RFP Document - 75H70424R00011A.pdf

Solicitation #: 75H70425R00011A Medicare Cost Reporting Services

SECTION B – PRODUCTS OR SERVICES AND PRICES/COSTS

B.1. TYPE OF CONTRACT (FAR 52.216-1 (APR 1984))

The Government contemplates award of a firm-fixed price contract resulting from this solicitation.

B.2. CONSIDERATION AND PAYMENT

The Contractor shall provide the commercial services described in Section C, Description/ Specifications/Work Statement. Except as otherwise specified in the contract, the Contractor shall furnish the necessary personnel, materials, services, facilities, and otherwise provide all tasks necessary for or incident to the performance of the work set forth herein.

B.3. CONTRACT PRICE

The total firm-fixed price of this contract is:

_______________ (Base Period, See Pricing Sheet)

______$62,500.00 (Base Period Travel, Not To Exceed)

_______________ (Option Period One, See Pricing Sheet)

______$62,500.00 (Option Period One Travel, Not To Exceed)

_______________ (Option Period Two, See Pricing Sheet)

______$62,500.00 (Option Period Two Travel, Not To Exceed)

_______________ (Option Period Three, See Pricing Sheet)

______$62,500.00 (Option Period Three Travel, Not To Exceed)

_______________ (Option Four, See Pricing Sheet)

______$62,500.00 (Option Period Four Travel, Not To Exceed)

_______________ TOTAL CONTRACT COST (Cumulative)

*Travel is to an estimated twenty five (25) facilities annually.

The Contractor shall be paid upon submission of an invoice and completion and acceptance (if deliverable) or verification (if service) by the Contracting Officer's Representative (COR), of the deliverables and/or services indicated below. Invoices shall be submitted in accordance with the instructions contained in FAR clause 52.232-25, Prompt Payment, and Section G.2 of this contract.

SECTION C – DESCRIPTION/SPECIFICATIONS/STATEMENT OF WORK

C. TITLE

Medicare Cost Reporting Services

C.1. BACKGROUND

The Indian Health Service (IHS) provides comprehensive primary health care and disease prevention services to approximately 2.1 million American Indians and Alaska Natives through a network of over 632 hospitals, clinics, and health stations on or near Indian reservations.

Facilities are predominantly located in rural primary care settings and are managed by IHS, Tribal, and Urban Indian health programs. The IHS provides a wide range of clinical, public health and community services primarily to members of 576 federally recognized Tribes. Under special legislative authority, Social Security Act (SSA), Title 18 and Title 19, the IHS is eligible for Medicare and Medicaid payment for services provided to these beneficiaries. The IHS is required to submit Medicare cost reports (Method A) to establish inpatient and outpatient Medicare and Medicaid rates used as the basis to set Medicare and Medicaid rates for reimbursement. Over $1 billion annually in collections from Medicare and Medicaid is used to maintain its current level of health care.

Contract support services are required to complete tasks associated with the annual submission of cost reports to the Centers for Medicare and Medicaid Services (CMS). Federal and tribal facilities operating within the Indian Healthcare Delivery System (IHDS) and participating in Medicare are obligated to file annual cost reports with CMS. Additionally, the Indian Health Service (IHS) is responsible for calculating and publishing 8 All-Inclusive Rates (AIR) in the Federal Register, which are used for Medicare and Medicaid reimbursement purposes. Moreover, facility-specific rates must be determined for hospitals designated as Critical Access Hospitals.

As part of this contract, the completion of Home Office Cost Reports is also required to be completed and submitted to CMS. In addition to these requirements, the contractor shall be expected to undertake additional tasks, such as completing an ancillary study, performing cost analysis, and fulfilling other duties associated with the completion of cost reports and calculating rates.

C.2. SCOPE OF WORK

The Contractor shall develop and deliver Medicare cost reports, management cost analyses, cost report variances/explanations, support to determine the cost of delivering health care and developing recommendations on cost of care for Medicare and Medicaid to support rate setting, CAH financial analysis, CMS Disproportionate Share Hospitals (DSH) Analysis, and an ancillary cost ratio development. In addition, the Contractor will be responsible for other deliverables associated with the completion of cost reports and calculating rates outlined in the requirements document.

C.3. SPECIFIC REQUIREMENTS (TASKS)

*See Requirements Document Attached.

Locations are as follows:

*See Locations Attachments (x3).

C.3. Tasks

C.3.1. Task 1: Kick-Off Meeting

C.2.1.1 Contractor shall schedule a kick-off meeting within 10 business days of the execution date of the contract (EDOC)

C.2.1.2 Compile an agenda for the kick-off meeting and send to the COR within 48 hours of the Kick-Off meeting

C.2.1.3 Present work plan. The work plan should be provided to the COR no later than 48 hours prior to the kick-off meeting

C.2.1.4 Incorporate feedback into the work plan within 7 days of the kick-off meeting

C.3.2. Task 2: Monthly Progress Reports

C2.2.1 The Contractor shall submit a monthly technical progress report to the Contracting Officer’s Representative (COR) within 10 calendar days after the end of each month. The report shall include a review of the activities by task undertaken to date; problems and barriers to implementation/completion that have arisen and agreed-upon solutions;

and activities planned for the next month addressing scope of work deliverables.

C.3.3. Task 3: Cost Report Preparation

The contractor shall be responsible for performing all necessary tasks required to prepare and submit up to 53 cost reports to the Centers for Medicare and Medicaid Services (CMS) on an annual basis. The contractor shall ensure the completion of the cost reports in accordance with all Medicare regulations and meet all deadlines outlined by Medicare to submit the reports to CMS on time. In the event that the cost reports are deemed unacceptable by CMS or a facility, the contractor shall work collaboratively with CMS, the facility, and other relevant staff to correct the report and resubmit it until it is deemed acceptable. Furthermore, in the event of an audit, the contractor shall actively cooperate with CMS, the facility, and all other relevant parties to address and resolve any audit concerns. The contractor may utilize cost reporting software of their choice, provided it complies with Medicare regulations.

The Indian Health Service (IHS) will provide the contractor with financial obligation and payroll data, as well as facility workload data, to assist in preparing the cost reports. If additional data is required to complete the cost report, the contractor shall provide specific guidance on the necessary data and propose a solution for gathering that data. The contractor shall also provide a uniform collection tool (that is in compliance with federal government policy) to gather the additional data needed to complete the cost report or calculate the All-Inclusive Rates from each facility.

C.2.4.1 Critical Access Hospital Cost (CAH) Reports: The contractor shall be responsible for gathering and compiling the necessary data and information required to create and submit cost reports for CAHs, in accordance with Medicare regulations. The cost reports will be submitted to the appropriate regulatory bodies in compliance with the reporting requirements by February 28 of each calendar year.

C.2.4.1.1 The contractor shall calculate and submit the specific CAH facility rates for the CAHs in accordance with Medicare regulations. The submission of these CAH facility rates shall be completed by February 28 of each calendar year. The IHS staff at the hospital will certify the draft cost reports.

C.2.4.2 Inpatient Prospective Payment System (IPPS) Cost Reports:

The contractor shall be responsible for gathering and compiling the necessary data and information required to submit cost reports for IPPS facilities, in accordance with Medicare regulations. The Contractor shall ensure conformity for of the cost reports per the Method-A model and provide uniform materials for collecting data. The IHS staff at the hospital will certify the draft cost reports. The cost reports will be submitted to the appropriate regulatory bodies by June 30 of each calendar year.

C.2.4.3 Home Office Cost Report Preparation

The contractor shall be responsible for gathering and compiling the necessary data and information required to create comprehensive cost reports for tribal and federal home office cost reports in accordance with Medicare regulations. The contractor shall ensure conformity of the cost reports with the Method-A model and provide uniform materials for data collection. The staff at the appropriate home office will be responsible for certifying the draft cost report. Home office cost reports associated with CAH cost reporting are due February 28, the remaining are due March 31 each calendar year.

C.2.4.4 Rural Emergency Health (REH) Cost report The contractor shall be responsible for gathering and compiling the necessary data and information required to create and submit cost reports for REHs, in accordance with Medicare regulations. The cost reports will be submitted to the appropriate regulatory bodies in compliance with the reporting requirements by February 28 of each calendar year C.2.4.5 The Contractor shall conduct site visits, as appropriate, to gather the required data for the preparation of the cost reports. Additionally, the contractor shall conduct an introductory meeting at the beginning of the site visit, followed by an exit Conference to debrief all parties involved on the findings and any follow-up items. The Contractor shall schedule pre-meetings virtually with the sites to ensure they are aware of the purpose of the site visit.

Moreover, the contractor will schedule virtual post-meeting calls if additional information is needed. It is important to note that site reviews may not be necessary for all facilities on an annual basis. The decision on which facilities to visit and at what time is at the discretion of the contractor. Draft copies of the cost report and any discussion items will be made available prior to the site visit.

C.2.4.6 The contractor shall provide responses to CMS audit staff upon their review of the cost reports. The contractor shall respond within the timeframe given by CMS and IHS staff on follow up questions.

C.2.4.7 In addition to preparation of the cost reports, the Contractor shall compare fully allocated costs from IHS data on Worksheet B, Part 1, to the prior year cost report. Where significant variances are noted, further review of inquiry must be made and documented, including written responses to CMS and IHS upon request. This analysis must be done prior to September 30 each year.

C.2.4.8 The contractor shall conduct a Low Payment Volume Analysis. This analysis should identify payment trends, evaluate operational costs against these low volumes, review specific diagnosis-related groups contributing to lower payments, assess any associated risks, and offer recommendations for optimization. Upon completion, a detailed report summarizing your findings and actionable insights will be invaluable.

Our primary aim is to enhance our processes for better reimbursement and adherence to regulatory guidelines.

C.2.4.8 The contractor will provide documentation to the COR at the end of each cost reporting cycle. The documentation will include, but may not be limited to, the 51 completed cost reports, summary documents and/or cover page explaining the methodology used to complete the cost reports, and other pertinent documentation deemed necessary by the COR and/or the program office. Their main point of contact for each cost report location will be listed on the summary page for each cost report record.

A full list of cost report locations and due dates can be found on Locations Attachment A.

C.3.4. Task 4: Develop All Inclusive Rate (AIR)

On an annual basis, IHS calculates and publishes, in the Federal Register, 8 specific calendar year reimbursement rates. These rates are often referred to as the All-Inclusive Rates (AIR), Office of Management and Budget (OMB) rates, or encounter rates.

Due to the higher cost of living in Alaska, separate rates are calculated for Alaska and the Lower 48 States. The 8 specific rates are as follows:

• Inpatient Hospital Per Diem Rate

1. Lower 48 States

2. Alaska

• Outpatient Per Visit Rate (Excluding Medicare)

3. Lower 48 States

4. Alaska

• Outpatient Per Visit Rate (Medicare)

5. Lower 48 States

6. Alaska

• Medicare Part B Inpatient Ancillary Per Diem Rate

7. Lower 48 States

8. Alaska

Before September 30 of each calendar year the contractor shall:

C.2.4.1 Gather all required data necessary to calculate the 8 specific All- Inclusive Rates (AIR), perform the calculations, and provide the rates to the COR in a format consistent with historical practices.

C.2.4.2 Provide documentation that explains the methodology, identifies mathematical elements utilized in the calculations, and identifies the data sources employed for determining the rates. Provide variance analysis for the rates which includes reasons why rates are going up or down. The contractor may be required to explain these documents to various IHS and Tribal staff members.

C.2.4.3 Collaborate and provide IHS with document to assist with the development with briefing documents that substantiate the proposed rates and adhere to IHS current best practices. The contractor may be required to be present at these briefings C.2.4.4 Provide documents that can be used to update the AIR webpage.

C.2.4.5 Participate in a rate preview and data verification process to support the development of the AIRs. This task entails providing estimated rates and working in collaboration with IHS and tribal staff to ensure the accuracy of the data utilized in the AIRs calculations. Although we anticipate the AIR preview to take place on October 15th annually, it could potentially occur as early as June or July.

C.3.5. Task 5: Various Management Reports and tasks The Contractor shall submit management reports on an ongoing basis. The contractor shall extract information for the reports from the Medicare cost reports, national inpatient and outpatient workload data, Medicare and other legislation affecting or potentially affecting IHS revenue, ancillary costs reviews and studies and historical knowledge regarding IHS unit cost and Medicare and Medicaid method(s) of payment to IHS facilities.

As the Medicare cost reports are being completed, the Contractor shall gather information on workload from several National IHS data sources and compile information from each of the hospitals to identify Medicare and Medicaid billable workload. After the cost reports have been completed, the Contractor shall summarize applicable cost report data elements and integrate IHS workload data to form a basis to evaluate and analyze cost of delivering health care in IHS facilities. This analysis is the basis for determining the per diem payments for Medicare and Medicaid inpatient and outpatient services.

The Contractor shall provide special expertise and assistance to help the IHS in its review and interpretation of the Medicare hospital cost reports planned for completion during the contracting period. The Contractor shall provide data analysis and integration of the Medicare and Medicaid workload with the Medicare hospital cost reports to assist in the development of individual hospital estimates of the costs for a wide range of inpatient and outpatient services. Based on this analysis, the Contractor shall assist IHS in evaluating alternatives for use in evaluating cost and to consider in the development of rates.

C.2.5.1 Management reports include:

1. Summary of payments made by the Medicare Fiscal Intermediary (FI) (from Program

Summary and Reimbursement [PS&R]), data with a view toward identifying areas where additional revenue may be possible

2. Comparison of hospital cost, workload and unit cost for each hospital, Fiscal Years

(FY) 2025-2029, where Medicare hospital cost reports were completed

3. A report evaluating interim Calendar Year (CY) inpatient and outpatient rates and revenue impacts for CAH facilities and recommending rate changes as appropriate

4. An evaluation of financial impact potential for the conversion of selected hospitals to

CAH status or REH status or back to IPPS

5. Developing outpatient visit workload and finalizing inpatient workload consistent with FY cost reports for the Lower 48 state facilities and Alaska

6. Questionnaires provided to facilities and templates used to prepare and complete cost reports provided electronically

7. Ancillary cost review and ratio development (only available for the Option Period 1 and Option Period 4, See Section C.3.7 Task 7).

C.3.6. Task 6: Disproportionate Share Hospital (DSH) Reimbursement Calculation

Disproportionate Share Hospital Reimbursement is an add-on to DRG payments for hospitals that serve a large number of low-income patients for which virtually all IHS non-CAH hospitals qualify.

C.2.6.1: Prior to June 30 each year. The contractor shall complete the following analysis to determine the DSH reimbursement rate as part of the cost report development as follows:

1. Obtain raw data for analysis from federal and tribal facilities

2. Perform various data validation exercises to normalize the total patient data

3. Verify patient Medicaid eligibility through third party vendor

4. Analyze and test the validity of the Medicaid eligibility information obtained or received from third party vendors.

5. Ensure patients identified as Medicaid by the Hospital have proper Medicaid eligibility information.

6. Perform out-of-state eligibility analysis

7. Perform separate analysis to match newborns with mother’s eligibility.

8. Review and test proposed final eligibility results.

9. Respond to any related audit questions by CMS Fiscal

Intermediary by working with the hospitals to fulfill documentation requests and responding to questions.

C.3.7. Task 7: Conversion analysis report C.2.7.1 The contractor shall prepare an annual report for the Indian Health Service (IHS) that outlines any recommended facilities that may benefit from converting to Critical Access Hospital (CAH) or Rural Emergency Hospital (REH) status by September 30 of each calendar year.

This process involves conducting reports and analyses of financial and workload data, specifically evaluating the applicability of conversion to CAH or REH status. The contractor shall project revenue and workload data for current CAHs and other hospitals that meet the requirement of having 25 or fewer beds. In cases where CAH audits by the Medicare Fiscal Intermediary (FI) identify areas for improvement, follow-up work shall be conducted. For potential conversion sites, the contractor shall provide technical assistance to support the transition to CAH or REH status. Additionally, the contractor shall develop a report summarizing selected information from the cost reports and data from the Medicare FI Payment System. This report will assist IHS sites in evaluating the potential for converting to CAH or REH status and assessing the impact of prior-year conversions. Regular analyses may be conducted to assist the IHS in determining if certain facilities would benefit from a cost perspective by converting to CAH or REH status.

C.3.8. Task 8: Work plan

C.2.8.1 The contractor shall create a work plan to be included with their proposal and evaluated by the Technical Evaluation Panel. The work plan document should clearly outline your plan of action to execute the tasks outlined in this PWS. The plan should clearly delineates roles and responsibilities between the contractor, federal staff and our tribal partners, includes a timeline with major milestones deadlines. The plan should also identify sources of data required to complete the cost reports and calculate the rates and if it is the contractor’s or federal staff’s responsibility to collect/furnish that data. The work plan can be completed in the software program of the contractor’s choice. The work plan will be created for the Base Period, then updated for each Option Period.

C.2.8.2 Present the work plan at the kick-off meeting

C.3.9. Task 9 Revenue Cycle Analysis (optional task)

A revenue cycle analysis in a healthcare setting, such as a hospital or clinic, involves a comprehensive review of processes and practices associated with revenue cycle management. This analysis traverses the entire patient care journey, from initial appointment scheduling and patient registration to the final payment collection. It aims to identify inefficiencies, errors, and potential areas for improvement in key components of the revenue cycle. Third-party revenue is a critical aspect of operations in our IHS facilities. Efficient revenue cycle operations allow these facilities to enhance their financial health, streamline operational efficiency, and provide superior patient care.

C.2.9.1 The contractor shall conduct a comprehensive revenue cycle analysis. The contractor will interview relevant staff and gather all data necessary to perform this extensive review. The review can be conducted in-person or virtually, as decided by the contractor and the

COR.

C.2.9.2 The contractor will provide a detailed report of their findings. This report will include an executive summary, a summary of findings, process flows, visual aids, recommendations, suggested improvements, and next steps.

C.2.9.3 Present report of findings to relevant IHS facility staff and other stakeholders as determined by the contractor and the COR.

C.3.10. Task 10: Ancillary Ratio Development (Optional Task)

C.2.10.1 Perform the ancillary study and develop the ancillary ratio The objective of the ancillary cost study is to develop an ancillary ratio that is representative of the population, is statistically valid, auditable, and supportable with patient charts. Rather than utilizing 82 separate universes and 82 different sample selections (41 inpatient and 41 outpatients), the population should be a combination of all facilities into only four separate universes (Critical Access Hospitals and Non- Critical Access Hospitals). Samples will be selected from the following four subsets.

- Critical Access Hospital Inpatients

- Critical Access Hospital Outpatients

- Other Hospital Inpatients

- Other Hospital Outpatients

A total of the 2,220 patient charts shall be reviewed to document the cost relationship between an inpatient day and an outpatient visit. The total chart samples should include 1,067 inpatient charts and 1,153 outpatient charts should be reviewed for the nine CAH’s. Two sample frames for the CAH inpatient chart review be drawn and a second frame be utilized if the first review results in an outpatient to inpatient ratio above 60% or below 20%. Should the second sample frame review be necessary, the second frame ancillary outpatient ratio result should be utilized for the CAH’s.

For the non- CAH hospitals to be reviewed, a total of 749 inpatient charts and a total of 769 outpatient charts should be reviewed. It is believed that a 769 outpatient chart review or 95% confidence level is necessary because of the large variation in the size of each of the remaining hospitals.

Specific optional task requirements include:

A. Coding and pricing of ancillary services for all charts including inpatient charts (admissions) and outpatient charts (visits) provided by each facility in accordance with Medicare reimbursement rules to be provided by IHS. A certified coder is required to code all the charts. Chart documentation must be maintained on coded charts with the summary file submitted.

B. A summary by Service Unit of each inpatient and outpatient cost by revenue code utilizing the guideline provided by IHS in excel format.

C. The Contractor shall provide an electronic record (copies) of the charts provided by the hospitals listing of charts by patient and specific medical coding and pricing by patient and revenue code to the Service Unit to enable CMS and/or the FI to review and audit if necessary.

D. The Contractor shall provide a summary of all facilities on excel spreadsheet. The Contractor shall also provide summary statistics for all facilities in excel format of evaluation and maintenance codes and revenue codes. The ancillary costs analysis shall include two face to face meetings with the COR for Option Period 1 and Option Period 4.

C.3.11. Task 11 – Urban Indian Organization AIR Development (Optional) The IHS enters into limited, competing contracts and grants with non-profit organizations as defined in 501(c)(3) of the Internal Revenue Code to provide health care and referral services for Urban Indians throughout the United States. Urban Indian Organizations (UIO) are defined under the Indian Health Care Improvement Act (IHCIA). Urban Indian Organizations are non-profit corporate bodies situated in an urban center, governed by an Urban Indian-controlled board of directors. The 41 Urban Indian Organizations provide unique access to culturally appropriate and quality health care for Urban Indians. This task will require the contractor to gather and analyze information from 15 of 29 UIO ambulatory health centers.

As part of this contract, there is an option to develop an Urban Indian Organization All- Inclusive Rate (UIO AIR) or multiple UIO AIRs that will be used for reimbursing Urban Indian Organizations for Medicaid outpatient encounters. These rates will be published annually before December 31, following the existing IHS AIR methodology. Below, we outline the tasks required to fulfill this optional requirement.

C.2.11.1 Methodology Development: The contractor, in collaboration with the Contracting Officer's Representative (COR) and the UIO point of contact (POC), shall develop the methodology required to establish a single UIO AIR or up to six distinct UIO AIRs. This methodology must include a comprehensive guide outlining the new approach. Additionally, the contractor will be responsible for creating all necessary forms to collect the information required for calculating the UIO Rate(s). The contractor should also ensure compliance with any state or CMS audit requirements if an audit of the rate is required.

C.2.11.2 Information and Data Gathering: The contractor shall interface with UIOs either virtually or in person, as deemed necessary by the contractor, the COR and the UIO POC, to collect and analyze the required information for implementing the methodology established in

C.2.11.3. A uniform collection methodology will be developed by the contractor to gather the data and information needed to implement the methodology established in C.2.11.1. The contractor will provide training as necessary to gather and transmit the required information from the UIOs. The contractor is required to gather information and data from at least 15 out of the 29 UIOs. The methodology developed must meet IHS privacy standards and is subject to review and approval by the IHS privacy officer.

C.2.11.4 Meetings and Briefings: The contractor shall actively participate in meetings and briefings as needed to explain and describe the UIO AIR methodology.

Collaboratively with the COR and the UIO POC, the contractor shall develop briefing materials necessary for publishing the UIO AIR(s) annually in the Federal Register.

Additionally, the contractor will be expected to undertake various tasks, including cost and/or payment analysis and other duties associated with completing the UIO AIR methodology.

C.2.11.5 The contractor shall provide documentation to the COR at the end of each cost reporting cycle. The documentation will include, but may not be limited to, the 15 completed cost reports, summary documents and/or cover page explaining the methodology used to complete the cost reports, and other pertinent documentation deemed necessary by the COR and/or the program office. Their main point of contact for each cost report location will be listed on the summary page for each cost report record.

C.2.11.6 The contractor shall provide draft Urban Indian Organization AIRs by August 15 each calendar year with the goal of publishing final rates before December 31 each calendar year.

A full list of potential cost report locations can be found on Locations Attachment B.

C.3.12. Youth Regional Treatment Centers (YRTC) AIR Development

As part of this contract, there is an option to develop a Youth Regional Treatment Centers (YRTC) All-Inclusive Rate (AIR) or multiple YRTC AIRs that will be used for reimbursing Youth Regional Treatment Centers for Medicaid outpatient and inpatient encounters. These rates will be published annually before December 31, following the existing IHS AIR methodology. Below, we outline the tasks required to fulfill this optional requirement.

C.2.12.1 Methodology Development: The contractor, in collaboration with the Contracting Officer's Representative (COR) and the YRTC point of contact (POC), shall develop the methodology required to establish a single YRTC AIR or up to six distinct YRTC AIRs. This methodology must include a comprehensive guide outlining the new approach. Additionally, the contractor will be responsible for creating all necessary forms to collect the information required for calculating the YRTC Rate(s). The contractor should also ensure compliance with any state or CMS audit requirements if an audit of the rate is required.

C.2.12.2 Information and Data Gathering: The contractor shall interface with YRTCs either virtually or in person, as deemed necessary by the contractor, the COR, and the YRTC POC, to collect and analyze the required information for implementing the methodology established in

C.2.12.3. A uniform collection methodology will be established by the contractor to gather the data and information needed to implement the methodology established in C.2.12.1. The contractor will provide training as necessary to gather and transmit the required information from the YRTCs. The contractor is required to gather information and data from at up to 7 YRTCs. The exact number will be decided by the COR and the YRTC POC. The methodology developed must meet IHS privacy standards and is subject to review and approval by the IHS privacy officer.

C.2.12.4 Meetings and Briefings: The contractor shall actively participate in meetings and briefings as needed to explain and describe the YRTC AIR methodology. Collaboratively with the COR and the YRTC POC, the contractor shall develop briefing materials necessary for publishing the YRTC AIR(s) annually in the Federal Register. Additionally, the contractor will be expected to undertake various tasks, including cost and/or payment analysis and other duties associated with completing the YRTC AIR methodology.

C.2.12.5 The contractor shall provide documentation to the COR at the end of each cost reporting cycle. The documentation will include, but may not be limited to, the 7 or more completed cost reports, summary documents and/or cover page explaining the methodology used to complete the cost reports, and other pertinent documentation deemed necessary by the COR and/or the program office. Their main point of contact for each cost report location will be listed on the summary page for each cost report record.

C.2.12.6 The contractor shall provide draft Youth Regional Treatment Centers (YRTC) AIRs by August 15 each calendar year with the goal of publishing final rates before December 31 each calendar year.

A full list of cost report locations can be found on Locations Attachment C.

C.3.13. Deliverables Table

Task Deliverable:

Delivery method Due Date:

C.2.1 Task 1: Kick-Off Meeting

C.2.1 Schedule Kick-Off Meeting

Electroni c meeting Zoom or teams or equivale nt

Within 5 working days of The execution date of the contract

C.2.1.2 Create Agenda

Electroni c via email within 24 hours of the Kick-Off meeting

C.2.1.3 Present comprehensive event plan

Electroni c via email

No later than 48 hours prior to the kick-off meeting

C.2.1.4 Incorporate feedback

Electroni c via email within 7 days of the kick-off meeting

C.2.2 Task 2: Monthly Progress Report

C.2.2.1 Monthly Status Report

Electroni c via email

Within 10 calendar days after each month end

C.2.3 Task 3: Cost Report Preparation

C.2.4.1 Critical Access Hospital Cost (CAH) Reports

Electroni cally to

CMS

by February 28 each calendar year

C.2.4.1.1 Calculate CAH Rates

Electroni cally to

CMS

by February 28 each calendar year

C.2.4.2 Inpatient Prospective Payment System (IPPS) Cost Reports

Electroni cally to

CMS

By June 30 each calendar year

C.2.4.3 Home Office Cost Report Preparation

Electroni cally to

CMS

Home office cost reports associated with CAH cost reporting are due February 28, the remaining are due March 31 each calendar year.

C.2.4.4 Rural Emergency Hospital Cost Report Preparation

Electroni cally to

CMS

by February 28 each calendar year

C.2.4.5 Conduct site visits as appropriate various As needed

C.2.4.6 Participate and provide responses to CMS auditors

Electroni c meeting Zoom or teams or equivale nt As needed

C.2.4.7 Compare worksheet B, Part 1 to prior years cost reports

Electroni cally via email by September 30 each year

C.2.4.8 The contractor shall conduct a Low Payment Volume Analysis

Electroni cally via email by September 30 each year

C.2.4 Task 4: Develop All-Inclusive-Rates

C.2.4.1 Provide the 8 rates to the COR Electroni cally by September 30 each calendar year

C.2.4.2 Provide documentation that explains the methodology

Electroni cally by September 30 each calendar year

C.2.4.3 Assist to develop briefing documents

Electroni cally by September 30 each calendar year

C.2.4.4 Assist to update AIR webpage Electroni cally by September 30 each calendar year

C.2.4.5 Participate in a rate preview and data verification process

Electroni cally by September 30 each calendar year

C.2.5 Task 5: Various Management Reports and Tasks

C.2.5.1 Complete the various management reports as outlined the PWS

Electroni cally As needed

Task 6:

Disproportionate Share Calculations

C.2.6.1 Complete tasks and calculate DSH calculations

Electroni cally

By June 30 each calendar year

Task 7:

Conversion Analysis

C.2.7.1 Complete and submit the conversion analysis

Electroni cally by September 30 each calendar year

Task 8: Work plan

C.2.8.1 Create a work plan to be included with their proposal

Electroni cally at the beginning of the base year and the beginning of each option period

C.2.8.2 Present the work plan at the kick-off meeting Virtually

Optional Tasks C.2.9 Ad-Hoc Analysis C.2.9.1 Conduct Revenue Cycle Analysis Virtual or in-person C.2.9.2 Report of findings Electronic C.2.9.3 Present report of findings Virtual C.2.10 Ancillary Ratio Development

C.2.10.1 Perform the ancillary study and develop the ancillary ratio electroni cally As needed

C.2.11 Urban Indian Organization AIR Development

C.2.11.1

Provide documentation on the methodology and provide the UIO rate(s) to the COR

Electroni cally

Aug 15 each Calendar Year

C.2.11.2 Collect and analyze data for implementing methodology

Electroni cally

Aug 15 each Calendar Year

C2.11.3 Gather information and data from UIOs

Electroni cally

Aug 15 each Calendar Year

C2.11.4 Assist in developing briefing documents

Electroni cally

C.2.11.5 provide documentation to the COR at the end of each cost reporting cycle

Electroni cally

Sept 30 each Calendar Year

C.2.11.6 provide draft Urban Indian Organization AIRs

Electroni cally

Aug 15 each Calendar

C.2.12 YRTC AIR Development

C.2.12.1

Provide documentation on the methodology and provide the YRTC rate(s) to the COR

Electroni cally

Aug 15 each Calendar Year

C.2.12.2 Collect and analyze data for implementing methodology

Electroni cally

Aug 15 each Calendar Year

C2.12.3 Gather information and data from

YRTC

Electroni cally

Aug 15 each Calendar Year

C2.12.4 Assist in developing briefing documents

Electroni cally

Aug 15 each Calendar Year

C2.12.5 provide documentation to the COR at the end of each cost reporting cycle

Electroni cally

Sept 30 each Calendar Year

C2.12.6 provide draft Urban Indian Organization AIRs

Electroni cally

SECTION D – PACKAGING AND MARKING

D.1. PACKAGING

All deliverables shall be preserved, packaged, and packed in accordance with normal commercial practices to meet the packing requirements of the carrier including that which is necessary to prevent deterioration and damages due to the hazards of shipping, handling, and storing.

D.2. MARKING

Each package/container shall be delivered to the address shown in Section G.1.3 entitled “Contracting Officers’ Representative Appointment and Authority” and shall be clearly marked as follows:

A. Name of Contractor

B. Contract Number C. Description of Items Contained Therein D. Consignee’s Name and Address

SECTION E – INSPECTION AND ACCEPTANCE

E.1. INSPECTION AND ACCEPTANCE

All work under this contract is subject to inspection and final acceptance by the Contracting Officer or the duly authorized representative of the government. The COR, as a duly authorized representative of the Contracting Officer, shall assume the responsibilities for monitoring the Contractor’s performance, evaluating the quality of services provided by the Contractor, and performing final inspection and acceptance of all deliverables and services called for by the contract.

E.2. FEDERAL ACQUISITION REGULATION (48 CFR CHAPTER 1) CLAUSES

FAR Clause No. Title and Date 52.246-04 Inspection of Services – Fixed Price (AUG 1996)

SECTION F – DELIVERIES OR PERFORMANCE

F.1 PERIOD OF PERFORNMANCE

The period of performance is a base period of 12 months with four (4) 12 month option periods, unless the period is extended by modification to this contract. The Government may exercise options to extend the period of performance in accordance with FAR Clause 52.217-9 – Option to Extend the Term of the Contract (MAR 2000); upon written notification by the Contracting Officer within 30 days of contract expiration.

The period of performance shall be as follows:

Base Period: 10/01/2024 through 9/30/2025 Option Period One: 10/01/2025 through 9/30/2026 Option Period Two: 10/01/2026 through 9/30/2027 Option Period Three: 10/01/2027 through 9/30/2028 Option Period Four: 10/01/2028 through 9/30/2029

F.2. PLACE OF PERFORMANCE

The Contractor shall perform the required services at the IHS hospitals and Area and Headquarters Offices including the following Government site:

U.S. Department of Health and Human Services Indian Health Service

Office of Resource Access and Partnerships 5600 Fishers Lane Rockville, MD 20857

F.3. DELIVERABLE SCHEDULE

The Contractor shall submit the below deliverable items to the COR at the address shown in Section G.1.3.

Items specified for delivery below are subject to the review and approval of the COR prior to acceptance. The Contractor shall be required to make revisions deemed necessary by the COR.

Task: Deliverable: Due Date:

Kickoff Meeting Kick off call Within 5 working days of contract execution date Monthly Progress Reports Monthly Status Report Within 10 calendar days after each month end Business Associate Agreement, Confidentiality and Records Sharing Agreement, Required Trainings

BAA, CARSA, Required Trainings

Within 10 calendar days of the contract execution date.

Critical Access Hospital Cost Reports

Cost reports delivered to CMS February 28th each calendar year

Method A Cost Reports Cost reports delivered to CMS June 30th each FY Disproportionate Share Hospital Reimbursement Analysis Report

DSH analysis report annually 60 days following September 30 each year

Critical Access Hospital Analysis Report

CAH analysis report annually 60 days following September 30 each year

All Inclusive Rate Calculation AIR Analysis & Proposal 60 days following September 30 each year

Ancillary Ratio Analysis Report

Ancillary Ratio Analysis Report

60 days following September 30th in Option years 2 & 4.

F.4. DELIVERY REQUIREMENTS

When a deliverable due date occurs on a weekend or a Government holiday, the deliverable will be due on the following Government business day.

GOVERNMENT HOLIDAYS

New Year’s Day January 1

Martin Luther King’s Birthday Third Monday in January President’s Day Third Monday in February Memorial Day Last Monday in May Juneteenth (NID) June 19 Independence Day July 4 Labor Day First Monday in September Columbus Day Second Monday October Veteran’s Day November 11 Thanksgiving Day Fourth Thursday November Christmas Day December 25

SECTION G – CONTRACT ADMINISTRATION

G.1. AUTHORITIES OF GOVERNMENT PERSONNEL

Notwithstanding the Contractor’s responsibility for total management during the performance of this Contract, the administration of the Contract will require maximum coordination between the Government and the Contractor. The following individuals will be the Government’s points of contact during the performance of this Contract.

G.1.1. Contracting Officer

The IHS Contracting Officer is the only individual authorized to modify this Contract. The Contracting Officer responsible for administrative and contractual issues concerning this Contract is:

Kenneth Truesdale, Deputy Director – Division of Acquisition Policy Indian Health Service/ Division of Acquisition Policy 5600 Fishers Lane, M/S 09E70 Rockville, MD 20857 Phone: N/A Email: kenneth.truesdale@ihs.gov

All communications pertaining to contractual and/or administrative matters under the contract shall be sent to the address above and to the following Contract Specialist:

G.1.2. Contract Specialist mailto:kenneth.truesdale@ihs.gov

All Contract administration shall be performed by:

Brendon Moran, Contracting Officer Indian Health Service/Division of Acquisition Policy 5600 Fishers Lane, M/S 09E70 Rockville, MD 20857 Phone: N/A Email: brendon.moran@ihs.gov

G.1.3. Contracting Officer’s Representative Appointment and Authority

The name and address of the COR assigned to this project is:

Announced Upon Award, Contracting Officer’s Representative Indian Health Service/Office of Resource Access & Partnership 5600 Fishers Lane, M/S 09E70 Rockville, Maryland 20857 Phone: N/A; Fax: N/A; Email: Announced Upon Award Technical Monitoring:

a) Performance of work under this contract must be subject to the technical direction of the Contracting Officers’ Representative identified above, or a representative designated in writing.

The term “technical direction” includes, without limitation, direction to the contractor that directs or redirects the labor effort, shifts the work between work areas or locations, fills in details and otherwise serves to ensure that tasks outlined in the work statement are accomplished satisfactorily.

(b) Technical direction must be within the scope of the specification(s)/work statement.

The Contracting Officers’ Representative does not have authority to issue technical direction that:

(1) Constitutes a change of assignment or additional work outside the specification(s)/statement of work;

(2) Constitutes a change as defined in the clause entitled “Changes”;

(3) In any manner causes an increase or decrease in the contract price, or the time required for contract performance;

(4) Changes any of the terms, conditions, or specification(s)/work statement of the contract;

(5) Interferes with the contractor's right to perform under the terms and conditions of the contract; or

(6) Directs, supervises or otherwise controls the actions of the contractor's employees.

(c) Technical direction may be oral or in writing. The Contracting Officers’ Representative shall confirm oral direction in writing within five work days, with a copy to the Contracting Officer.

mailto:brendon.moran@ihs.gov

(d) The contractor shall proceed promptly with performance resulting from the technical direction issued by the Contracting Officers’ Representative. If, in the opinion of the contractor, any direction of the Contracting Officers’ Representative, or his/her designee, falls within the limitations in (b), above, the contractor shall immediately notify the Contracting Officer no later than the beginning of the next Government work day.

(e) Failure of the contractor and the Contracting Officer to agree that technical direction is within the scope of the contract shall be subject to the terms of the clause entitled “Disputes.”

G.2. INVOICE SUBMISSION

The Contractor shall submit invoices once per month. A complete invoice with all required back-up documentation shall be submitted electronically to the Invoice Processing Platform (IPP). Additional information at: Invoice Processing Platform (treasury.gov).

In addition, a back-up copy of the invoice shall be sent electronically via e-mail to:

1. Contract Specialist* (CS): Brendon Moran, brendon.moran@ihs.gov

2. Contracting Officer’s Representative (COR): Announced Upon Award

* No other non-invoice related documents (i.e. deliverables, reports, balance statements) shall be sent to the CS or the COR. Failure to submit directly to the IPP and offices listed above will delay prompt payment of your invoice.

For invoices submitted by email: the subject line of your email invoice submission shall contain the contractor name, contract number, and invoice. The Contractor shall send one email per contract monthly. The email may have multiple invoices for the contract. Invoices must be in one of the following formats: PDF, TIFF, or Word. No Excel formats will be accepted. The electronic file cannot contain multiple invoices; example, 10 invoices requires 10 separate files (PDF, TIFF, or Word).

Additionally, the Contractor is required to include its Data Universal Numbering System (DUNS) number on each invoice. For additional information about the Dun & Bradstreet (D&B) DUNS number, please visit http://fedgov.dnb.com/webform.

Invoices shall be submitted in accordance with the contract terms, i.e. payment schedule, progress payments, partial payments, deliverables, etc.

All information set forth in FAR Clause 52.212-4(g), Invoice, must be included in all invoices for it to constitute a proper invoice.

FAR 52.212-4(g) Invoice.

(1) The Contractor shall submit an original invoice and three copies (or electronic invoice, if authorized) to the address designated in the contract to receive invoices. An invoice must include-https://fiscal.treasury.gov/ipp/ mailto:brendon.moran@ihs.gov http://fedgov.dnb.com/webform

(i) Name and address of the Contractor;

(ii) Invoice date and number;

(iii) Contract number, contract line item number and, if applicable, the contract number;

(iv) Description, quantity, unit of measure, unit price and extended price of the items delivered;

(v) Shipping number and date of shipment, including the bill of lading number and weight of shipment if shipped on Government bill of lading;

(vi)Terms of any discount for prompt payment offered;

(vii) Name and address of official to whom payment is to be sent;

(viii) Name, title, and phone number of person to notify in event of defective invoice;

(ix) Taxpayer Identification Number (TIN). The Contractor shall include its TIN on the invoice only if required elsewhere in this contract.

(x) Electronic funds transfer (EFT) banking information.

(A) The Contractor shall include EFT banking information on the invoice only if required elsewhere in this contract.

(B) If EFT banking information is not required to be on the invoice, in order for the invoice to be a proper invoice, the Contractor shall have submitted correct EFT banking information in accordance with the applicable solicitation provision, contract clause (e.g., 52.232-33, Payment by Electronic Funds Transfer-Central Contractor Registration, or 52.232-34, Payment by Electronic Funds Transfer-Other Than Central Contractor Registration), or applicable agency procedures.

(C) EFT banking information is not required if the Government waived the requirement to pay by EFT.

(2) Invoices will be handled in accordance with the Prompt Payment Act (31 U.S.C. 3903) and Office of Management and Budget (OMB) prompt payment regulations at 5 CFR Part 1315.

In accordance with OMB Memorandum, M-11-32, Agencies shall make payments to small businesses as soon as practicable, with the goal of making payments within 15 days of receipt of a proper invoice. If a small business contractor is not paid within this (15 day) accelerated period, the contractor will not be given a late-payment interest penalty. Interest penalties, as prescribed by the Prompt Payment Act, remain unchanged by means of this memorandum. All small businesses shall label all invoices as “Small Business.”

Additionally, in accordance with OMB Memorandum, M-12-16, all prime contractors are encouraged to disburse funds received from the Federal Government to their small business subcontractors in a prompt manner. To assist prime contractors in expediting contractor payments to small business subcontractors, Agencies shall, to the full extent permitted by law, temporarily establish an earlier, accelerated date for making agency payments to all prime contractors. Consistent with OMB Memorandum M-11-32 above, Agencies shall have a goal of paying all prime contractors within 15 days of receiving proper documentation. In an effort to support small business growth, drive economic activity and job creation, the Contractor is encouraged to accelerate payments to their small business subcontractors.

https://www.acquisition.gov/far/current/html/52_232.html#wp1153351 https://www.acquisition.gov/far/current/html/52_232.html#wp1153375 http://uscode.house.gov/uscode-cgi/fastweb.exe?getdoc+uscview+t29t32+1665+30++%2831%29%20%20AND%20%28%2831%29%20ADJ%20USC%29%3ACITE%20%20%20%20%20%20%20%20%20

In accordance with the requirements of the Debt Collection Improvement Act of 1996, all payments under this contract will be made by electronic funds transfer (EFT). The Contractor shall provide financial institution information to the Finance Office designated above in accordance with FAR 52.232-33 Payment by Electronic Funds Transfer - Central Contractor Registration.

Failure to submit directly to the offices listed above will…