Limited_Source_Justification_REDACTED.pdf

General Services Administration Federal Supply Schedule Limited Source Justification

1. Identification of the agency and contracting activity.

a. Federal agency and contracting activity.

U.S Department of Health and Human Services (HHS), Office of the Secretary (OS), Office of Medicare Hearings and Appeals (OMHA) - Headquarters

b. Sponsoring organization.

HHS, OMHA, Division of Information Management and Systems

c. Project Officer Information.

2. Nature and/or description of the action being approved.

a. Acquisition purpose and objectives.

In order for OMHA to deliver excellent service in the face of rapidly growing Workloads, OMHA is in the process of developing the Electronic Case Adjudication and Processing Environment.(ECAPE) a stable, responsive, user friendly workflow and case management system with functionality that supports OMHA’s business process by providing the ability to work in a fully electronic environment. ECAPE is also a key component of the Department’s Medicare appeals backlog reduction initiative.

The ECAPE project is still in development, and OMHA requires the continued services from Capgemini Government Solutions LLC (Capgemini) for the final phases of the project.

Approval is requested through a limited source justification for a sole award to support the current level of effort required for the ECAPE Project under Federal Acquisition Regulation (FAR) 8.405-6(a)(1)(i)(C).

The Government intends to issue an award with a period of performance of 01/12/2016 through 01/11/2018. This justification will authorize the sole source award of services, to Capgemini Government Solutions LLC, 1900 Campus Commons Dr #250, Reston, VA 20191 for the continuation of ECAPE Project Management Office Support Services.

b. Project background.

Starting in Fiscal Year (FY) 2010, OMHA began to experience an upward trend in the number of requests for hearings being filed, which resulted in longer average processing times for appeals. Between FY 2009 and FY 2014 OMHA’s traditional workload increased 543%.

OMHA currently has over 850,000 appeals pending. Since opening its doors in 2005 OMHA has received over 1.3 million appeals and has decided nearly 500,000. Although Administrative Law Judge (ALJ) team productivity has more than doubled from FY 2009 through FY 2014, the magnitude of the increase in workload has exceeded OMHA’s ability to adjudicate incoming appeals within the 90-day time frame that Congress contemplated for most appeals. As a result of the significant disparity between workload and capacity, adjudication time frames have increased to their current level of 615 days (as of June 26, 2015), and will continue to increase until receipt levels and adjudication capacity are brought into balance.

As a result of these rapidly growing workloads, OMHA has an urgent need to move from paper-based case processing to an electronic processing environment. Currently, OMHA uses a paper process to manage their pending workload and uses the Medicare Appeals System (MAS) primarily as a data repository. MAS is operated by the Centers for Medicare and Medicaid Services (CMS). ECAPE will seamlessly interface with MAS, including its component/ supporting systems, and a number of feeder systems providing data regarding claims, providers, beneficiaries, and etc. This project is critical to the mission of OMHA and will improve the delivery and efficiency of appeals processing services.

In the face of these growing workloads, the Department has also recognized the need to deliver high quality and timely decisions on benefits and services to the Medicare community with greater efficiency, and under Secretary Burwell’s leadership the Department has undertaken a backlog reduction initiative to improve the Medicare Appeals process. A key component to this strategy includes leveraging IT initiatives to increase efficiency. Although the ECAPE project was initially funded in 2013, it has now become a crucial part to the Department’s backlog reduction strategy’s overall success. Chief Administrative Law Judge Nancy J. Griswold provided testimony to the Committee on Oversight & Government Reform United States House of Representatives in July 2014 and to the Senate Finance Committee in April 2015. In both instances she stressed the criticality of ECAPE to the backlog reduction plan. The Office of Management and Budget approved funding for ECAPE and has a strong interest in ensuring its success.

OMHA must continue to meet project milestones to ensure that the ECAPE project is not endangered and it stays on track as a critical component to the Department’s backlog reduction strategy. While significant progress has been made with the award of the ECAPE contract, there are critical milestones and deliverables remaining: conducting development/ requirements sessions, implementing ECAPE, completing user acceptance testing and data migration, and providing user training. These activities are expected to last through mid- 2017. Continuity of project management support is essential to ECAPE’s success.

The current contract with Capgemini was established in 2014 to provide Project Management Office Support Services during the development of ECAPE. The core ECAPE development work is provided under a separate contract. The ECAPE development contract took longer to award than originally anticipated due to the complexity of the statement of work, the technical evaluation, and the remediation of vendor deficiencies. The ECAPE contract was successfully awarded on March 30, 2015. While significant progress has been made with

ECAPE, there are a myriad of critical milestones and deliverables that remain. Both contracts are necessary for critical future releases, completion, and implementation of the project.

The Office Support Services contract order was competed from General Service Administration (GSA) Federal Supply Schedule (FSS) MOBIS schedule. The original Office Support Services contract order (Contract Number: HHSP23320100007JB; Order Number:

HHSP23337004) has a period of performance of 04/14/2014 through 01/11/2016 for a total amount of $2,721,140.49. The original total contract period of performance was based on the ECAPE contract being in place by 2013 - early 2014, but this did not happen.

3. Description of the supplies or services required to meet the agency’s needs (including the estimated value).

a. Project title.

Electronic Case Adjudication and Processing Environment (ECAPE) Project Management Office Support Services for HHS-OMHA

b. Project description.

This project is to provide project management office (PMO) support services for the ECAPE project management, integration, implementation project, security, management information, and verification and validation. The Government seeks to acquire a small cadre of multi-functional resources, tightly integrated with the PMO, to perform defined management and technical tasks that cannot be performed by Government staff due to limitations on resources and/or expertise. The contractor will assist the Government PMO with drafting/editing/maintaining/reviewing Department of Health and Human Services (HHS) Enterprise Performance Life Cycle (EPLC) and project documents; performance of PMO implementation, oversight, and review activities-including cost, schedule, project, and technical performance evaluation of the ECAPE contractor(s); and provide the Government PMO with analysis and substantive advice and recommendations regarding a wide range of management and technical issues within the purview of the PMO.

Requirement type.

X Support services (non-research & development) Supplies/equipment Information technology (IT) Other (specify): ____________________

Type of action.

New requirement X Follow-on (for Limited Justification-Sole Source) Other (specify): ______________________

Proposed contract/order type.

Firm-fixed-price X Time and materials Indefinite delivery (specify whether indefinite quantity, definite quantity or requirements): ___________ Other (specify): ___________

Acquisition identification number.

This action is a follow on to order #HHSP23337004S that was placed against BPA #HHSP23320100007J. The BPA and order are against the General Service Administration (GSA) Federal Supply Schedule (FSS) MOBIS schedule.

c. Total estimated dollar value and performance/delivery period.

Option Period of Performance Amount

Base Year 1/12/2016 - 1/11/2017

Option Year 1 01/12/2017 -01/11/2018

4. Identification of the justification rationale and, if applicable, a demonstration of the proposed contractor’s unique qualifications to provide the required supply or service.

a. Acquisition authority.

This acquisition is conducted under the authority of the Multiple Award Schedule Program through GSA FSS. Consideration of schedule contractors will be restricted to fewer than the number provided by Federal Acquisition Regulation (FAR) 8.405-6(a)(1)(i)(C). In the interest of economy and efficiency, the new work is a logical follow-on to an original Federal Supply Schedule order and the original order was placed in accordance with the applicable Federal Supply Schedule, also known as GSA FSS, ordering procedures. The initial award was competed from General Service Administration (GSA) Federal Supply Schedule (FSS) MOBIS schedule.

b. Demonstration of the proposed contractor(s) unique qualifications to provide the required supply or service.

Name and address of the proposed contractor(s).

Proposed sole source contractor information:

Capgemini Government Solutions LLC 1900 Campus Commons Dr #250, Reston, VA 20191

DUNS: 132048377

Cage Code: 3CXP3

Nature of the acquisition and proposed contractor(s) unique qualifications.

ECAPE is being implemented over three releases scheduled through mid-2017. The ECAPE development contract has twelve contract line item numbers (CLIN) representing each release and other major ECAPE components (hosting, data migration, support services). In addition, there are other multiple contracts and interagency agreements that provide support for specific/limited areas related to ECAPE. The work covered under this limited source justification for sole source is a logical follow-on for the ECAPE program. The follow-on is "logical" in the sense that it continues the ECAPE program work started under an earlier contract and/or is a consequence of an earlier contract(s).

Currently the program is approaching the implementation of the first release. The pilot for the first release of ECAPE is expected to occur in early 2016 and is comprised of case intake, and the first phase of the Appellant Public Portal. We expect to begin piloting the second release of ECAPE in early 2017. Release two provides functionality that covers the remainder of the adjudication process, from assignment to case closure. The final release is expected to be implemented in mid-2017 and consists of enhancements to the Appellant Public Portal. However, OMHA may choose to implement additional enhancements after Release III under CLIN 0008 ECAPE Capability Group E - additional features and capabilities and CLIN 0009: Technical Directions.

Capgemini provided full PMO support for the acquisition/award of the ECAPE development contract and for all activated severable and nonseverable CLINs, has knowledge and experience with the project and the Medicare appeals program that no other Contractor possesses. Capgemini is uniquely qualified based on the work they have already successfully performed for OMHA’s ECAPE project. The key Capgemeni personnel have been with the project since the PMO contract was awarded and have gained extensive familiarity with our complex administrative appeals business processes and the organizational structure of the department. In addition, there are multiple external dependencies that require close oversight to ensure that they do not negatively impact the OMHA release schedule and only Capgemini has the knowledge to do so.

A different vendor would require time to catch up in order to perform the follow-on, which would add cost, time, and money. Additionally, it would increase project or program cost, schedule, and performance risk. A different vendor would not have sufficient time to ramp up and eliminate or minimize delays to become effective without jeopardizing the ECAPE release schedule. This would have a significant negative impact on the Department’s backlog initiative. Keeping the current vendor in place will assure seamless monitoring of the ECAPE project development and ability to leverage the framework and tools already developed by Capgemini, avoiding project risk and uncertainty. The time and expense necessary to get up to speed on the ECAPE program, OMHA mission, the multiple interfaces and systems connected to CMS and the broader adjudication process would be equivalent to six (6) months of duplication.

Capgemini’s extensive and unique experience with large scale, complex program management systems is necessary for the success of ECAPE. They have ensured the project is on track technically, and delivered within budget and schedule. These skills are crucial to meeting the government’s requirements. The work is complex and technical in nature and to utilize another vendor during the remaining ECAPE implementation would require an inordinate amount of time and expense to understand and fulfill OMHA’s requirements. In addition, another vendor would have to familiarize itself with the existing work statements under all related contractors along with the current ongoing work under this contract. A new vendor would also require the re-creation and/or reintroduction of significant project controls already completed such as the integrated project schedule, the ECAPE budget tool, earned value management, EPLC, the relationship of CMS interfaces, user requirements/stories and development sprints completed to date. The current vendor has been providing highly qualified, key subject matter experts in the program at this critical stage and any loss of momentum would have significant consequences. The delay of ECAPE would cause the OMA appeals backload to continue to increase and would have a negative effect on the Department’s backlog initiative.

This will be a new, noncompetitive procurement by a separate new contract. Such placement was necessitated by prior procurement decisions because award to any other source would result in substantial duplication of cost to the government that is not expected to be recovered through competition.

5. Determination by the ordering activity Contracting Officer that the order represents the best value consistent with FAR 8.404(d).

Before an award is issued under this limited source justification, Capgemini will be asked to provide a proposal and pricing for the work, which the Contracting Officer Representative and the Contracting Officer will review, and the Contracting Officer will negotiate, as necessary. The Contracting Officer hereby determines the anticipated cost to the Government will be fair and reasonable based upon the contractor utilizing the labor categories and material on a Time and Material contract, from their GSA schedule price list.

Services offered on the GSA FSS are priced either at hourly rates, or at a fixed price for performance of a specific task. GSA FSS has determined the prices of supplies and fixed-price services, and rates for services offered at hourly rates, to be fair and reasonable for the purpose of establishing the schedule contract.

In accordance with FAR 8.405-2(d) the ordering activity contracting officer will have the responsibility of making the determination of fair and reasonable pricing for this action, using comparison of proposed prices to historical prices paid, comparison of proposed prices with independent Government cost estimates, and/or actual costs previously incurred by the same offeror. In addition, the labor mix and level of effort proposed will be considered in the evaluation.

6. Description of the market research conducted among schedule holders and the results, or a statement of the reasons market research was not conducted.

Other GSA FSS contractors were not solicited for this sole source action due to the reasons outlined in paragraph 4(b) and in the interest of economy and efficiency; this work is a logical follow-on to an original Federal Supply Schedule order. Additionally, at this point, there would not be enough time for a different contractor to gain the necessary knowledge needed for current activities, specific to ECAPE Project. Finally, Capgemini is the only responsible source capable of providing continued services without significant ramp-up time or a break in service, which is unacceptable to the Government.

7. Any other facts supporting the justification.

In the interest of economy and efficiency, the new work is a logical follow-on to an original GSA FSS order (order #HHSP23337004S that was placed against BPA #HHSP23320100007J) and the original order was placed in accordance with the applicable GSA FSS ordering procedures. The original contract order was not previously issued under sole-source or limited-sources procedures and was competed from the General Service Administration (GSA) Federal Supply Schedule (FSS) MOBIS schedule.

The current contractor currently has staff in place with historical knowledge of ECAPE and the OMHA business processes and systems. There would be unacceptable delays in fulfilling the agency’s requirements by going with another vendor with over 50% of the ECAPE project and phases completed. In addition, the current vendor has formed the critical connections with OMHA and other federal agencies required to implement ECAPE between CMS and OMHA. A new contractor would create a duplication of cost. The extent and nature of the harm would equate to funds estimated in the amount of six (6) months of a learning curve at a cost of( 6 months learning curve using FTE of 1880 hours/year) $905,979.40. Using the current contract, the estimated calculations are below:

These delays and cost are unacceptable and preventable with the award of a sole source contract with the current vendor. OMHA mission will be significantly impaired if this award is not issued and OMHA does not have the resources (civilian staff) to conduct the vital tasks, while a new vendor transitions. In the Government and taxpayer’s interest, OMHA proposes allowing the current vendor to continue the services through the final phases of the project.

The proposed period of performance is the minimum acceptable period necessary to meet mission requirements and a shorter period is not advisable because continuity of project management support throughout the project is critical and is essential to the success of ECAPE.

Capgemini is responsible for several activities that occur post-release including integration testing and IV&V. Future extensions are not anticipated.

8. Statement of the actions, if any, the agency may take to remove or overcome any barriers that led to the restricted consideration before any subsequent acquisition for the supplies or services is made.

a. Removal of barriers to competition.

No actions have been or will be undertaken to overcome barriers to competition for future acquisitions. The only identified barrier to competition in this instance is the immediate and continued needs of the specialized skills and historical knowledge Capgemini has of the ECAPE project, which cannot be resolved through competition without having a significant financial impact as outline in paragraph seven (7) above. There are no future plans or need for these services once the ECAPE project is in place, and for this reason, and the reasons set forth in paragraph four (4) above, OMHA has no plans at this time to compete future