JA Exemption to Fair Opportunity-A West 210165 posting 1-7-21.pdf

JUSTIFICATION FOR AN EXCEPTION TO FAIR OPPORTUNITY

Acquisition Title: Part A West Jurisdiction (APP 210165) Qualified Independent Contractor (QIC)

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

Acquisition Year: 2021 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-500-2004-00007I

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: $9,982,892.66

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 January 1, 2021 – December 31, 2021 in the following QIC jurisdiction:

Part A West 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 A West QIC task order (HHSM-500-2004-00007I/HHSM-500-T0011)was competed amongst all the QIC IDIQ contract holders.

Part A West QIC Task Order (HHSM-500-2004-00007I/HHSM-500-T0011):

Awarded in June 2016 to MAXIMUS Federal Services, Inc. (MAXIMUS). The total funding obligated on the task order to date is approximately $38.6 million.

The current period of performance is as follows:

Transition Period: June 22, 2016 – August 31, 2016 Base Operational Period: September 1, 2016 – August 31, 2017 Renewal Year 1: September 1, 2017 – August 31, 2018 Renewal Year 2: September 1, 2018 – August 31, 2019 Renewal Year 3: September 1, 2019 – December 31, 2020

The proposed period of performance of the 1-year logical follow-on is:

Base Operational Period: January 1, 2021 – December 31, 2021 Optional Transition-Out: January 1, 2022 – April 30, 2022

2. Description of Supplies or Services:

The estimated value of the proposed action is $9,982,892.66.

The purpose of the proposed logical follow-on Part A West QIC task order is to process reconsiderations requested as a result of Medicare Administrative Contractors (MACs) redeterminations of Medicare Part A claims. This workload includes processing reconsideration requests for, at a minimum, hospital inpatient, home health, skilled nursing home, hospice, and other Part A services and claims. It also includes Part B services billed through MACs (sometimes referred to as “Part B of A”).

It shall be noted that the QIC is also responsible for reconsiderations based on “initial determinations” regarding Medicare Secondary Payer (MSP) recovery claims against beneficiaries or providers/suppliers where the redetermination was processed by a MAC. Such recovery claims against beneficiaries routinely include both Part A & Part B claims.

The APP number is 210165.

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 [FAR16.505(b)(2)(i)(A)];