Industry QA -- TCRS RFP Amendment 0001.pdf

Question Number

RFP/Manual Location Subsection/Citation Subject Question Government Response

78 Section B - Supplies or Services and Price/Cost

Section 1.2 Maximum Contract Value Can DHA please provide specifics on the contract ceiling increase of $13M?

Ceiling increased due to potential for PIAA audits.

79 Section C - Description/ Specifications/ Work Statement

Section 1.8 and Section 1.14.4 Contractor Travel Please confirm that all travel costs associated are at contractor expense.

Yes.

80 Section C - Description/ Specifications/ Work Statement

Section 1.11.1 CAC Requirements

Section 1.11.1 requires all personnel be issued a CAC. Please verify the claims auditing software should perform CAC authentication.

All Government systems require CAC authentication..

Access to Contractor network, applications, and the DMS do not require CAC authentication.

81 Section C - Description/ Specifications/ Work Statement

Section 3.5 DEERS Interface The RFP references the DEERS Interface Environment. Does this interface offer API access capable of supporting the eligibility check?

No

82 Section C - Description/ Specifications/ Work Statement

Section 5.1.7.3 Software/ Applications Would the government consider providing an API or other connection that could provide access to data from systems that are critical to the audit?

No

83 Section C - Description/ Specifications/ Work Statement

5.1.8 Document Management System

Please provide the average electronic file size for each review type?

File size is dependent on the characteristics of the random sample.

84 Section C - Description/ Specifications/ Work Statement

5.1.8 Document Management System

How long is the contractor required to store both electronic and paper records for review?

Records should be maintained in accordance with DHA Records Management Guidelines.

85 Section C - Description/ Specifications/ Work Statement

5.1.8 Document Management System

Please provide the volume of paper claims the contractor should expect to process per year compared to electronic.

The Government anticipates that all claim reviews will be processed electronically. Electronic submissions to the DMS will be in accordance with the MOU's with the private sector care contractors.

86 Section C - Description/ Specifications/ Work Statement

Section 5.1.12 Continuity of Operations Plan Please provide metrics for the Continuity of Operations Plan (COOP) site such as capacity, testing, requirements, maximum permitted downtime, etc. Please also provide the functions considered mission essential.

Plan is to be submitted to Government for approval.

87 Section C - Description/ Specifications/ Work Statement

Section 5.4.1.4 Claim Volume Fluctuation Can DHA provide provide a best or worst case scenario of claim volume fluctuation or assign a percentage so the contractor can budget accordingly?

Claim volume fluctuations will be agreed upon through contract modification if exceeding the estimates contained in Section J, Attachment J-6, TCRS Compliance Review Schedule.

88 Section C - Description/ Specifications/ Work Statement

5.4 and 5.5 Compliance Reviews, Medical Record Reviews, and Focus Studies

How many pages on average are received per review for each review type?

Page count is dependent on the characteristics of the random sample.

89 Section C - Description/ Specifications/ Work Statement

5.5 Focus Studies

Please confirm that the Annual Health Care Cost compliance reviews are the same as Annual PIIA Compliance Reviews

These are two different types of reviews.

90 Section C - Description/ Specifications/ Work Statement

5.5.1.2.2 Focus Studies This section provides workload volumes. However, the timeframe for completion has not been provided. Please provide the timeframe allowed to complete focused studies.

Timeframes are established in the Performance Work Statement for each focused study, and evaluated during the proposal process.

91 Section C - Description/ Specifications/ Work Statement

5.5.2.2.1 Medical Record Reviews This section provides workload volumes. However, the timeframe for completion has not been provided. Please provide the timeframe allowed to complete medical record reviews.

Timeframes are established in the Performance Work Statement for each focused study, and evaluated during the proposal process.

92 Section C - Description/ Specifications/ Work Statement

Section 6.6 Risk Management Framework (RMF) for DoD IT

Please describe what the Govt means by "reserved" for Section 6.6.

"Risk Management Framework (RMF) for DoD IT: Reserved"

"Reserved" means "not applicable"

93 Section C - Description/ Specifications/ Work Statement

6.11.2 DHA IT Security This section states, "6.11.2 The contractor shall submit the completed DD Form 2875 to the DHA IT Security for verification of Tier I or Tier II Designation. The DHA Personnel Security will verify that the contractor employee has the appropriate background investigation completed or a request for background investigation has been submitted to the Office of Personal Management (OPM).

Acknowledgment from OPM that the request for a background investigation has been received and that an investigation has been scheduled will be verified by the DHA Personnel Security prior to access being approved."

Please provide a copy of the DD Form 2875.

The form is available at https://www.esd.whs.mil/Portals/54/Documents/D D/forms/dd/dd2875.pdf

94 Section C - Description/ Specifications/ Work Statement

7.1.1 and 7.1.2 Documents Please provide the documents that are currently imbedded in 7.1.1 and 7.1.2, as they are unable to be opened from the RFP.

The documents have been provided as attachments in the final RFP PDF.

95 Section L - Instructions, Conditions, Notices to Offerors

L.2.2 Organizational Conflict of Interest Please confirm that the offeror may submit a single statement that no organizational conflicts of interest exist.

Please refer to L.2.2.4

96 Section L - Instructions, Conditions, Notices to Offerors

L.2.2 Organizational Conflict of Interest If a single OCI statement is not acceptable, can the government provide a template for offerors' use?

Please refer to L.2.2.4

97 Section L - Instructions, Conditions, Notices to Offerors

Section L.4.1 Proposal Preparations Section L.4.1 states, "The font for submissions shall be Times New Roman, not smaller than 12 point font; however, smaller fonts are permitted on illustrations, organization charts, supporting data exhibits, report listings or labels on process flows." Please confirm Calibri or Arial font is acceptable for graphics, charts, tables, and narrative headings.

Please continue using times new roman across all graphics, charts, tables, and narrative headings.

98 Section L - Instructions, Conditions, Notices to Offerors

Section L.4.2 Proposal Submission What size files are accepted by the Government, are there any restrictions on Governement incoming email?

File size limit coming from outside organizations to Government e-mails is 20 megabytes

99 Section L - Instructions, Conditions, Notices to Offerors

Section L.6.1.3 and CDRL

AP020

Program Management Plan The PMP that meets the requirements of CDRL AP020 is close to the management approach that is required in L.6.1.4. Are we expected to submit with the proposal a PMP that meets the requirements of the CDRL as an attachment AS WELL AS include in Vol II information that answers L.6.1.4?

Please include CDRL in Volume II and it does not count towards the page limit, L.6.1.3.

100 Section L - Instructions, Conditions, Notices to Offerors

Section L.7.3.2.1 Past Performance Contract Descriptions

We plan to submit multiple task orders for an ordering type contract vehicle. As ordering type contracts with multiple orders do not typically have concurrent periods of performance or periods of performance limited to 12 consecutive months, would the government consider allowing multiple orders not to exceed 24 consecutive months as only 1 past performance reference?

No

101 Section L - Instructions, Conditions, Notices to Offerors

Sections L.7.7. and M.6.2 Past Performance Questionnaires Please confirm that PPQs are not expected for contracts that already have informaiton in Past Performance Information Retrieval System

(PPIRS).

It is incumbent upon the contractor to provide PPQs for past performance submitted.

102 Section L - Instructions, Conditions, Notices to Offerors

L.9.2 Financial Data Section L.9.2 states, "The offeror shall submit the following documents:

- The offeror's most recent Dun and Bradstreet (D&B) Comprehensive Report, or if not available, another rating company report that is essentially equivalent to D&B (e.g., A.M. Best Company)

- Annual Reports for the offeror's three(3) most recent fiscal years (including audit opinions)

- Balance Sheets, Income Statements, Statement of Retained Earnnings, and Statements of Cash Flows

- Statement of projected quarterly cash flows for a one (1) year period beginning with the start of the contract (i.e., Transition-In period) -Form 10-K Annual Report"

Please confirm offerors are only required to submit the financial documents that are applicable. For example, Form 10-K Annual Report would only be applicable to public companies.

Please see revised Section L language.

103 CDRLs CDRLs OT020 - OT060 Memorandums of Understanding - Patient Claims History

We have found a best practice for Memorandums of Understanding to be reviewed and revised as needed for every ordering period (similar to A020-A070). Please advise, as this is listed as a one-time

CDRL.

Historically, a one-time CDRL for OT020-OT060 has been sufficient.

104 Section J Attachments Attachment J-6 Compliance Reviews Workload Please confirm the 4,000 estimated claim volume shown for each compliance review cycle for the East Region and West Region row is a combined workload of 4,000 for both East and West Regions.

Yes, this is the combined workload.

105 Section J Attachments Attachment J-6 Annual PIIA Compliance Reviews Workload provided in Ordering Period 2 for Annual PIIA Compliance Reviews of 16,000 appears to be received and due during Ordering Period 1. Please advise which Ordering Period this should be priced.

Ordering Period 2 starts March of 2024, and the estimated date claims information from PCC is due to TCRS Contractor in March of 2024.

106 Section J Attachments Attachment J-10 Compliance Review Guidelines Document states, “Prior to beginning an audit, the auditor will review the Deficiency File for the individual contract he/she is to audit to become familiar with error findings from previous audits”.

Can the DHA provide an example of the Deficiency Guide?

The Deficiency File is a part of the Analysis of Purchased-Care Contractor Payment and Occurrence Audit Error Report. It is prepared by the TCRS contractor in accordance with attachment J-10, Chapter 1, Section D.

107 Section L L.6.2.2, Page L14 of L22 Table 2 Proposal Page Limits, Page L9 of L22

Section L.6.2.2 indicates the draft transition-in plan is to be submitted in the format and description required by CDRL R010. The last sentence states, “The plan shall not count against the 50 page limit and is limited to 10 pages.” CDRL R010 indicates the first submission of this draft plan is 7 days after contract award and it is to be in a Microsoft Project format.

Is this draft plan due with the submission of the proposal or 7 days after contract award?

The draft plan is due with proposal submission and the final plan is due 7 days after contract award.

108 Section L L.6.2.2, Page L14 of L22 Table 2 Proposal Page Limits, Page L8-9 of L23

Section L.4.3 indicates the technical proposal shall not exceed 50 pages and Table 2 indicates the Technical Proposal is limited to 40 pages with the “Transition-in- Overview (included in the Technical Proposal” limited to 10 pages. However, Section L.6.2.2 indicates the draft transition in plan “shall not count against the 50 page limit as is limited to 50 pages.”

Can the page limit for the Technical Proposal listed in Table 2, Proposal Page Limits, be changed to 50 pages and an annotation added to the Transition-in Overview in Table 2 that its 10 page limit is not counted in the 50 page limit if the Technical Proposal?

Please see revised Section L language.

109 Section L L.6.1.3, Page L12 of L22 Subsection L.6.1.3 states that offeror’s proposal shall include its Program Management Plan (PMP) in the format and description required by CDRL AP020 and that the CDRL document shall not count against the 50 page limit.

CDRL AP020 states it is due 5 calendar days after contract award.

Is this draft plan due with the submission of the proposal or 5 days after contract award?

The draft plan is due with proposal submission and the final plan is due 5 days after contract award.

110 Section L Exhibit L-4, Solicitation Cross Reference Table in the list of Exhibits is titled Exhibit L-5 in its header when printed.

Can this document be re-titled? The Government will update accordingly.

111 Section L Exhibit L-5, Price Proposal Template in the list of Exhibits on the second and third tab, it is titled Exhibit L-7 in its header when printed.

Can this document be re-titled? The Government will update accordingly.

112 Section L Exhibit L-7, TCRS Historical Rebuttal Report (2017 – 2021) in the list of Exhibits is titled Exhibit L-8 in its header when printed.

Can this document be re-titled? The Government will update accordingly.

113 Section L Exhibit L-8, Historical TRICARE Overseas Program Data in the list of Exhibits is titled Exhibit L-9 in its header when printed

Can this document be re-titled? The Government will update accordingly.

114 Section L Exhibit L-9, Draft Quality Assurance Surveillance Plan

(QASP)

in the list of Exhibits is titled Exhibit L-10 in its header when printed

Can this document be re-titled? The Government will update accordingly.

115 Section C paragraph 5.4.2.1.4 and 5.4.2.1.5 indicate that the TCRS contractor evaluates for payment errors and for occurrence errors

Can the Government provide data or information as to how many or what percentage of previously assessed historical errors have been in each of those two categories.

Error ratios are variable. Historically, the random sample for occurrence claims audits has been lower in volume than the random sample for payment claims audits.

116 NA NA Extension (Potential Offeror) would like to request an extension to the closing date of the solicitation.

No, the Government will not be granting an extension due to the fact that a draft RFP closed in February and this posting was synopsized 14 days prior to the final posting.

117 Whether companies from Outside USA can apply for this?

(like,from India or Canada)

No

Whether we need to come over there for meetings?

Logistical requirements for meetings are still TBD by the Government, due to the on-going pandemic.

119 Can we perform the tasks (related to RFP) outside USA? (like,from India or Canada)

No

120 Can we submit the proposals via email? Please refer to sam.gov posting and Section L.

121 Can an a fillable pdf be provided for SF 33 and Section B.

documents?

No, text can be added to the PDF through Adobe Acrobat.

Will the Government provide Wage Determination(s) and provide a mapping of RFP labor categories to the WD Occupation Code(s)?

No, the Government will not provide mapping of labor categories as there is no stated required labor categories.

123 Section B - Supplies or Services and Price/Cost

Sections 1.6.1, 1.6.1.2, 5.3.2, CDRL W020

Transition-Out

Please confirm the number of months for the Transition-Out period.

The transition-out timeframe is dependent on workload.

Please refer to Section C.5.3.2. The Contractor shall complete all work assigned during the ordering period to include all associated reports.

124 Section C - Description/ Specifications/ Work Statement

Section 5.1.14 Attachment Section 5.1.14 states, "All contractor personnel must meet Government requirements for access to Government computers and/or systems. This includes providing fingerprints (CDRL M010, Employee Access to DoD IS/Networks Report)."

Attachment J-9 is the Example of Active Duty Dental Audit Detail Report. Please provide the Questionnaire for Public Trust Positions referenced in 5.1.14.

The reference to J-9 has been removed.

125 Section L - Instructions, Conditions, Notices to Offerors

Section L.6.1.3/CDRL AP020 and Section L.6.2.2/CDRL R010

Program Management Plan and Transition-In Plan Section L.6.1.3 indicates that the Program Management Plan be in accordance with CDRL AP020, which indicates the plan be submitted in Word. However, an element of the plan is a project plan with a detailed schedule that must be submitted in a "format agreed to by the COR."

Section L.6.2.2 states, "Additionally, the offeror shall submit its draft transition-in plan in the format and descriptions required by CDRL R010." CDRL R010 states this plan should be submitted in Microsoft Project.

Please confirm the project plans can be submitted in Adobe PDF for the proposal in accordance with L.4.1 requiring electronic formats of Volumes I-III and V are Adobe PDF and Microsoft Word."

Historically, the project plan schedule has been submitted in MS Excel.

Government will update CDRL R010 to change MS Project to MS Office format.

Yes, acceptable electronic file formats for Volumes I-III and V are Adobe PDF and/or Microsoft Word.

126 Section L - Instructions, Conditions, Notices to Offerors

Section L.8.4 CDRL Pricing This section states, "….reports shall not be separately priced in Section B, Form 33." However, it contines, "The Offeror shall provide a price for each CDRL in each ordering period. The Price Proposal Template (Exhibit L-5, TAB entitled "CDRL Cost Estimate") provides a worksheet for the Offeror to enter its price."

Exhibit L-5's CDRL Cost Estimate worksheet only provides for a total price for CDRLs, not an individual price for each CDRL.

Please advise where offerors should submit individual pricing for CDRLs.

Include the total CDRL price in the L-5 pricing spreadsheet and individual CDRL price using the DD1423 in block 18. Section L langauge updated to clarify

127 Section L - Instructions, Conditions, Notices to Offerors

Section L.8.4 CDRL Pricing Please confirm offerors are not required to submit a price for CDRLs for the Option to Extend period since it is not included in Exhibit L-5.

Yes

128 CDRLs CDRL W030 Audit Status Report CDRL W030's beginning date is contract award, due "First business day after end of reporting period following receipt of the first set of compliance review documentation." However, workload will not begin until Ordering Period 1. Please confirm CDRL W030 is not due during Base Period.

CDRL W030 will be changed for clarity.

129 Will you please clarify the size standard for this solicitation? The NAICS listed is 5416911 with the size of $16.5M; however, the following sections seem to add to the size standard or make an exception to it. We are currently listed in SAM as other than small for 541611 but with the new threshold as of May 2, 2022 we are small under the NAICS (we understand that SBA is not changing the size standards in SAM until Oct, 2022). We are also certified HUBZone and verified SDVOSB. Are we eligible to bid as a prime?

The size standard will be updated based on May 2nd update.