JA Exemption to Fair Opportunity-200371- Final Redacted.pdf

JUSTIFICATION FOR AN EXCEPTION TO FAIR OPPORTUNITY

Acquisition Title: Part B North Jurisdiction (APP 200371) Qualified Independent Contractor (QIC)

Agency: Health and Human Services (HHS)/Centers for Medicare & Medicaid Services (CMS)

Acquisition Year: 2020 Authors: Matthew Waskiewicz and Mark Smolenski

1. Description of Action:

A. Nature

a. New Requirement

b. Follow-On Order

c. Modification of Existing Purchase Order / Contract Number

B. Order Against

a. Multiple Award Indefinite Delivery Indefinite Quantity (IDIQ) Contract Number

HHSM-500-2004-00005I

C. Contract Type

a. Firm-Fixed Price

b. Time and Materials

c. Cost Plus Fixed Fee (CPFF)

i. Term

ii. Completion

d. Cost Plus Award Fee (CPAF)

e. Other:

D. Projected Cost / Price: $8,987,914.02

E. Funding Source (s): Medicare Operations (FMIB 1539), Recovery Audit Contractor (FMIB 6782), and QIC Participation in ALJ (FMIB 2960) Funds

CMS seeks consideration to award a one (1) year logical-follow-on (LFO) task order from September 1, 2020 – August 31, 2021 in the following QIC jurisdiction:

Part B North QIC

Award of a LFO task order is requested after consideration of the following:

FAR 16.505(b)(2)(i)(C) allows for a task order to be issued on a sole-source basis under an IDIQ contract in the interest of economy and efficiency because it is a logical follow-on to an order already issued under the contract, provided that all awardees were given a fair opportunity to be considered for the original order.

The Part B North QIC task order (HHSM-500-2004-00005I/HHSM-500-T0004) was competed amongst all the QIC IDIQ contract holders.

Part B North QIC Task Order (HHSM-500-2004-00005I/HHSM-500-T0004):

Awarded in August 2012 to C2C Innovative Solutions (C2C), the total funding obligated on the task order is approximately $68 million.

The period of performance is as follows:

Base Transition Period: September 1, 2012 – December 31, 2012 Base Operational Period: January 1, 2013 – December 31, 2013 Renewal Period I: January 1, 2014 – December 31, 2014 Renewal Period II: January 1, 2015 – December 31, 2015 Renewal Period III: January 1, 2016 – December 31, 2016 Renewal Period IV: January 1, 2017 – December 31, 2017 Renewal Period V: January 1, 2018 – December 31, 2018

2. Description of Supplies or Services:

The estimated value of the proposed action is $8,987,914.02.

The purpose of the proposed logical follow-on Part B North QIC task order is to process reconsiderations requested as a result of Medicare Administrative Contractors (MACs) redeterminations of Medicare Part B claims. The Part B workload includes, at a minimum, processing reconsideration requests for doctors’ services, outpatient medical and surgical services, diagnostic tests, and ambulatory surgery. It also includes outpatient mental health care, and outpatient physical and occupational therapy.

Furthermore, the work under this task order includes all reconsideration activities, comprising of Medicare Secondary Payer (MSP), Program Safety Contractor (PSC)/Zone Program Integrity Contractor (ZPIC)/Unified Program Integrity Contractor (UPIC), and Recovery Audit Contractor (RAC) appeals.

The APP number is 200371.

3. Authority and Rationale:

The Contracting Officer shall give every awardee a fair opportunity to be considered for a delivery/task order exceeding $3,000 unless one of the following statutory exceptions applies. FAR 16.505(b)(2).

Mark the applicable exception:

The agency need for the supplies or services is so urgent that providing a fair opportunity would result in unacceptable delays [FAR 16.505(b)(2)(i)(A)];

Only one awardee is capable of providing the supplies or services required at the level of quality required because the supplies or services are unique or highly specialized [FAR16.505(b)(2)(ii)(B)];