Questions and Responses Industry Day 7-14-2020.pdf

RFQ # OIG260145

Questions and Answers

Date: July 14, 2020

Question 1- With regards to organizational conflicts of interest (OCI), does the government anticipate that the awarded contract will include any limitation on future contracting language?

The government does not anticipate that there will be any limitations on future contracting language included in the contract. The Contractor shall have programs in place to identify, report, and mitigate actual and potential conflicts of interest for itself, its employees, subcontractors and consultants (OCI Mitigation Plan). It would be the responsibility of the Contractor to ensure that any future contracting or activities do not present conflicts of interest with this contract or such conflicts of interest can be mitigated in accordance with the OCI Mitigation Plan.

Question 2- To minimize proposal development costs and allow contractors to not have to develop orals while waiting for the phase 1 outcome, will the government allow at least two weeks from notice of phase 1 results to the orals start date? You mentioned the government’s timeline to finalize phase 1 results was 1 week. If that gets delayed, will the start date for orals be delayed to allow for two weeks?

Yes. We will allow two weeks for oral prep and ensure that timelines are adjusted accordingly.

Question 3- How does the government manage risk of conflicts on the current performance of the contract?

Offerors will be required to identify OCI and steps that will be taken to address or mitigate them. The OIG does not disclose oversight and mitigation strategies currently used under existing contracts. We look forward to reviewing OCI Mitigation Plans submitted by offerors in phase two, the Oral Presentation stage of the solicitation. The offeror will be required to submit a written in advance of the meeting

Question 4– Can the past performance/experience come from any member of the proposed vendor team?

Offerors should demonstrate prior experience (Factor 1 in the White Paper) of the Offeror as an entity and all other persons and entities with whom the Offeror intends to partner or contract to provide services under the awarded contract. Offerors should disclose whether key members of the Offeror in acquiring prior experience will no be members of the team for this project.

Question 5- Is the software solution currently in place to link claims & medical records, track reviews, and manage PDF docs available to bidders? Or will bidders need to propose their own solution? Please describe the software solution currently in place to request and track medical records. Is this solution available to the incoming contractor as part of the transition or is it proprietary and/or not preferred by the client?

There is no prescribed software solution. OIG currently uses Kiteworks for the secure transmission of medical and personally identifiable information. Transmissions is typically done as PDF documents. Any additional software and its intended use to be used by the offeror should be described in the White Paper and Oral Presentation.

Question 6- Will the government match the pricing proposal to validate that the subcontractor is being used at the rate proposed in their small business plan?

Question unclear. Please resubmit for clarity.

Question 7- Are there OCI restrictions relating to prime or subcontractors who also provide Medicare medical review services to CMS as a MAC, UPIC, RAC, QIC, or NQQIC/QIO?

There are no blanket restrictions in the solicitation, but offerors will need to identify potential conflict of interests in the solicitation and propose an OCI Mitigation Plan to address these conflicts. Please see the Statement response to Question 3.

Question 8- Regarding workload volumes, please clarify the volume of Medical Records received hard copy and the volume received as PDF files (or other electronic formats if applicable).

Please see the Statement of Objectives.

Question 9- Are Medical Records requests mailed to providers or is there another Medical Record request mechanism?

Please see the Statement of Objectives.

Question 10- Does the HHS IG reimburse providers for their Medical Record submissions? If so, what is the reimbursement rate and the total annual cost for these reimbursements?

Please see the Statement of Objectives.

Question 11- Can the HHS OIG provide historical annual costs and staffing levels for this contract?

Please segment any costs associated with provider reimbursement for photocopying/mailing (if applicable).

The OIG does not disclose the individual costs associated with past contracts. HHS OIG obtains the medical records for its audits. Please see the Statement of Objectives.

Question 12- Are there statutory, regulatory or policy documents that provide the authority language for these HHS IG reviews? This will help offerors ensure proposed solutions comply with all applicable requirements.

Please see the Statement of Objectives.

Question 13- Does the current HHS IG Medical Review contractor use the CMS esMD system for medical record requests and/or provider submissions?

No, we do not utilize the CMS system.

Question 14- If a prime contractor does not have (Factor 1) 2,000 health care related claims performed annually with a minimum contract dollar value of $1,000,000, can the prior experience of the subcontractor be used as demonstrated prior experience?

Please see the answer to Question #4 above.

Question 15- Can you please clarify the HHS Subcontracting goals (Subfactor B)

• Is the total SB goal 41% (including SDB, WOSB, HUBZone, SDVOSB, VOSB)

• Or is the total SB goal 60% (including SB, SDB, WOSB, HUBZone, SDVOSB, VOSB)

HHS Small Business for OIG

SB 47%

SDB 5%

WOSB 5%

Hub Zone 3%

SDVOSB 3%

Question 16- Please advise whether there is a deadline for receipt of or required format for any requests for clarification concerning this notice and associated documents.

Questions will be accepted up until the White Paper is due date.

Note to OMP: We don’t recommend adding the questions below or providing answers. We believe that the answers are generally covered in the material above.

Question - If we were to partner with another Health Information Management company for this government solicitation can experience be combined? They have been in business for 5 years and have more government coding experience. We have been in business for 3 years but have more auditing experience. My CEO has more than 17 years of coding, auditing, and continuing education experience.

Question - Can we utilize my CEO's auditing experience (including as a Recovery Audit Contractor) as well?

Question - Will you advise if Medicare Administrative Contractors (MAC) and/or subcontractors for a MAC will pose a conflict of interest? Kimberly Hornik asked a similar question at the end of the presentation today. OIG’s response was that they could answer this question after receiving there OCI response. Will OIG please advise if they can redact information from the claim that could mitigate a OCI with a contractor that performs reviews on MAC contracts.

Question - Would the government consider allowing a prime to meet one, two or three of five of the small business requirements with a total of 41% of the work executed by small business instead of meeting all five of the small business categories?

1. How are you sourcing the 2000-3000 leads? How do we know those are the best ones to go after?