror"? If not, please provide missing word.

(2) Should enroll be recruit? If not, enrolled in what and by whom?

Yes, the missing word is “offeror”. The term enroll is correct as it relates to clinicians that receive assistance. Offeror’s should plan to assist all eligible clinicians in need, and propose the strategy to meet those needs per quarter, year, etc.

92 L.12 - Technical Approach and Targeted Outcomes

99 Bullet # 2 states, "Describe methodology for a tailored technical assistance strategy to serve ALL Eligible Providers based on customer segments," but Bullet 4 states, "Propose, at a minimum, the total % of providers in a proposed area of contiguous states/territories that meet the MIPS/APM enrollment requirements as stated in the legislation." Are contractors able to propose a % of the eligible population they will offer assistance to?

Yes.

93 L.12 - Technical Approach and Targeted Outcomes

99 Can CMS provide data prior to the proposal submission deadline that will enable us to break out providers who fall under more than one category? It seems we would need to have provider-level data in order to do this.

Please refer to the Revised J.3 attachment in the amendment.

94 L.12 - Technical Approach and Targeted Outcomes

Do sub contractors need to be explicitly listed in the proposal or should a proposal include types of subs that may be engaged and the work for which they would be engaged?

Yes, subcontractors need to be explicitly listed in both the technical and business proposals. In addition, subcontractors must be identified in teaming arrangements and staffing plans.

95 L.12 - Technical Approach and Targeted Outcomes

How will the 200,000 practice target identified in this procurement be distributed nationwide? Does CMS have a state target based on a practice profile assessment?

CMS expects to cover all eligible clinicians meeting the target population requirements designated in the statute that need assistance across the country.

96 L.12 - Technical Approach and Targeted Outcomes

99 Identify % of eligible providers/target numbers for first 6, 9, 12 months for what service areas (i.e.by state for all states)?

Offeror's should propose a % of the eligible population they will offer assistance to by identifying and providing a breakout if any of the providers fall under more than one of the categories:

1. Individual and small practice providers

2. Providers located in primary care HPSAs

3. Providers in practices located in rural counties

4. Providers serving large underserved populations

97 L.12 - Technical Approach and Targeted Outcomes

99 In italics, above the D requirement, the following direction is provided, "Using a table or chart format is encouraged for the following areas but will be counted towards the page count and is not to be made part of the appendix…"

Although this instruction reads "areas," we assume the suggestion to present the required information in chart format is only referring to D. and not E-H. Please confirm or correct.

Yes.

98 L.12 - Technical Approach and Targeted Outcomes

99 Is the required table showing eligible providers by category to be broken out by State. If yes, proposing multiple states presents a disadvantage based on the table's inclusion in the page limit. Will additional space be allowed to accommodate proposals to serve multiple states?

Yes, the table should be broken out by state.

99 L.12 - Technical Approach and Targeted

100 On page 100 of the RFP it says "Identify how the approach and methodology solutions to address provider need that was provided in L.12.A will be applied to the identified categories (i.e.

crosswalk)." Can you say more about your expectation in cross-walking local presence, TA and monitoring strategy, target % (L.12.A) to 4 priority eligible provider categories (L.12.E)?

Offerors should demonstrate how they will assess needs and provide customized support to previously under or unsupported clinicians. Develop and use technical assistance approaches that will aid clinicians to effectively solve their challenges most efficiently. In extreme cases, technical assistance including a physical “boots on the ground” presence in practices may be required. Describe methodology to determine the right level of technical assistance at the right time with the least amount of intervention and expenditure of resources, progressing if necessary.

100 L.12 - Technical Approach and Targeted Outcomes

100 Please explain which is required of the MQIDTA: EITHER, as stated in L.12.F: " 80% of providers achieving a neutral or positive score by the end of 2021" OR, as stated in the SOW, C.3.4.3, page 14, a., "80% of clinicians achieving IMPROVED MIPS composite score."

The SOW is accurate "80% of clinicians achieving IMPROVED MIPS composite score."

101 L.12 - Technical Approach and Targeted Outcomes

99 Please clarify the wording in Section D. For which target does CMS want us to provide numbers: enrollment or engagement?

Both engagement and enrollment.

102 L.12 - Technical Approach and Targeted Outcomes

99 Please confirm the first word should be identify and not identity. Yes. Please refer to the amendment

103 L.12 - Technical Approach and Targeted Outcomes

99 Section E reads, "Describe the methodology in which direct customized technical assistance will be determined at the level of provider at the right time…." Should Section E read, "Describe the methodology in which direct customized technical assistance will be delivered at the level of the provider at the right time..."?

Otherwise, Section H appears to ask for the same information.

No. Section E is asking Offerors to demonstrate how they will assess needs and deliver customized support to previously under or unsupported clinicians.

104 L.12 - Technical Approach and Targeted Outcomes

100 The following appear to be the same requirement. Please clarify the difference between the two, or provide more explicit instructions for each.

A.3 reads, "Provide mode to monitor proposed technical assistance in order to improve overall customer satisfaction including plan for timeliness of support and useful resources (i.e.

webinars and other communication resources) to be used throughout each contract year."

G. reads, "Provide approach and measures to continuously monitor eligible providers’ satisfaction with technical assistance which includes timeliness of touch, support, and useful resources."

These are different requirements.

A.3 is requesting the Offeror's mode to monitor proposed technical assistance, which will result in the overall customer satisfaction.

G. is requesting the Offeror to provide approach and measures to continuously monitor eligible providers’ satisfaction with technical assistance.

105 L.12 - Technical Approach and Targeted

100 The following appear to be the same requirement. Please clarify the difference between the two, or provide more explicit instructions for each.

E. reads, "Describe the methodology in which direct customized technical assistance will be determined at the level of provider at the right time and with the least amount of intervention and expenditure of resources needed for the following categories. Include how the need and solution will be prioritized for those eligible providers who fall in more than one of following categories: 1. Individual and small practice providers; 2. Providers located in primary care HPSAs; 3.

Providers in practices located in rural counties; 4. Providers serving large underserved populations. Identify how the approach and methodology solution to address provider need that was provided in L.12.A will be applied to the identified categories (i.e. crosswalk).

H reads, "Describe methodology to determine the right level of technical assistance at the right time with the least amount of intervention and expenditure of resources, progressing if necessary."

Item E refers to the strategy for prioritization across categories. H refers to the strategy for targeting and the methodology for providing the assistance at the right level.

106 L.12 - Technical Approach and Targeted Outcomes

100 What is meant by "progressing if necessary"? Offerors should demonstrate how they will assess needs and provide customized support to previously under or unsupported clinicians. Develop and use technical assistance approaches that will aid clinicians to effectively solve their challenges most efficiently, "progressing if necessary" and in extreme cases, technical assistance including a physical “boots on the ground” presence in practices may be required.

Describe methodology to determine the right level of technical assistance at the right time with the least amount of intervention and expenditure of resources, progressing if necessary.

107 L.12 - Technical Approach and Targeted Outcomes

100 What metrics will be used to measure the success of the QPPSURS contract (in addition to provider satisfaction and # of providers reached)?

The offeror should propose measures to determine contractor succes, which will be used to evaluate contractor performance. CMS will work with support contractors to identify additional measures as appropriate.

108 L.12 - Technical Approach and Targeted Outcomes

99 Words appear to be missing from question #4. It says "…that the will successfully…" Please clarify.

Correct. Propose, at a minimum, the total % of providers in a proposed area of contiguous states/territories that meet the MIPS/APM enrollment requirements as stated in the legislation, that the Offeror will successfully enroll and describe the approach and methodology to reach and/or engage the providers.

109 L.13 - Corporate Experience, Operational Capacity and Key Personnel

98 Can an offeror propose to provide services to more than one area?

If they do, can CMS choose to award some or all of those regions to an individual offeror?

Prime offerors may only submit one proposal for one contiguous state cluster.

110 L.13 - Corporate Experience, Operational Capacity and Key Personnel

98 How does CMS want the bidder to indicate any potential cost difference from what was proposed vs what was awarded if not all states within a proposal are awarded?

This will be handled during negotiations.

111 L.13 - Corporate Experience, Operational Capacity and Key Personnel

101 Can resumes be provided as an Appendix? Yes.

112 L.13 - Corporate Experience, Operational Capacity and Key Personnel

Can you elaborate on the encouraged "collaboration" of contractors & sub-contractors? What are the requirements of and expected roles of a sub-contractor that is not a QIO, REC, or RHC?

CMS strongly encourages teaming arrangements between organizations in order to fully meet the requirements of the SOW. Upon award, contractors will be expected to collaborate with other Quality Network contractors ( QINs, RHCs, RECs, PTNs, SANs,etc) to ensure that there is not duplication of effort and that resources are being used efficiently and effectively.

113 L.13 - Corporate Experience, Operational Capacity and Key Personnel

98 How does CMS want bidders to indicate what geographic areas they are proposing to provide services to? Each State separately or regionally?

Each state separately

114 L.13 - Corporate Experience, Operational Capacity and Key Personnel

99 How will CMS evaluate bids with overlapping areas? For example, a regional approach vs. a bidder who proposed a single state within that region.

Awards will be made based on the quality of proposals received. Evaluations will be conducted on a tradeoff basis and award will be made to the offeror(s) that offers the best value to the government.

115 L.13 - Corporate Experience, Operational Capacity and Key Personnel

101 If CMS is not willing to remove the requirement for letters of commitment from unhired staff, does the requirement apply to all proposed new staff or just proposed key personnel that are yet to be hired?

Letters of commitment are required for key personnel and other recommended staff who are not currently an employee of the organization. See amendment.

116 L.13 - Corporate Experience, Operational Capacity and Key Personnel

100 Must the two examples of corporate experience that required the Bidder to be agile with delivering services be limited to the provision of technical assistance, optimization of the use of health information technology, or improving clinical quality?

Corporate experience is not limited to those listed in the solicitation. Examples may come from any corporate experience.

117 L.13 - Corporate Experience, Operational Capacity and Key Personnel

101 Proposers may need to advertise for the proposed staff to be hired. Due to the cost of advertising and the timing (actual employment would not start for almost 5 months), the requirement to include letters of commitment from unhired staff seems unreasonable. Would CMS consider removing this requirement?

No. Offerors must demonstrate that they have required staff to perform the tasks outlined in the Statement of Work.

118 L.13 - Corporate Experience, Operational Capacity and Key Personnel

100 Section L.12 requires addressing 12 items (A through L), including partnership management, labor mix and key personnel, yet the page limit is 4. Would CMS consider expanding the page limit or allowing reference to multiple attachments containing the requested information?

No, CMS is not expanding the page limit.

119 L.13 - Corporate Experience, Operational Capacity and Key Personnel

100 Should we include the information requested in this section for significant subcontractors?

Yes, if applicable.

120 L.13 - Corporate Experience, Operational Capacity and Key Personnel

101 This section states, " H. Identify the positions that will be assigned to manage performance and supervise the work and relevant experience, including anticipated level of effort (LOE) for each individual. (Note: Include a Letter of Commitment for each proposed staff who is not currently employed by your organization.)"

(1) What is meant by position? Should this read proposed staff member(s)?

(2) What is meant by "supervise...the relevant experience"?

(3) May we report LOE by providing FTEs?

(1) Position refers to proposed staff

(2) Offerors must demonstrate relevant experience as well as experience managing this type of work

(3) Yes

121 L.13 - Corporate Experience, Operational Capacity and Key Personnel

100 What is labor mix? Labor mix includes all of the labor categories for your proposed solution.

122 L.13 - Corporate Experience, Operational Capacity and Key Personnel

100 What is meant by "agile"?

This section states, "D. Successful MQIDTA contractors will need to commit to and meet quantifiable outcomes that must align with the overall aims of the MACRA requirements, many of which are yet to be defined. Provide 2 (two) examples of corporate experience that required you to be agile with delivering services.