FINAL Request for Proposal Questions and Responses 10092023.pdf

HT9402‐23‐R0001 CPD, Final RFP Questions Question Government Response

1 What is the anticipated contract award date? The Government expects to award 2 contracts before the end FY24.

CDRL File A170 ‐ Financial Incentive for Quality of Care ‐ NCQA Audited Results (CPD) appears to be missing. The document provided for A170 is the same as Value‐Added Items Services for A180. Will the government provide an updated A170?

The Government has revised A170 and is provided under Amendment 0001.

For Volume III: PAST PERFORMANCE INFORMATION. After review of Sections L.4.3 and L.7, for clarity, we are seeking confirmation that Volume III can include up to 62‐pages total of 'PAST PERFORMANCE

INFORMATION'.

Volume III of the Request for Proposal is limited to 50 pages total including references noted at L.7.3. The information provided under L.7.7. and L.7.8. do not count towards the page count illustrated at L.4.3.

An inconsistency was identified between sections M.10.2 and L.5.2 regarding AbilityOne small businesses. AbilityOne is not referenced specifically in section L.5.2 and it states contractors "may use the services...for the blind", however, AbilityOne is referenced specifically in the percentage goals listed in section M.10.2. Can the government confirm that AbilityOne small businesses are required to be included in the small business plan at the prescribed percentage target?

The overall Subcontracting goal is 25% to be derived from those subcontracting categories listed at M.10.2.

Potential offerors should consider and pursue those goals to the maximum extent practical. Offerors will be evaluated on their subcontracting plan considering those groups, as described in M.10.2. Offerors should explain their rationale for not including any particular small business subcategory in their subcontracting plans, as applicable.

03033023 Government Responses to CPD DRAFT RFP 2, #354 states that CAS requirements would not be applicable to the effort; however, it appears a number of requirements and contract clauses applicable to CAS or cost reimbursable contracts remain (see e.g.Section I reference to FAR 52.230‐2 Cost Accounting Standards (JUN 2020), FAR 32.230‐6 Administration of Cost Accounting Standards (JUN 2010)). Can you clarify if this was intentional or if these will be removed?

The Government has re‐evaluated its position for CAS applicability due to CLIN X003. Because of the capitation rate recalculation process required during performance and the flexibility of pricing, CAS is applicable to the subsequent contract. The Government may seek a CAS waiver if it is in the best interest of the Government. Firms without existing, adequate CAS Disclosure Statements are not prohibited from submitting proposals.

Section L.9.4.1. requires the offeror to provide adequate documentation that its accounting system is capable of tracking and segregating cost data in sufficient detail to administer the contract. IAW FAR 16.301(a)(3), cost reimbursable contracts require this limitation, not fixed price contracts. Can you clarify if this expectation remains or will be removed? If it remains, would you confirm whether information provided under financial viability Section L.9 would suffice for this requirement (i.e., no additional information required)?

The information required under Section L.9 , Volume V, Financial, requires submission of information that speaks to the financial viability of the offeror and does not address the ability of the offeror to sufficiently segregate cost data. Section L.9.4.1. states, “The Offeror shall provide documentation that its accounting system is capable of tracking and segregating cost data in sufficient detail to administer the contract.” The offeror may provide evidence from, but not limited to, the Defense Contract Management Agency, Defense Contract Audit Agency or a Certified Public Accounting firm that its accounting system is capable of tracking and segregating cost data. The annual capitated rate adjustment, as outlined in G.2.3, updating the Originally Awarded Capitation Rates, will require the availability of such cost data.

Section I includes FAR 52.216‐7 Allowable Cost and Payment; however, IAW FAR 16.307, our understanding is that this clause should only be included in cost reimbursable contracts. Can you clarify if this was intentional or if it will be removed?

FAR 52.216‐7 will remain in the solicitation due to the nature of recalculations described with CLIN X003.

The capitated rate recalculation process required during performance and the flexibility of pricing, CAS is applicable to the subsequent contract.

Is there a maximum penalty they can assess for non‐performance under section H.1.3.2 in the event of repeated missed PG assessments? It indicates $20,000 per occurrence, and defines occurrence, but doesn’t indicate if there is a limit to how many occurrences they can assess or the frequency of such assessments.

The Government has decided to remove the Customer Service performance guarantee from the RFP.

Though there will not be a financial penalty associated with this area, the contractor is still expected to meet the 95% accuracy score before SHCD. Assessments will begin 60 days before SHCD (during the PRAV) and will continue until the contractor achieves the 95% accuracy score. Once the 95% score is achieved, assessments will be performed periodically to ensure this level is maintained and the Customer Service specifications outlined in the TRICARE Operations Manual (TOM) and the Quality Assurance Surveillance Plan (QASP) are adhered to.

For the TOM, as it relates to CPDs, in Section 1, 6.0 “Finality of Initial Determination”. Please provide clarification on this term.

The initial determination is final and binding unless the initial determination is reopened by the contractor or revised upon appeal. This means the original initial determination is the end of the process unless the contractor independently reopens the claim (as in the discovery of an error after issuing the initial determination), or if the initial determination is changed during the appeals review process which can occur at the reconsideration level with the contractor, or as a result of DHA appeals issuing a Formal Review Decision which overturns the initial determination and reconsideration determination made by the contractor.

For the TOM, as it relates to CPDs, in Section 3, please clarify the highlight, is this referring to a par‐ provider appealing on behalf of an enrollee?

A participating provider may appeal on behalf of a beneficiary when there has been an appointment of representative form completed, which is where the beneficiary designates the participating provider as their representative. The rest of the section is to clarify that non‐network non‐participating providers may not utilize the appeals process, and that issues involving waiver of liability for non‐network non‐ participating providers are treated as allowable charge reviews which are not subject to the appeals process.

10/9/2023 Any questions regarding the information herein should be referred to the Contracting Officer, Marcus R.

Webb @303‐676‐3451