ODMR 2627-0005 Attachment C - Cost Proposal Form.pdf
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- Solicitation number
- SRC0000037033
- Issued by
- Ohio
About this file
This is a Cost Proposal Form (Attachment C) issued by the Ohio Department of Medicaid (ODM) for Request for Competitive Sealed Proposals ODMR 2627-0005, which seeks a qualified vendor to provide Provider Reimbursement Technical Assistance activities. The selected contractor will deliver expert assistance and consultation, operational support, and liaison activities for Medicaid healthcare business initiatives. Offerors must submit a completed cost proposal that reflects their full understanding of and commitment to perform the entire scope of work, including all program, preparatory, primary, and incidental costs at no additional expense to ODM. The contract term spans State Fiscal Years 26 through 31, with pricing required for each initial fiscal year and each renewal period.
Offerors must provide a detailed rate card identifying hourly rates and hours of effort for all staff positions, including Lead Medicaid Healthcare Business Expert, Medicaid Healthcare Business Manager, Medicaid Regulatory Analysts, Medicaid Financial and Budget Analysts, Medicaid Program Specialists, Medicaid Program Evaluators, Medicaid Program Researchers, Junior Financial and Budget Analysts, Junior Medicaid Program Specialists, and Junior Medicaid Program Evaluators. The proposed annual not-to-exceed cost must be firm and effective for the entire contract period, including renewals. Offerors must complete the cost proposal form with signatures from an authorized representative, including printed name, title, and contact information, and submit separate annual not-to-exceed cost totals for SFY26, SFY27, SFY28, SFY29, SFY30, and SFY31.
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Text version
ODMR 2627-0005
PROVIDER REIMBURSEMENT TECHNICAL ASSISTANCE
ATTACHMENT C – COST PROPOSAL FORM
Offerors are to use this Attachment C, Cost Proposal Form, sign and submit it fully completed as the separate Cost Proposal. The Cost Proposal Form requires interested Offerors to price those services defined in Specifications of Deliverables and to estimate the effort for the work based on the information in the RFP, resulting in a total not-to-exceed cost.
In calculating their total effort, Offerors must consider cost resulting from each Deliverable listed in the RFP, as well as all program, preparatory, primary, and incidental costs necessary to complete all program activities (whether explicitly identified by ODM in this RFP or not) at no additional cost to ODM. The Offeror’s not-to-exceed cost must take into account all costs incurred in the performance of this work.
The Selected Offeror for this project will be required to provide expert assistance and consultation, operational assistance, and liaison support activities for Provider Reimbursement Technical Assistance activities related to Medicaid healthcare business initiatives and work activities. Offeror Proposals submitted in response to this RFP must reflect the Offeror’s understanding of, and commitment to, perform this Scope of Work fully.
The Offeror must offer an annual not-to-exceed cost for each initial State Fiscal Year (SFY) and each renewal (i.e., 26, 27, 28, 29, 30, and 31) for the full and satisfactory performance of all applicable primary and incidental deliverables, tasks, and functions (whether explicitly identified by ODM in this RFP or not) necessary to complete the work as described in the RFP. The proposed annual not-to-exceed cost should be supported by a rate card for all staff identified in the RFP, as follows:
Key Personnel/Staff Title Hourly Rate # of Hours Dollar Amount Lead Medicaid Healthcare Business Expert
Medicaid Healthcare Business Manager
Medicaid Regulatory Analysts
Medicaid Financial and Budget Analysts
Medicaid Program Specialists
Evaluator(s)
Researcher(s)
Junior Financial and Budget Analyst(s)
Junior Medicaid Program Specialist(s)
Junior Medicaid Program Evaluator(s)
Offeror Name:
The cost offered below is firm and is effective for the entire Contract period, including renewal contracts, established in the RFP:
Total Cost: _________________________________
Offerors are to complete and sign this form and include it as their Cost Proposal.
Signature of Offeror’s authorized representative: __________________________________
Printed name, title, and contact information: __________________________________
SFY26 SFY27 SFY28 SFY29 SFY30 SFY31
Total Not-to-Exceed Cost
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