JH Draft RFP Backpages.docx
DOCX document 547 KB Posted
- Attached to
- Medicare Administrative Contractor (MAC) Jurisdiction H (JH) - Synopsis/Draft RFP / Presolicitation
- Solicitation number
- 75FCMC26R0001
About this file
This draft Request for Proposal (RFP) seeks a Medicare Administrative Contractor (MAC) for Jurisdiction H, covering Arkansas, Colorado, Louisiana, Mississippi, New Mexico, Oklahoma, and Texas. The Centers for Medicare & Medicaid Services (CMS) intends to award a cost-reimbursement contract with a base year and six one-year option periods to provide Medicare fee-for-service claims processing and benefit administration services. The contract will involve processing Part A and Part B Medicare claims, provider enrollment, customer service, medical review, audit and reimbursement, and other related Medicare program support functions.
Key procurement details include a NAICS code of 524114 with a small business size standard of $41.5 million, anticipated final solicitation release on August 1, 2025, and proposal due date of September 2, 2025. The contract will be awarded using a best value trade-off process, evaluating technical factors more heavily than price. Offerors must submit questions electronically by July 15, 2025, and the anticipated contract award is scheduled for July 2025, pending fund availability. The evaluation will consider factors such as staffing plan, operations approach, targeted experience, past performance, small business utilization, and AbilityOne participation.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| JH Attachments DRAFT.zip | ZIP file | |
| Solicitation - 75FCMC26R0001.pdf |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
| SECTION B - SUPPLIES OR SERVICES AND PRICES/COSTS | 14 | |
| B.1 | BRIEF DESCRIPTION OF SERVICES | 14 |
| B.2 | CONTRACT TYPE | 14 |
| B.3 | AWARD FEE | 14 |
| B.4 | ESTABLISHED COST AND AWARD FEE | 14 |
| B.5 | TASK DIRECTIVES | 15 |
| B.6 | SCHEDULE OF SUPPLIES/SERVICES | 15 |
| SECTION C - DESCRIPTION/SPECIFICATIONS/WORK STATEMENT | 22 | |
| C.1 | STATEMENT OF WORK | 22 |
| SECTION D - PACKAGING AND MARKING | 23 | |
| D.1 | PACKAGING AND MARKING | 23 |
| SECTION E - INSPECTION AND ACCEPTANCE | 24 | |
| E.1 | FAR 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998) | 24 |
| E.2 | APPROVALS BY THE CONTRACTING OFFICER REPRESENTATIVE | 24 |
| E.3 | INSPECTION OF SERVICES –COST-REIMBURSEMENT | 24 |
| SECTION F - DELIVERIES OR PERFORMANCE | 25 | |
| F.1 | FAR 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998) | 25 |
| F.2 | PERIOD OF PERFORMANCE (JAN 2014) | 25 |
| F.3 | DELIVERABLES | 27 |
| SECTION G - CONTRACT ADMINISTRATION DATA | 29 | |
| G.1 | ACCOUNTING AND APPROPRIATION DATA | 29 |
| G.2 | PAYMENT, SELECTED ITEMS OF COST REIMBURSEMENT CONTRACTS | 29 |
| G.3 | DISSEMINATION, PUBLICATION & DISTRIBUTION OF INFORMATION | 29 |
| G.4 | SUBCONTRACTING REPORTING | 31 |
| G.5 | SUBCONTRACTING PROGRAM | 31 |
| G.6 | SUBCONTRACT CONSENT | 31 |
| G.7 | SERVICE OF CONSULTANTS/SUBCONTRACTORS | 32 |
| G.8 | GOVERNMENT REPRESENTATIVES AND RESPONSIBILITIES (NOV 2024) | 32 |
| G.9 | CONTRACT PROPERTY ADMINISTRATION | 35 |
| G.10 | GOVERNMENT FURNISHED PROPERTY | 36 |
| G.11 | CONTRACTOR FURNISHED PROPERTY | 36 |
| G.12 | PAYMENTS – INVOICES – (SEPT 2024) | 36 |
| G.13 | SEPARATION OF MEDICARE INTEGRITY PROGRAM AND PROGRAM MANAGEMENT FUNDING | 38 |
| G.14 | SEPARATION OF TRUST FUND EXPENDITURES/ACCOUNTING FROM ADMINISTRATIVE EXPENDITURES/ACCOUNTING | 38 |
| G.15 | COMPLEMENTARY CREDITS | 39 |
| G.16 | CORRESPONDENCE PROCEDURES | 39 |
| G.17 | DATA TO BE DELIVERED | 39 |
| G.18 | AWARD FEE EVALUATION PLAN | 39 |
| G.19 | INDIRECT COST RATES (MAY 2021) | 40 |
| G.20 | USE OF GOVERNMENT DATA (REPORTS/FILES/COMPUTER TAPES OR DISCS) | 43 |
| G.21 | INCORPORATION OF REPRESENTATIONS AND CERTIFICATIONS | 43 |
| G.22 | CONTRACTOR PAST PERFORMANCE EVALUATION(S) (OCT 2014) | 43 |
| G.23 | CONTRACTOR WORK PERFORMED OUTSIDE THE UNITED STATES AND ITS TERRITORIES (JAN 2021) | 44 |
| G.24 | CMS CONTRACT FUNDS MANAGEMENT (CFM) (OCT 2023) | 46 |
| SECTION H - SPECIAL CONTRACT REQUIREMENTS | 47 | |
| H.1 | CONFLICT OF INTEREST (AUG 2024) | 47 |
| H.2 | HHSAR 352.237-75 KEY PERSONNEL (DEC 2015) | 50 |
| H.3 | APPROVAL OF CONTRACT ACQUIRED INFORMATION TECHNOLOGY (IT) | 51 |
| H.4 | HIPAA BUSINESS ASSOCIATE CLAUSE (OCT 2014) | 52 |
| H.5 | WAGE DETERMINATION | 57 |
| H.6 | INDEMNIFICATION | 57 |
| H.7 | DISCLOSURE OF INFORMATION | 59 |
| H.8 | PARTICIPATION IN DEMONSTRATIONS | 59 |
| H.9 | SEPARATION OF CERTIFICATION AND DISBURSEMENT RESPONSIBILITIES | 59 |
| H.10 | SURETY BONDS | 59 |
| H.11 | LIABILITY FOR MEDICARE BENEFIT PAYMENTS – CERTIFYING OFFICER | 59 |
| H.12 | LIABILITY FOR MEDICARE BENEFIT PAYMENTS – DISBURSING OFFICER | 60 |
| H.13 | LIABILITY FOR MEDICARE BENEFIT PAYMENTS–MEDICARE ADMINISTRATIVE CONTRACTOR | 60 |
| H.14 | LIABILITY FOR UNCOLLECTED OVERPAYMENTS | 60 |
| H.15 | MEDICARE RECORDS RETENTION | 60 |
| H.16 | SECURITY INCIDENT AND REPORTABLE EVENT REPORTING | 60 |
| H.17 | CMS SECURITY CLAUSE (MAY 2018) | 61 |
| H.18 | PRIVACY ACT ‘SYSTEMS NOTICE’ | 67 |
| H.19 | PUBLICITY | 67 |
| H.20 | CMS INFORMATION SECURITY (OCT 2020) | 68 |
| H.21 | REPORTING CHANGES IN CONTRACTOR TEAM ARRANGEMENTS, AND ACQUISITIONS/DIVESTITURES | 69 |
| H.22 | OPEN GOVERNMENT PROACTIVE PREDISCLOSURE NOTIFICATION (AUG 2023) | 69 |
| H.23 | CONTRACT RENEWAL | 70 |
| H.24 | HHSAR 352.204-71 INFORMATION AND INFORMATION SYSTEMS SECURITY (FEB 2024) (DEVIATION) | 70 |
| H.25 | HHSAR 352.204-72 RECORDS MANAGEMENT (FEB 2024) (DEVIATION) | 82 |
| H.26 | HHSAR 352.204-73 CONTRACTOR PERSONNEL SECURITY AND AGENCY ACCESS (FEB 2024) (DEVIATION) | 85 |
| H.27 | HHSAR 352.239-75 SECURITY CONTROLS COMPLIANCE TESTING (FEB 2024) (DEVIATION) | 89 |
| H.28 | HHSAR 352.239-76 SECURITY REQUIREMENTS FOR GOVERNMENT-OWNED CONTRACTOR-OPERATED AND CONTRACTOR-OWNED CONTRACTOR-OPERATED RESOURCES (FEB 2024) (DEVIATION) | 89 |
| H.29 | HHSAR 352.239-77 CLOUD COMPUTING SERVICES (FEB 2024) (DEVIATION) | 95 |
| H.30 | HHSAR 352.239-78 INFORMATION AND COMMUNICATION TECHOLOGY ACCESSIBILITY NOTICE (FEB 2024) (DEVIATION) | 102 |
| H.31 | HHSAR 352.239-79 INFORMATION AND COMMUNICATION TECHNOLOGY ACCESSIBILITY (FEB 2024) (DEVIATION) | 104 |
| H.32 | LIMITATION OF FUNDS | 105 |
| H.33 | MANDATORY CONTRACTOR TRAINING (SEPT 2024) | 106 |
| H.34 | CONTINUATION OF MISSION ESSENTIAL CONTRACTOR SERVICES (MAY 2024) | 106 |
| SECTION I - CONTRACT CLAUSES | 108 | |
| I.1 | FAR 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998) | 108 |
| I.2 | U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES ACQUISITION REGULATIONS (HHSAR) CLAUSES INCORPORATED BY REFERENCE | 111 |
| I.3 | FAR 52.204-21 BASIC SAFEGUARDING OF COVERED CONTRACTOR INFORMATION SYSTEMS (NOV 2021) | 112 |
| I.4 | FAR 52.204-29 FEDERAL ACQUISITION SUPPLY CHAIN SECURITY ACT ORDERS— REPRESENTATION AND DISCLOSURES (DEC 2023) | 113 |
| I.5 | FAR 52.204-30 FEDERAL ACQUISITION SUPPLY CHAIN SECURITY ACT ORDERS— PROHIBITION (DEC 2023) | 114 |
| I.6 | FAR 52.215-19 NOTIFICATION OF OWNERSHIP CHANGES (OCT 1997) | 118 |
| I.7 | FAR 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000) | 119 |
| I.8 | FAR 52.222-2 PAYMENT FOR OVERTIME PREMIUMS (JUL 1990) | 119 |
| I.9 | FAR 52.222-35 EQUAL OPPORTUNITY FOR VETERANS (JUN 2020) | 120 |
| I.10 | FAR 52.222-36 EQUAL OPPORTUNITY FOR WORKERS WITH DISABILITIES (JUN 2020) | 120 |
| I.11 | FAR 52.222-42 STATEMENT OF EQUIVALENT RATES FOR FEDERAL HIRES (MAY 2014) | 120 |
| I.12 | FAR 52.252-4 ALTERATIONS IN CONTRACT (APR 1984) | 121 |
| I.13 | HHSAR 352.224-71 CONFIDENTIAL INFORMATION (FEB 2024) (DEVIATION) | 121 |
| I.14 | HHSAR 352.232-71 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS (FEB 2022) | 121 |
| SECTION J – LIST OF ATTACHMENTS | 123 | |
| SECTION K - REPRESENTATIONS, CERTIFICATIONS, AND OTHER STATEMENTS OF OFFERORS OR QUOTERS | 125 | |
| K.1 | SOLICITATION PROVISIONS INCORPORATED BY REFERENCE | 125 |
| K.2 | TO BE COMPLETED BY THE OFFEROR: [THE REPRESENTATIONS AND CERTIFICATIONS MUST BE EXECUTED BY AN INDIVIDUAL AUTHORIZED TO BIND THE OFFEROR] | 125 |
| K.3 | FAR 52.204-8 ANNUAL REPRESENTATIONS AND CERTIFICATIONS (MAY 2024) | 126 |
| K.4 | FAR 52.204-20 PREDECESSOR OF OFFEROR (AUG 2020) | 130 |
| K.5 | FAR 52.209-5 CERTIFICATION REGARDING RESPONSIBILITY MATTERS (AUG 2020) | 131 |
| K.6 | FAR 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018) | 133 |
| K.7 | FAR 52.209-11 REPRESENTATION BY CORPORATION REGARDING DELINQUENT TAX LIABILITY OR A FELONY CONVICTION UNDER ANY FEDERAL LAW (FEB 2016) | 134 |
| K.8 | FAR 52.215-6 PLACE OF PERFORMANCE (OCT 1997) | 135 |
| K.9 | FAR 52.219-1 SMALL BUSINESS PROGRAM REPRESENTATIONS (FEB 2024) | 135 |
| K.10 | FAR 52.222-22 PREVIOUS CONTRACTS AND COMPLIANCE REPORTS (FEB 1999) | 139 |
| K.11 | FAR 52.222-25 AFFIRMATIVE ACTION COMPLIANCE (APR 1984) | 139 |
| K.12 | FAR 52.225-20 PROHIBITION ON CONDUCTING RESTRICTED BUSINESS OPERATIONS IN SUDAN CERTIFICATION (AUG 2009) | 139 |
| K.13 | FAR 52.230-1 COST ACCOUNTING STANDARDS NOTICES AND CERTIFICATION (JUN 2020) | 140 |
| K.14 | FAR 52.230-7 PROPOSAL DISCLOSURE – COST ACCOUNTING PRACTICE CHANGES (APR 2005) | 142 |
| SECTION L - INSTRUCTIONS, CONDITIONS AND NOTICES TO OFFERORS | 143 | |
| L.1 | INTRODUCTION | 143 |
| L.2 | FAR 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB 1998) | 144 |
| L.3 | U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES ACQUISITION REGULATIONS (HHSAR) PROVISIONS INCORPORATED BY REFERENCE | 144 |
| L.4 | FAR 52.216-1 TYPE OF CONTRACT (APR 1984) | 144 |
| L.5 | FAR 52.233-2 SERVICE OF PROTEST (SEP 2006) | 144 |
| L.6 | ALTERATIONS IN SOLICITATION 52.252-3 (APR 1984) | 145 |
| L.7 | HHSAR 352.232-70 INCREMENTAL FUNDING (DEC 2015) | 145 |
| L.8 | INTENT TO SUBMIT A PROPOSAL | 145 |
| L.9 | SOLICITATION QUESTIONS | 145 |
| L.10 | COMMUNICATIONS PRIOR TO CONTRACT AWARD | 146 |
| L.11 | SUBMISSION, DELIVERY, ORGANIZATION AND GENERAL INSTRUCTIONS | 146 |
| L.12 | VOLUME I, ADMINISTRATIVE REQUIREMENTS AND RESPONSIBILITY DETERMINATION PROPOSAL INSTRUCTIONS | 150 |
| L.13 | VOLUME II, PROPOSAL ASSUMPTIONS INSTRUCTIONS | 154 |
| L.14 | VOLUME III, TECHNICAL PROPOSAL INSTRUCTIONS TECHNICAL PROPOSAL EVALUATION FACTORS OVERVIEW | 158 |
| L.15 | VOLUME IV, BUSINESS PROPOSAL INSTRUCTIONS | 173 |
| L.16 | VOLUME V, CONFLICTS OF INTEREST PROPOSAL SUBMISSION INSTRUCTIONS (OCT 2020) | 181 |
| L.17 | VOLUME VI, 508 COMPLIANCE AND VOLUNTARY PRODUCT ACCESSIBILITY TEMPLATE (VPAT) | 181 |
| SECTION M - EVALUATION FACTORS FOR AWARD | 183 | |
| M.1 | FAR 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB 1998) | 183 |
| M.2 | BEST VALUE CONTINUUM | 183 |
| M.3 | TECHNICAL EVALUATION FACTORS (NON-COST/PRICE FACTORS) | 184 |
| M.4 | BUSINESS PROPOSAL EVALUATION CRITERIA (COST/PRICE FACTOR) | 184 |
| M.5 | CONFLICT OF INTEREST EVALUATION (OCT 2020) | 185 |
| M.6 | REVIEW OF ATTESTATIONS | 185 |
| M.7 | RESPONSIBILITY DETERMINATION | 185 |
| M.8 | 508 COMPLIANCE AND VOLUNTARY PRODUCT ACCESSIBILITY TEMPLATE (VPAT) (SECTION 508) | 185 |
| M.9 | POTENTIAL EXCLUSION OF SOURCES (FAR 6.202) | 186 |
Solicitation Number 75FCMC26R0001 A/B MAC Jurisdiction H
SECTION B - SUPPLIES OR SERVICES AND PRICES/COSTS
B.1 BRIEF DESCRIPTION OF SERVICES
The purpose of this contract is to obtain a Part A/Part B (A/B) Medicare Administrative Contractor (hereinafter referred to as “the contractor” or “MAC” or “A/B MAC”) to provide specified health insurance benefit administration services, including Medicare claims processing and payment services, in support of the “traditional” Medicare program (also known as the Medicare fee-for-service or FFS, program) for Jurisdiction H (JH). Jurisdiction H includes the states of Arkansas, Colorado, Louisiana, Mississippi, New Mexico, Oklahoma, and Texas.
B.2 CONTRACT TYPE
The Centers for Medicare & Medicaid Services (CMS) anticipates awarding a Cost Reimbursement type contract. In accordance with FAR 16.102 (b) Policies, “Contracts negotiated under Part 15 may be of any type or combination of types that will promote the Government’s interest, except as restricted in this part (see 10 U.S.C. 2306(a) and 41 U.S.C. 254(a))”. The primary pricing arrangement is anticipated to be Cost- Plus- Award-Fee (CPAF).
B.3 AWARD FEE
The amount of award fee the Contractor earns, if any, will be based upon an evaluation by the Government of the contractor’s performance in accordance with the Performance Evaluation Award Fee Plan (Attachment J.07). The CMS Fee Determination Official (FDO) will determine the amount of award fee earned by the contractor for the evaluation period. The determination of the amount of the award fee for the evaluation period is a unilateral decision made solely at the discretion of the FDO. Upon receiving written notification from the FDO of the amount of award fee earned for the evaluation period, the Contractor may submit an invoice for the earned award fee. The Government may unilaterally change the Performance Evaluation Award Fee Plan at any time. However, any revisions to the evaluation factors in the Performance Evaluation Award Fee Plan shall be presented to the Contractor prior to the evaluation period in which it will be used.
The award fee evaluations will be performed on an annual basis with the actual evaluation beginning in the month immediately following the evaluation period. The award fee available for each period shall be a portion of the total award fee pool available for the entire contract period (see Section G.18). Award fee evaluations will not be applied to contract period of 6 months or less.
*Note: A sample Performance Evaluation Award Fee Plan (Attachment J.07) is provided. The final Performance Evaluation Award Fee Plan will be provided at time of contract award.
B.4 ESTABLISHED COST AND AWARD FEE
The estimated cost of this contract is detailed in the chart below.
| Estimated Cost |
| Base Fee |
| Award Fee |
| Fixed Fee |
| Total Estimated CPAF |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
B.5 TASK DIRECTIVES
The Contracting Officer may use individual Task Directives with specifically defined scopes and schedules to direct the contractor to perform special projects. Task Directives may also be issued to request a special administrative or user support services project. This mechanism will be used on a project-by-project basis and will be incorporated into the contract through the Changes clause (FAR 52.243-2 Alternate I).
Task Directives issued under this contract may be fixed-price or cost reimbursement. The contractor is required to establish separate cost accounts for each Task Directive issued and to segregate those costs in their vouchers.
B.6 SCHEDULE OF SUPPLIES/SERVICES
| CONTRACT LINE ITEM NUMBER |
| ESTIMATED COST |
| BASE FEE |
| AWARD FEE |
| FIXED FEE |
| TOTAL ESTIMATED |
CPAF
| EST. COMP* |
| TOTAL CPAF NET COMP |
CREDITS
CLIN 0001*** –IMPLEMENTATION
Date: TBD
| TOTAL CLIN 0001 – IMPLEMENTATION |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| CONTRACT LINE ITEM NUMBER |
| ESTIMATED COST |
| BASE FEE |
| AWARD FEE |
| FIXED FEE |
| TOTAL ESTIMATED CPAF |
| EST. COMP* |
| TOTAL CPAF NET COMP CREDITS |
CLIN 0002** – AB MAC SERVICES
BASE YEAR OPERATIONS
0002AA
Program Management
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
0002AB
Medicare Integrity Program
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
0002AC
Recovery Audit Contractor
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
TOTAL CLIN 0002 – AB MAC SERVICES
BASE YEAR OPERATIONS
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| CONTRACT LINE ITEM NUMBER |
| ESTIMATED COST |
| BASE FEE |
| AWARD FEE |
| FIXED FEE |
| TOTAL ESTIMATED CPAF |
| EST. COMP* |
| TOTAL CPAF NET COMP CREDITS |
CLIN 0003** – AB MAC SERVICES OPTION YEAR 1 OPERATIONS
0003AA
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
0003AB
Medicare Integrity Program
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
0003AC
Recovery Audit Contractor
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
TOTAL CLIN 0003 – AB MAC SERVICES
OPTION YEAR 1
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| CONTRACT LINE ITEM NUMBER |
| ESTIMATED COST |
| BASE FEE |
| AWARD FEE |
| FIXED FEE |
| TOTAL ESTIMATED CPAF |
| EST. COMP* |
| TOTAL CPAF NET COMP CREDITS |
CLIN 0004** – AB MAC SERVICES OPTION YEAR 2 OPERATIONS
0004AA
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
0004AB
Medicare Integrity Program
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
0004AC
Recovery Audit Contractor
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
TOTAL CLIN 0004 – AB MAC SERVICES
OPTION YEAR 2
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| CONTRACT LINE ITEM NUMBER |
| ESTIMATED COST |
| BASE FEE |
| AWARD FEE |
| FIXED FEE |
| TOTAL ESTIMATED CPAF |
| EST. COMP* |
| TOTAL CPAF NET COMP CREDITS |
CLIN 0005** – AB MAC SERVICES OPTION YEAR 3 OPERATIONS
0005AA
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
0005AB
Medicare Integrity Program
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
0005AC
Recovery Audit Contractor
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
TOTAL CLIN 0005 – AB MAC SERVICES
OPTION YEAR 3
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| CONTRACT LINE ITEM NUMBER |
| ESTIMATED COST |
| BASE FEE |
| AWARD FEE |
| FIXED FEE |
| TOTAL ESTIMATED CPAF |
| EST. COMP* |
| TOTAL CPAF NET COMP CREDITS |
CLIN 0006** – AB MAC SERVICES OPTION YEAR 4 OPERATIONS
0006AA
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
0006AB
Medicare Integrity Program
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| BD |
| TBD |
0006AC
Recovery Audit Contractor
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
TOTAL CLIN 0006-AB MAC SERVICES
OPTION YEAR 4
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| CONTRACT LINE ITEM NUMBER |
| ESTIMATED COST |
| BASE FEE |
| AWARD FEE |
| FIXED FEE |
| TOTAL ESTIMATED CPAF |
| EST. COMP* |
| TOTALCPAF NET COMP CREDITS |
CLIN 0007** -AB MAC SERVICES OPTION YEAR 5 OPERATIONS
0007AA
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
0007AB
Medicare Integrity Program
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
0007AC
Recovery Audit Contractor
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
TOTAL CLIN 0007-AB MAC SERVICES
OPTION YEAR 5
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| CONTRACT LINE ITEM NUMBER |
| ESTIMATED COST |
| BASE FEE |
| AWARD FEE |
| FIXED FEE |
| TOTAL ESTIMATED CPAF |
| EST. COMP* |
| TOTALCPAF NET COMP CREDITS |
CLIN 0008** -AB MAC SERVICES OPTION YEAR 6 OPERATIONS
0008AA
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
0008AB
Medicare Integrity Program
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
0008AC
Recovery Audit Contractor
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
TOTAL CLIN 0008 – AB MAC SERVICES
OPTION YEAR 6
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| CONTRACT LINE ITEM NUMBER |
| ESTIMATED COST |
| BASE FEE |
| AWARD FEE |
| FIXED FEE |
| TOTAL ESTIMATED CPAF |
| EST. COMP* |
| TOTAL CPAF NET COMP CREDITS |
CLIN 0009*** - Outgoing Contractor Workload Transition Activities
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
CONTRACT LINE ITEM NUMBER
| ESTIMATED COST |
| BASE FEE |
| AWARD FEE |
| FIXED FEE |
| TOTAL ESTIMATED CPAF |
| EST. COMP* |
| TOTAL CPAF NET COMP CREDITS |
CLIN 0010*** – RSNAT BASE YEAR
Date: TBD
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
CLIN 0011*** – RSNAT OPTION YEAR 1
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
CLIN 0012*** – RSNAT OPTION YEAR 2
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
CLIN 0013*** – RSNAT OPTION YEAR 3
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
CLIN 0014*** – RSNAT OPTION YEAR 4
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
CLIN 0015*** – RSNAT OPTION YEAR 5
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
CLIN 0016*** – RSNAT OPTION YEAR 6
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| CONTRACT LINE ITEM NUMBER |
| ESTIMATED COST |
| BASE FEE |
| AWARD FEE |
| FIXED FEE |
| TOTAL ESTIMATED CPAF |
| EST. COMP* |
| TOTAL CPAF NET COMP CREDITS |
CLIN 0017*** - BASE YEAR
Medical Review for Therapy Claims KX Modifier (KX MODIFIER)
DATE: TBD
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
CLIN 0018*** - KX MODIFIER
OPTION YEAR 1
DATE: TBD
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
CLIN 0019*** - KX MODIFIER
OPTION YEAR 2
DATE: TBD
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
CLIN 0020*** - KX MODIFIER
OPTION YEAR 3
DATE: TBD
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| BD |
| TBD |
CLIN 0021***- KX MODIFIER OPTION YEAR 4
DATE: TBD
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
CLIN 0022*** – KX MODIFIER OPTION YEAR 5
DATE: TBD
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
CLIN 0023*** - KX MODIFIER
OPTION YEAR 6
DATE: TBD
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| CONTRACT LINE ITEM NUMBER | |
| ESTIMATED COST | |
| BASE FEE | |
| AWARD FEE | |
| FIXED FEE | |
| TOTAL ESTIMATED CPAF | |
| EST. COMP* | |
| TOTAL CPAF NET COMP CREDITS |
CLIN 0024*** - BASE YEAR
Veterans Affairs Medicare Equivalent Remittance Advice Project (VA RECLAIM))
DATE: TBD
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
CLIN 0025*** – VA RECLAIM
OPTION YEAR 1
DATE: TBD
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
CLIN 0025*** – VA RECLAIM
OPTION YEAR 2
DATE: TBD
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
CLIN 0025*** – VA RECLAIM
OPTION YEAR 3
DATE: TBD
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
CLIN 0025*** – VA RECLAIM
OPTION YEAR 4
DATE: TBD
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
CLIN 0025*** – VA RECLAIM
OPTION YEAR 5
DATE: TBD
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
CLIN 0025*** – VA RECLAIM
OPTION YEAR 6
DATE: TBD
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TOTAL AB MAC JURISDICTION H |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
*Refer to section G.15, Complementary Credits.
**Cost-Plus Award Fee (CPAF) CLIN/SLIN ***Cost-Plus Fixed Fee (CPFF) CLIN/SLIN (CLIN 0001 – IMPLEMENTATION and CLIN 0009 – Outgoing Contractor Workload Transition Activities and all other CLINS, except CLINs 0002-0008 are CPFF. CLINs 0002-0008 are CPAF.)
(NOTE: 1. For Incremental Funding Table, per HHSAR 332.703-72, refer to Section H.25 – Limitation of Funds)
(END OF SECTION B)
SECTION C - DESCRIPTION/SPECIFICATIONS/WORK STATEMENT
C.1 STATEMENT OF WORK
The Statement of Work (SOW) is provided in Section J as Attachment J.01 and shall be made a part of the contract. The SOW takes precedence over the Internet Only Manuals and Paper-Based Manuals unless otherwise specified.
(END OF SECTION C)
SECTION D - PACKAGING AND MARKING
D.1 PACKAGING AND MARKING
All deliverables required pursuant to the terms of the contract must be shipped and marked in accordance with Section F.3 Deliverables and any other requirements as set forth in Attachment J.02.
(END OF SECTION D)
SECTION E - INSPECTION AND ACCEPTANCE
E.1 FAR 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)
This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this address: https://www.acquisition.gov/far/
Federal Acquisition Regulation (FAR) Clauses:
52.246-5 INSPECTION OF SERVICES – COST REIMBURSEMENT (APR 1984)
E.2 APPROVALS BY THE CONTRACTING OFFICER REPRESENTATIVE
All services or supplies to be delivered to the Contracting Officer Representative (COR) will be deemed to have been accepted 30 calendar days after date of delivery, except as otherwise specified in this contract, if written approval or disapproval has not been provided within such period. The COR's approval or revision to the services or supplies delivered shall be within the general scope of work stated in the contract.
E.3 INSPECTION OF SERVICES –COST-REIMBURSEMENT
a) All work included in this contract is subject to inspection and final acceptance by the Contracting Officer or the duly authorized representative of the Government.
b) The Government's COR is a duly authorized representative of the Government and is responsible for inspection and acceptance of all items required to be delivered by this contract.
c) Inspection and acceptance of the Contractor's performance shall be in accordance with FAR Clause 52.246- 5, Inspection of Services-Cost Reimbursement.
(END OF SECTION E)
SECTION F - DELIVERIES OR PERFORMANCE
F.1 FAR 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)
This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this address: https://www.acquisition.gov/far/
Federal Acquisition Regulation (FAR) Clauses:
52.242-15 STOP WORK ORDER (AUG 1989) ALTERNATE I (APR 1984)
F.2 PERIOD OF PERFORMANCE (JAN 2014)
The period of performance for completion of all work included in this contract shall be from the effective date of contract award through 12 months, plus six (6) one (1) year options as follows:
| CLIN |
| DESCRIPTION |
| WORKLOAD |
| PERIOD OF PERFORMANCE |
| 0001 |
| IMPLEMENTATION |
| Part A Part B |
| Date of contract award - 4 months for Part A* Date of contract award - 6 months for Part B* |
| 0002 |
| BASE PERIOD (Program Management (PM), Medicare Integrity Program (MIP), Support of Recovery Audit Program Operations (RAC)) |
| Part A Part B |
| Cutover from Implementation - 8 months for Part A* Cutover from Implementation - 6 months for Part B * |
| 0003 |
| OPTION YEAR 1 (PM, MIP, RAC) |
| A/B |
| 12 months from exercise of option |
| 0004 |
| OPTION YEAR 2 (PM, MIP, RAC) |
| A/B |
| 12 months from exercise of option |
| 0005 |
| OPTION YEAR 3 (PM, MIP, RAC) |
| A/B |
| 12 months from exercise of option |
| 0006 |
| OPTION YEAR 4 (PM, MIP, RAC) |
| A/B |
| 12 months from exercise of option |
| 0007 |
| OPTION YEAR 5 (PM, MIP, RAC) |
| A/B |
| 12 months from exercise of option |
| 0008 |
| OPTION YEAR 6 (PM, MIP, RAC) |
| A/B |
| 12 months from exercise of option |
| 0009 |
| OUTGOING CONTRACTOR WORKLOAD TRANSITION ACTIVITIES |
| A/B |
| Not to exceed 6 months from exercise of option** |
| 0010 |
| BASE (Prior Authorization for Repetitive Scheduled Non- Emergent Ambulance Transport (RSNAT)) |
| Part B |
| Cutover from Implementation - 6 months |
| 0011 |
| OPTION YEAR 1 (RSNAT) |
| Part B |
| 12 months from exercise of option |
| 0012 |
| OPTION YEAR 2 (RSNAT) |
| Part B |
| 12 months from exercise of option |
| 0013 |
| OPTION YEAR 3 (RSNAT) |
| Part B |
| 12 months from exercise of option |
| 0014 |
| OPTION YEAR 4 (RSNAT) |
| Part B |
| 12 months from exercise of option |
| 0015 |
| OPTION YEAR 5 (RSNAT) |
| Part B |
| 12 months from exercise of option |
| 0016 |
| OPTION YEAR 6 (RSNAT) |
| Part B |
| 12 months from exercise of option |
| 0017 |
| BASE (Medical Review for Therapy Claims KX Modifier (KX MODIFIER)) |
| Part B |
| Cutover from Implementation - 6 months |
| 0018 |
| OPTION YEAR 1 (KX MODIFIER) |
| Part B |
| 12 months from exercise of option |
| 0019 |
| OPTION YEAR 2 (KX MODIFIER) |
| Part B |
| 12 months from exercise of option |
| 0020 |
| OPTION YEAR 3 (KX MODIFIER) |
| Part B |
| 12 months from exercise of option |
| 0021 |
| OPTION YEAR 4 (KX MODIFIER) |
| Part B |
| 12 months from exercise of option |
| 0022 |
| OPTION YEAR 5 (KX MODIFIER) |
| Part B |
| 12 months from exercise of option |
| 0023 |
| OPTION YEAR 6 (KX MODIFIER) |
| Part B |
| 12 months from exercise of option |
| 0024 |
| BASE (Medical Review for Therapy Claims KX Modifier (KX MODIFIER)) |
| Part B |
| Cutover from Implementation - 6 months |
| 0025 |
| OPTION YEAR 1 (VA RECLAIM) |
| Part B |
| 12 months from exercise of option |
| 0026 |
| OPTION YEAR 2 (VA RECLAIM) |
| Part B |
| 12 months from exercise of option |
| 0027 |
| OPTION YEAR 3 (VA RECLAIM) |
| Part B |
| 12 months from exercise of option |
| 0028 |
| OPTION YEAR 4 (VA RECLAIM) |
| Part B |
| 12 months from exercise of option |
| 0029 |
| OPTION YEAR 5 (VA RECLAIM) |
| Part B |
| 12 months from exercise of option |
| 0030 |
| OPTION YEAR 6 (VA RECLAIM) |
| Part B |
| 12 months from exercise of option |
**CLIN 0001 and CLIN 0002 may be overlapping periods of performance.
**This option may be exercised approximately 6 months prior to the expiration of the current year of performance.
(NOTE: 1. The option periods delineated above are subject to the FAR option clauses incorporated in Section I of the contract.
2. For Incremental Funding Table, per HHSAR 332.703-72, refer to Section H.25 - Limitation of Funds.)
F.3 DELIVERABLES
a) The Deliverable Schedule is provided under Section J as Attachment J.02 and shall be made a part of this contract.
b) The Contractor shall submit all required deliverables and reports in accordance with the attached schedule. Reports submitted under the contract shall reference and cite the contract number and identify CMS as the sponsoring agency.
c) Deliverables shall be submitted to the MAC/CMS Data Exchange (MDX) MAC Deliverables Tracking (MDT) module.
d) If unable to upload deliverables electronically to MDT, contact CMS.
e) Hardcopy Implementation deliverables should be sent to the JH Implementation Lead. Refer to JSM Number 10337 for further instructions.
f) Satisfactory performance under the contract shall be deemed to occur upon delivery and acceptance by the Contracting Officer, or the duly authorized representative, of the items in the attached Deliverable Schedule (Attachment J.02). Reports submitted under the contract shall reference and cite the contract number and identify CMS as the sponsoring agency. The following abbreviations apply to Attachment J.02:
| IAW | In accordance with NLT | Not later than COB | Close of business |
| E | Electronic copy (email or diskette) H | Hard copy | |
| CP | Cover page | ||
| COR | Contracting Officer’s Representative | ||
| CS | Contract Specialist |
Note: Additional deliverables may be assigned as part of the project planning process. Individual projects may be released, as necessary by the direction of the Contracting Officer. Addressees:
· CONTRACTING OFFICER’S REPRESENTATIVE (COR): Please refer to Section G.8, Government Representatives and Responsibilities
· CONTRACTING OFFICER (CO): Please refer to Section G.8, Government Representatives and Responsibilities
· CONTRACT SPECIALIST (CS): Please refer to Section G.8, Government Representatives and Responsibilities
All electronic files shall be submitted in a format compatible with Microsoft Office PC-based software. As this requirement is subject to change, the contractor shall be able to adapt to any new CMS standard in order to submit deliverables. Unless specifically denoted as “workday(s),” all timeframes are in calendar days, calendar weeks, calendar months, etc. after the effective date of the contract.
(END OF SECTION F)
SECTION G - CONTRACT ADMINISTRATION DATA
G.1 ACCOUNTING AND APPROPRIATION DATA
| CLIN/SLIN |
| Requisition Number |
| Accounting Commitment Number |
| Object Class |
| Appropriation |
| CAN |
| Amount |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
| TBD |
G.2 PAYMENT, SELECTED ITEMS OF COST REIMBURSEMENT CONTRACTS
a) Travel Costs (Including Foreign Travel)
The Contractor shall be reimbursed for travel costs in accordance with FAR 31.205-46 Travel Costs.
b) Per Diem
Expenses for subsistence and lodging shall be reimbursed to the Contractor only to the extent where overnight stay is necessary for performance under this contract. Incurred costs shall be considered to be reasonable and allowable only to the extent that they do not exceed, on a daily basis, the maximum per diem rates in effect at the time of travel as set forth in the Federal Travel Regulations in accordance with FAR 31.205-46(2).
c) Cost of Materials
The cost of materials furnished or used under this contract shall be reimbursed in accordance with FAR 52.216-7 Allowable Cost and Payment, Reimbursing costs for cost reimbursement contracts. Expendable material costs for items such as office supplies, report paper, etc., and tools of the trade shall be priced in accordance with the Contractor’s approved accounting practices or standards, as applicable. The Contractor shall be required to support all material costs claimed.
d) Relocation Costs
In accordance with FAR 31.205-35, Relocation costs, either direct charged or included in the contractor's indirect cost pools, associated with an individual not completing a term of service equal to one (1) year working under this contract shall be an unallowable cost under this contract.
G.3 DISSEMINATION, PUBLICATION & DISTRIBUTION OF INFORMATION
a) Data and information either provided to the Contractor, or to any subcontractor or generated by activities under this contract or derived from research or studies supported by this contract, shall be used only for the purposes of the contract. It shall not be duplicated, used or disclosed for any purpose other than the fulfillment of the requirements set forth in this contract. This restriction does not limit the contractor's right to use data or information obtained from a non- restrictive source. Any questions concerning "privileged information" shall be referred to the Contracting Officer.
b) Some data or information may require special consideration with regard to the timing of its disclosure so that preliminary findings which could create erroneous conclusions are not stipulated. Some data or information, which relate to policy matters under consideration by the Government, may also require special consideration with regard to the timing of its disclosure so that the open and vigorous debate within the Government of possible policy options is not damaged.
c) Any questions about use or release of the data or information or handling of material under this contract shall be referred to the Contracting Officer who must render a written determination. The Contracting Officer's determinations will reflect the results of internal coordination with appropriate program and legal officials.
d) Written advance notice of at least forty-five (45) days shall be provided to the Contracting Officer of the Contractor's desire to release findings of studies or research or data or information described above. If the Contractor disagrees with the Contracting Officer's determination, and if this disagreement cannot be settled by the Contractor and the Contracting Officer in a mutually satisfactory manner, then the issue will be settled pursuant to the FAR 52.233.1 Disputes.
e) Any presentation of any report, statistical or analytical material based, on information obtained from this contract shall be subject to review by the COR before dissemination, publication, or distribution. Presentation includes, but is not limited to, papers, articles, professional publications, speeches, testimony or interviews with public print or broadcast media. This does not apply to information that is requested pursuant to the Federal Freedom of Information Act (FOIA).
f) The COR review shall cover accuracy, content, manner of presentation of the information, and also the protection of the privacy of individuals. If the review finds that the Privacy Act is or may be violated, the release/use of the presentation shall be denied until the offending material is removed or until the Contracting Officer makes a formal determination, in writing, that the privacy of individuals is not being violated.
g) If the review shows that the accuracy, content, or manner of presentation is not correct or is inappropriate in the light of the purpose of the project, the COR shall immediately inform the Contractor, in writing, of the nature of the problem. If the Contractor disagrees, the COR may insist that the presentation contain, in a manner of equal importance, materials, which show the Government's problem with the presentation.
h) The Contractor agrees to acknowledge support by CMS whenever reports of projects funded, in whole or in part, by this contract are published in any medium. The Contractor shall include in any publication resulting from work under this contract, an acknowledgment substantially, as follows:
"The analyses upon which this publication is based were performed under Contract Number entitled, A/B MAC Jurisdiction H. Sponsored by the Centers for Medicare & Medicaid Services, U.S. Department of Health & Human Services."
Any deviation from the above legend shall be approved, in writing, by the Contracting Officer.
G.4 SUBCONTRACTING REPORTING
The Contractor shall report all subcontract awards to small, small disadvantaged, women-owned, HUBZones, veteran-owned and service-disabled veteran-owned small business concerns. The reports shall be prepared using the electronic Subcontracting Reporting System (eSRS) via the internet at Electronic Subcontracting Reporting System Site (https://www.esrs.gov/).The Individual Subcontracting Report (ISR), formerly SF 294, and the Summary Subcontracting Report (SSR), formerly SF 295, shall be submitted as detailed in the chart below.
| Reporting Period |
| Report Due |
| Due Date |
| Oct 1 – Mar 31 |
| ISR |
| Apr 30 |
| Apr 1 – Sept 30 |
| ISR |
| Oct 30 |
| Oct 1 – Sept 30 |
| SSR |
| Oct 30 |
| Contract Completion |
| OF 312 (If required) |
| 30 days after completion |
G.5 SUBCONTRACTING PROGRAM
Contractors are to submit Small Business Subcontracting Plans per FAR 52.219-9, Small Business Subcontracting Plan. In accordance with FAR 19.704, Subcontracting Plan Requirements, the subcontracting plan shall be submitted using the U.S. Department of Health and Human Services (HHS) Small Business Customer Experience (SBCX) system. The plan shall cover the entire contract period of performance, and the Contractor shall strive to achieve the HHS small business utilization goals outlined in section L.12.6 when developing its small business subcontracting plan. Offerors are directed to https://osdbu.hhs.gov/subcontracting/24711a72-4de0-4cbd-b854-78729f0ee7d0 for this submission.
The contractor hereby agrees to implement the conditions of the subcontracting plan submitted and approved by the Contracting Officer for this contract.
G.6 SUBCONTRACT CONSENT
a) To facilitate the review of a proposed subcontract by the COR and the Contracting Officer, the Contractor shall submit the information required by FAR Clause 52.244-2, Subcontracts (Jun 2020) to the Contracting Officer. The Contracting Officer shall review the request for subcontract approval as well as the COR's recommendation and advise the Contractor of his/her decision to consent or object to the proposed subcontract, in writing.
b) Consent is hereby given to issue the following subcontract(s): (To be completed at time of award, if applicable).
G.7 SERVICE OF CONSULTANTS/SUBCONTRACTORS
a. For the purposes of this contract, consultants are considered subcontractors. The Contractor shall follow the procedures established in FAR Clause 52.244-2, Subcontracts.
b. The Contractor shall be reimbursed at the rates(s) set forth below for services provided by consultants/subcontractors in connection with this contract:
| Name Rate Per Hour |
| Number of Hours |
| Total Cost Not to Exceed |
| TBD |
| TBD |
| TBD |
(To be completed at time of award, if applicable)
G.8 GOVERNMENT REPRESENTATIVES AND RESPONSIBILITIES (NOV 2024)
Following are the Government Representatives and their respective roles and responsibilities on this contract:
a. Contracting Officer
As defined in Federal Acquisition Regulation (FAR) 2.101, Definitions, and in accordance with FAR 1.602- 1, Authority, “Contracting officers have authority to enter into, administer, and/or terminate contracts and make related determinations and findings.” There is no other authorized representative, or any other Administrative Contracting Officer assigned to this contract to carry out a Contracting Officer’s duties, except for technical direction assigned to the Contracting Officer’s Representative, if applicable.
The Contracting Officer is:
Centers for Medicare & Medicaid Services Office of Acquisition & Grants Management Medicare Support Contracts Group Division Medicare Program Contracts ATTN: Amy Duckworth 7500 Security Blvd.
Baltimore, MD 21244-1850 Phone: 410-786-3111 Email Address: amy.duckworth@cms.hhs.gov@cms.hhs.gov
b. Contract Specialist
Notwithstanding any of the other provisions of this Contract, the Contract Specialist will assist the Contracting Officer with his/her responsibilities as defined in the FAR.
The Contract Specialist is:
Office of Acquisition & Grants Management Medicare Support Contracts Group Division Medicare Program Contracts ATTN: Edward Drannbauer 7500 Security Blvd. Baltimore, MD 21244-1850 Phone: 872-287-1396 Email Address: edward.drannbauer@cms.hhs.gov
c. Contracting Officer’s Representative The Contracting Officer’s Representative (COR), as defined in FAR 2.101, Definitions, is: Centers for Medicare & Medicaid Services Medicare Contractor Management Group ATTN: TBD 7500 Security Blvd., Mail-stop: TBD Baltimore, MD 21244-1850 Phone: 410-786-XXXX Email Address: TBD
In accordance with FAR 1.602-2(d), Responsibilities, the COR’s delegated responsibilities are identified in the Contracting Officer’s appointment memorandum, a copy of which will be furnished to the contractor.
The COR will serve as the primary liaison between the Contractor and the Contracting Officer and perform duties within the limitations of the COR’s responsibilities in accordance with FAR 1.602-2(d).
Technical direction must be within the general scope of the work stated in the contract. The term "technical direction" is defined to include, without limitation, the following:
(1) Directions to the Contractor which direct the contract effort, shift work emphasis between work areas or tasks, require pursuit of certain lines of inquiry, fill in details or otherwise serve to accomplish the contractual technical requirements as identified in the Statement of Work or Performance Work Statement; or
(2) Provision of information to the Contractor, which assists in the interpretation of drawings, specifications, or technical portions of the work description.
Technical direction within the scope of the contract, shall be “in writing” whenever possible and routed through the CO prior to release to the Contractor. If technical direction is verbally communicated, the COR must immediately confirm its direction in writing. Where doubt exists as to whether proposed technical direction is within or outside the scope of the contract, the CO shall be contacted.
If, in the opinion of the Contractor, any instruction or direction issued by a Government representative constitutes a change to the contract or constitutes a “Change Order” as defined in FAR 2.101, Definitions, the Contractor shall follow the instructions identified in FAR 52.243-7 Notification of Changes.
The COR “has no authority to make any commitments or changes that affect price, quality, quantity, delivery, or other terms and conditions of the contract nor in any way direct the contractor or its subcontractors to operate in conflict with the contract terms and conditions.” See FAR 1.602-2(d)(5). The COR’s authority is not re-delegable and the COR may be personally liable for unauthorized acts in accordance with FAR 1.602-(d)(7)(iv) and (v). For example, the COR does not have the authority to:
1. Make changes to contract terms and conditions;
2. Direct the contractor to perform work or make deliveries not specifically required under the contract;
3. Waive or relax the Government’s rights with regard to the Contractor’s compliance with the specifications, price, delivery or any other terms or conditions of the contract;
4. Make any commitments or approve any actions that would create any financial obligation on the part of the Government; or
5. Issue direction that constitutes a “change” as defined in:
FAR 52.243-1, Changes – Fixed Price;
FAR 52.243-2, Changes – Cost-Reimbursement;
FAR 52.243-3, Changes – Time-and-Materials or Labor-Hours;
FAR 52.243-4, Changes; or, FAR 52.243-5, Changes and Changed Conditions.
In addition to the above responsibilities, the COR and/or Contractor shall immediately notify the Contracting Officer of any contractual concerns related to the following:
1. Personal Services: FAR 37.104(a) provides that, “[a] personal services contract is characterized by the employer- employee relationship it creates between the Government and the contractor’s personnel. The Government is normally required to obtain its employees by direct hire under competitive appointment or other procedures required by the civil service laws. Obtaining personal services by contract, rather than by direct hire, circumvents those laws unless Congress has specifically authorized acquisition of the services by contract.”
Under this contract, the services to be performed do not require the Contractor or the Contractor’s personnel to exercise personal judgement and discretion on behalf of the Government. Rather, the Contractor’s personnel will act and exercise personal judgement and discretion on behalf of the Contractor. The services to be performed under this contract are not for personal services as defined by FAR 37.104.
Both the Government and the Contractor have a responsibility to monitor contract activities. The CO must be notified immediately if at any time during contract performance the interaction between the Government representative and Contractor personnel constitutes or is perceived to constitute personal services. Both the Government and Contractor personnel must exercise caution to ensure that service contracts not personal in nature avoid even the appearance of a personal services contract.
2. Inherently Governmental Functions: The agency shall not use contractors for the performance of inherently governmental functions unless issued under statutory authority See FAR 7.5 Inherently Governmental Functions. As defined in FAR 2.101, “Inherently Governmental Function” means, as a matter of policy, a function that is so intimately related to the public interest as to mandate performance by Government employees. An inherently governmental function includes activities that require either the exercise of discretion in applying Government authority, or the making of value judgments in making decisions for the Government. Inherently governmental functions DO NOT normally include gathering information for or providing advice, opinions, recommendations, or ideas to Government officials.
FAR 7.503(c) provides a list of examples of functions considered to be inherently governmental functions or which shall be treated as such.
To this effect, during contract performance, care should be taken to ensure that any change or expansion in scope of the requirement does not include inherently governmental functions. Further, due to the nature of a given requirement, there is a potential for close working relationships to develop between Government and Contractor personnel; however, care should be taken to ensure that any familiarity established between the Government and Contractor personnel never promotes or fosters an environment that allows for the assignment of inherently governmental functions to contractor employee(s).
3. Unauthorized Commitments: In carrying out your duties, you are reminded that in accordance with FAR 1.602- 2(d)(5), the COR “[h]as no authority to make any commitments or changes that affect price, quality, quantity, delivery, or other terms and conditions of the contract, or in any way direct the Contractor, or its Subcontractors, to operate in conflict with the contract terms and conditions.” Doing so constitutes an “unauthorized commitment.” The Contracting Officer is the only individual with the authority to enter into an agreement on behalf of the Government. An unauthorized commitment is defined as “an agreement that is not binding solely because the Government representative who made it lacked the authority to enter into that agreement on behalf of the Government.” FAR 1-602-3(a). Examples of unauthorized commitments include, but are not limited to, the following:
· Orders placed with a Contractor without a valid contractual instrument in place.
· Directing any Contractor to do additional work, in excess of the contract value, or work beyond the Period of Performance.
· Authorize new work to a contract without notifying the Contracting Officer (CO) or Contract Specialist (CS) and having a modification in place for the new work.
· Directing the Contractor, in any way that could change the terms and conditions of the contractual instrument or be deemed outside the Scope of the Statement of Work.
Unauthorized commitments are a serious matter and may result in personal liability on the part of the employee who committed the unauthorized commitment. Ratification, is “the act of approving an unauthorized commitment by an official who has the authority to do so.” FAR 1.602-3(a).
G.9 CONTRACT PROPERTY ADMINISTRATION
(a) Contractor agrees to furnish information regarding Government Property to the Contract Property Administrator in the manner and to the extent required by the Contract Property Administrator, his duly designated successors, and in accordance with FAR Part 45 – GOVERNMENT PROPERTY and Appendix Q of the U.S. Department of Health & Human Services (HHS) Contracting Guide for Contract of Government Property, (April 2009) which is provided as Attachment J.04 to this solicitation.
(b) The Contractor is responsible for an annual physical inventory accounting for all government property under this contract. The inventory must be conducted by September 30th and the Standard Form 1428 Inventory Schedule, (or other form designated by the Contract Property Administrator), submitted by October 31st of each year.
(c) The inventory report shall include all items acquired, furnished, rented or leased under the contract. Employees who conduct the inventories should not be the same individuals who maintain the property records. The contractor must complete an HHS-342, Report of Survey, for any Government Furnished Equipment/Government Furnished Property inventory damages or shortages upon the direction of the Contract Property Administrator. Following the physical inventory, the Contractor shall prepare an inventory report and submit the report to the CMS Contract Property Administrator at the following address:
Centers for Medicare & Medicaid Services Office of Operations Management Administrative Services Group Division of Printing, Mail, and Logistics Attn: TBD 7500 Security Boulevard, M/S SL-13-12 Baltimore, Maryland 21244-1850
(410) 786-XXXX
AND
Email the Contract Specialist (Refer to Section G.8 for contact information).
(d) Commercially leased software is subject to these reporting requirements.
(e) The Contractor shall submit a consolidated report of all accountable government property under this contract, including subcontractor inventory information.
(f) The final inventory report shall indicate that all items required for continued contract performance are acceptable and free from contamination. Property that is no longer usable or required shall be reported and disposition requested from the Contract Property Administrator at least 60 days prior to contract expiration. The final inventory report shall be submitted upon the date of contract expiration.
G.10 GOVERNMENT FURNISHED PROPERTY
Pursuant to FAR Part 45 – Government Property and FAR Clause 52.245-1, Government Property, of this contract, the Government will furnish for performance of the work required herein a list of accessible government systems, which is provided under Attachment J.05 and is hereby made part of this contract.
G.11 CONTRACTOR FURNISHED PROPERTY
A list of Contractor Furnished Property is incorporated as Attachment J.06 (To be completed at time of award).
G.12 PAYMENTS – INVOICES – (SEPT 2024)
a. GENERAL: Effective August 31, 2020, the Contractor/Vendor shall create an invoice within the Invoice Processing Platform (IPP), a secure Web-based service for federal agencies and their vendors to manage government invoicing from purchase order (PO) through payment notification. Note: All invoice terms and conditions are contract specific and may vary from contract to contract.
b. CONTENT OF INVOICE: FAR 32.905 Payment Documentation and Process, provides the required content for a proper invoice. In addition to the requirements of FAR 32.905, the following items shall also be included on the invoice to be considered proper:
· Line item number (i.e. CLIN/SLIN as applicable);
· Contractor/Vendor’s Unique Entity Identifier (UEI) Number;
· Period of Performance (POP) or delivery date of goods or services provided;
· Attachments and applicable support documentation requested by the CO;
· The first page of the PDF invoice or PDF SF-1034 shall include:
1. Contractor/Vendor name and address;
2. Bill to: CMS, P.O. Box 7520, Baltimore, MD 21207;
3. Full CMS contract number and task order number;
4. Summary of charges by CLIN/SLIN (if applicable) with a grand total. CLIN/SLIN(S) on the PDF shall be identical to what is entered in IPP;
5. Invoice number shall be identical to what is entered in IPP. Each Contractor/Vendor invoice number must be unique across all CMS contracts awarded to the Contractor/Vendor. For example, If Contractor/Vendor A has 5 CMS contracts, Contractor/Vendor A cannot use the same invoice number on any of the 5 contracts they have with CMS. If using a dash in IPP then the dash must be used on the PDF. IPP does not allow any special characters (i.e.*, #);
6. Within IPP, the “Bill Period Start” and “Bill Period End” dates should align with the “Service From” and “Service To” dates (this is not the entire POP dates);
7. Date of Delivery or Service dates shown on the PDF should: (i) Fall within the contract POP (unless contract indicates otherwise) (ii) Align with the “Bill Period Start” and “Bill Period End” dates and “Service From” and “Service To” dates, and (iii) Note when the work was performed;
8. Date invoice was prepared;
9. The total invoice amount on the first page of the invoice or SF-1034 must be a debit. A credit may be shown on the first page of the invoice or SF-1034 if the credit falls within the Period Of Performance and is for the same CLIN as the debit. CMS does not accept credit vouchers or process refunds in IPP or the Invoice Submission Box. Credits in excess of $5.01 must be submitted via Pay.gov (For questions surrounding Pay.gov, contact pay.gov.clev@clev.frb.org or 1-800-624-1373 (Option 2)). Credits sent to Pay.gov shall be copied to the CO, CS and COR. Credits valued at or less than $5.01 must be submitted via Credit Gateway; however, it is preferred that the Contractor/Vendor wait until a dollar amount is accumulated in order to submit the refund through Pay.gov (For questions surrounding Credit Gateway, contact customer.care@usbank.com or 1-877-815-1206);
· When an invoice has been resubmitted, an “R” should be added after the invoice number on the PDF and in IPP; this will ensure that the original invoice number is not duplicated in IPP. If a resubmitted invoice is rejected again, each subsequent resubmission requires an additional “R” added after the invoice number (i.e. “RR”);
· The “final” designation should only be used when the contract is being closed out by OAGM. Do not use for the end of POP or Option Year;
· Contractor/Vendor must maintain active registration in SAM.gov. If your SAM account is about to expire, wait until it is updated before submitting your invoice; and,
· Banking or address changes must be submitted via email to CCRchanges@cms.hhs.gov.
c. INVOICE SUBMISSION: The contractor/vendor shall create an invoice from the Purchase Order (PO)/ Contract via the IPP website http://www.ipp.gov/. For questions, call IPP Customer Support at (866) 973-3131 or email the IPP Customer Support at IPPCustomerSupport@fiscal.treasury.gov. Only one PDF invoice per submission is allowed in IPP.
d.
This is the start of the file's text. The full file is on GovTribe.
File details come from the government source that posted it. Updated .