TMA_TDEFIC_Solicitation_Questions_2_5-6-13.docx

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TRICARE Dual-Eligible Fiscal Intermediary Contract (TDEFIC)
Solicitation number
HT9402-12-R-0005
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The Government's Responses to 12 Solicitation Questions previously identified as pending.

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TRICARE Dual-Eligible Fiscal Intermediary Contract (TDEFIC) HT9402-12-R-0005 TMA TDEFIC Solicitation Questions

No:
Solicitation Citation
Question/Comment
Government Response
3
Section B, 0X03 TRANSITION-OUT
The Transition-Out CLIN description of Section B indicates the CLIN establishes a fixed price for the transition-out costs and limits those costs to the performance of the transition-out tasks as defined in Section C Description/Specifications/Work Statement. According to FAR 31.205-6(g) severance costs are allowable costs. However, these costs would not meet the definition of what is included in the Transition-Out CLIN.

(a) Should offerors include severance costs in the Transition-Out CLIN?

(b) If the answer is yes,

(1) How should they be submitted?

(2) Are they part of the total evaluated price?

(a) Severance costs are allowable as defined in FAR 31.205-6(g)(2), but they do not meet the requirements for the Transition Out CLIN definition in the solicitation. The Government encourages offerors to review the Administration CLIN definition, the applicability of FAR 31.205-6(g)(2), and the offeror’s Cost Accounting Standards Board (CASB) Disclosure Statement and its accounting procedures.

(b) If an offeror includes severance costs in its price proposal,

(1) It shall be in accordance with the solicitation, the offeror’s CASB Disclosure Statement, and its accounting procedures.

(2) Yes, they are part of the total evaluated price when proposed in Section B, Supplies or Services and Price/Costs.

4
Attachment L-2 Workload Volumes
Exhibit L-2 provides historical workloads. This exhibit indicates there was a significant increase in adjustment receipts in 2011 for an extended period.

(a) Considering the increased workload incurred with claim adjustments with no reimbursement to the contractor, could the Government please provide the cause for this increase and how the Government reimburses a contractor for these types of increased adjustment volumes?

(b) Does the Government expect to experience such spikes in adjustment claims in the future?

(a) The increased adjustment workload volume during 2011 was the result of changes to Medicare physician fees signed into law requiring retroactive adjustments. In accordance with DFARS 252.243-7002 contractors may submit requests for equitable adjustment if they believe the work performed is outside the normal contract scope.

(b) We do not expect such spikes to occur.

5
L.6.3.2 under Subfactor 2
According to Section L.6.3.2. the offeror cannot propose its own beneficiary and provider surveys and may use the Government survey results in the offeror’s approach. Satisfaction surveys are a valuable tool for obtaining information from customers on areas to improve. Will the government consider allowing contractors to perform questionnaires for the purpose of gathering information from customers on the services the contractor provides?
No. TMA considers a questionnaire to be a type of survey.
Are there periods where the revenue stream for funding the payment of TRICARE claims is interrupted, due to federal government budgeting shortfalls/limitations, or for any other reason? How often does this occur? How do you address this challenge to the FI, (i.e. increased call center activities, satisfaction survey scores)?
Historically, budgeting shortfalls have been infrequent and of little impact to TRICARE claims payment funding.

Any task order issued against the TDEFIC contract shall denote the quantity ordered and the associated obligated funding amount.

20
CDRL Reference A010
Please provide the volume of Third Party Liability (TPL) claims for 2010, 2011 and 2012.
The Government has historical data for the number of cases, not the number of claims. Below are reported potential TPL cases for the years shown.

FY10= 48,944,

FY11=49,475,

FY12=51,695

33
Exhibit L-2

Workload Volumes

Can TMA provide the historical data associated with the number of Program Integrity cases processed similar to the historical data provided in exhibit L-2?
Volume of Program Integrity Cases per quarter:

1/11-3/11 = 64 Opened and 60 Closed 4/11-6/11 = 75 Opened and 27 Closed 7/11-9/11 = 32 Opened and 36 Closed 10/11- 12/11 = 69 Opened and 75 Closed 1/12-3/12 = 54 Opened and 51 Closed 4/12-6/12 = 42 Opened and 39 Closed 7/12-9/12 = 61 Opened and 46 Closed 10/12-12/12 = 44 Opened and 39 Closed

37
Section L.6.1.5.2
L.6. Volume II, Technical Proposal, Section L.6.1.5.2. Indicates that "a proposal may state information on the offeror’s experience (for this purpose, experience refers to what an offeror has done, not how well it was accomplished) in performing the proposed processes and procedures. This information may be considered in the evaluation of specific technical approaches and related technical proposal risk." However, Section L.6.1.5.3. indicates that...past performance information shall not be addressed in...the technical proposal volume. Does this mean that we cannot use client names or performance based information in the technical volume? Can the Government please clarify these sections?
No, offerors are not prohibited from using client names in their Technical Proposal. The technical proposal may include information related to what the offeror has done. This information may be considered in evaluation of the offerors proposed approach and related risk (see L.6.1.5.2).\

Past Performance information will evaluate how well an offeror has performed on recent and relevant work. Section L.6.1.5.3 is indicating, from a past performance standpoint, that information regarding “how well an offeror has done” shall not be addressed in the technical proposal.

40
Section I
FAR Part 9903.201-1 CAS applicability contains the categories of contracts and subcontracts that are exempt from all CAS requirements. There are 15 categories listed and number 15 states that “firm fixed price contracts or subcontracts awarded on the basis of adequate price competition without submission of cost or pricing data” are exempt from all CAS requirements. Cost or pricing data is defined as data requiring certification in accordance with FAR 15.406-2. Section L states that this is a competitive acquisition, submission of certified cost or pricing data is not required and the resulting contract will be a requirements contract with fixed unit prices.

Can TMA explain why it has included the following clauses in Section I of the RFP? Our understanding is that all of these clauses are triggered because of the CAS coverage and that the contract would be exempt from all CAS requirements as stated above.

I.35. 52.215-15 PENSION ADJUSTMENTS AND ASSET REVERSIONS (OCT 2010)

I.36. 52.215-18 REVERSION OR ADJUSTMENT OF PLANS FOR POSTRETIREMENT BENEFITS (PRB) OTHER THAN PENSIONS (JUL 2005)

I.37. 52.215-19 NOTIFICATION OF OWNERSHIP CHANGES (OCT 1997)

I.38. 52.215-21 REQUIREMENTS FOR COST OR PRICING DATA OR INFORMATION OTHER THAN COST OR PRICING DATA--MODIFICATIONS (OCT 2010)

I.73. 52.230-2 COST ACCOUNTING STANDARDS (MAY 2012)

I.74. 52.230-6 ADMINISTRATION OF COST ACCOUNTING STANDARDS (JULY 2010)

I.75. 252.231-7000 SUPPLEMENTAL COST PRINCIPLES (DEC 1991)

I.90. 252.242-7005 CONTRACTOR BUSINESS SYSTEMS (FEB 2012)

In whole, the contract to be awarded is not a Firm Fixed-Priced contract. It will be a requirements contract with fixed unit prices and estimated quantities and contains performance guarantees. In addition, these clauses are included in Section I for the coverage of post-award cost determination events in which cost and pricing data are required.

45
J-1, TOM, Chapter 20, paras 1.1.1 & 2.6
If the contractor hosts the DID / Toll-Free numbers, are any calling costs from outside the CONUS be part of the contractor’s responsibility?
The contractor must provide toll-free telephone access in accordance with Section J, Attachment J-1, TOM, Chapter 20, Section 4, paragraph 1.1. This service includes telephone access to the continental United States, Hawaii, Alaska, and Puerto Rico.
46
Contact Center
Are there any specific calls or screen recording requirements? If yes, please specify call retention details.
It is assumed that this question is requesting specific requirements for recording of telephone inquiries or noting in a written format the outcome of telephone inquiries and how long to retain the information. While there are no specific requirements outlined to record, note or store telephone inquiry information, it is the contractor's responsibility to ensure contract objectives/requirements are met.
49
General
Via what sources are claims forms received? We envision postal mail, fax, email, email attachments, web, etc.?
In addition to receiving claims via postal mail and HIPAA-compliant standardized electronic transitions, it is the contractor's business decision to determine other acceptable sources to receive TRICARE claims in order to meet the objectives of the contract.
66
General
Aside from DEERS, what other data sources are necessary to authorize a claim?
If this question is referring to services that require preauthorization, the requirement for claims with services that require preauthorization are outlined in the TOM, Chapter 7, Section 2. No other data sources are necessary or required to issue preauthorizations. DEERS will verify beneficiary eligibility.

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