HHSM-500-2017-RFP-0016.pdf

HHSM-500-2017-RFP-0016

SOLICITATION, OFFER AND AWARD

4. TYPE OF SOLICITATION2. CONTRACT NUMBER 3. SOLICITATION NUMBER

7. ISSUED BY CODE 8. ADDRESS OFFER TO (If other than Item 7)

ORDER UNDER DPAS (15 CFR 700)

6. REQUISITION/PURCHASE NUMBER

NOTE: In sealed bid solicitations "offer" and "offeror" mean "bid" and "bidder".

NEGOTIATED (RFP)

SEALED BID (IFB)

5. DATE ISSUED

1. THIS CONTRACT IS A RATED RATING PAGE OF PAGES

1 128

C. E-MAIL ADDRESS

EXT.NUMBERAREA CODE

B. TELEPHONE (NO COLLECT CALLS)A. NAME

10. FOR

INFORMATION

CALL:

CAUTION: LATE Submissions, Modifications, and Withdrawals: See Section L, Provision No. 52.214-7 or 52.215-1. All offers are subject to all terms and conditions contained in this solicitation.

(Date)(Hour) local timeuntildepository located in copies for furnishing the supplies or services in the Schedule will be received at the place specified in Item 8, or if hand carried, in the

SOLICITATION

9. Sealed offers in original and

PART IV - REPRESENTATIONS AND INSTRUCTIONS

OTHER STATEMENTS OF OFFERORS

EVALUATION FACTORS FOR AWARD

INSTRS., CONDS., AND NOTICES TO OFFERORS

REPRESENTATIONS, CERTIFICATIONS AND

LIST OF ATTACHMENTS

CONTRACT CLAUSES

PART III - LIST OF DOCUMENTS, EXHIBITS AND OTHER ATTACH.

I

J

K

L

M SPECIAL CONTRACT REQUIREMENTS

CONTRACT ADMINISTRATION DATA

DELIVERIES OR PERFORMANCE

INSPECTION AND ACCEPTANCE

PACKAGING AND MARKING

DESCRIPTION/SPECS./WORK STATEMENT

SUPPLIES OR SERVICES AND PRICES/COSTS

SOLICITATION/CONTRACT FORM

PART II - CONTRACT CLAUSESPART I - THE SCHEDULE

H

G

F

E

D

C

B

A

SEC. DESCRIPTION PAGE(S) (X) DESCRIPTION SEC. (X)

11. TABLE OF CONTENTS

18. OFFER DATE17. SIGNATURE

SUCH ADDRESS IN SCHEDULE.

IS DIFFERENT FROM ABOVE - ENTER

15C. CHECK IF REMITTANCE ADDRESS

EXT.NUMBERAREA CODE

15B. TELEPHONE NUMBER

(Type or print)AND

ADDRESS

OF

OFFEROR

CODE FACILITY

16. NAME AND TITLE OF PERSON AUTHORIZED TO SIGN OFFER15A. NAME

DATEAMENDMENT NO.DATEAMENDMENT NO.

and related documents numbered and dated):

amendments to the SOLICITATION for offerors

(The offeror acknowledges receipt of

14. ACKNOWLEDGEMENT OF AMENDMENTS

CALENDAR DAYS (%)30 CALENDAR DAYS (%)20 CALENDAR DAYS (%)10 CALENDAR DAYS (%)

(See Section I, Clause No. 52.232.8)

13. DISCOUNT FOR PROMPT PAYMENT

designated point(s), within the time specified in the schedule.

by the offeror) from the date for receipt of offers specified above, to furnish any or all items upon which prices are offered at the price set opposite each item, delivered at the

12. In compliance with the above, the undersigned agrees, if this offer is accepted within ______________ calendar days (60 calendar days unless a different period is inserted

NOTE: Item 12 does not apply if the solicitation includes the provisions at 52.214-16, Minimum Bid Acceptance Period.

OFFER (Must be fully completed by offeror)

IMPORTANT - Award will be made on this Form, or on Standard Form 26, or by other authorized official written notice.

28. AWARD DATE

(Signature of Contracting Officer)

27. UNITED STATES OF AMERICA

25. PAYMENT WILL BE MADE BY

26. NAME OF CONTRACTING OFFICER (Type or print)

CODE 24. ADMINISTERED BY (If other than Item 7)

ITEM

(4 copies unless otherwise specified)

23. SUBMIT INVOICES TO ADDRESS SHOWN IN

41 U.S.C. 253 (c) ( 10 U.S.C. 2304 (c) (

22. AUTHORITY FOR USING OTHER THAN FULL AND OPEN COMPETITION:

21. ACCOUNTING AND APPROPRIATION20. AMOUNT19. ACCEPTED AS TO ITEMS NUMBERED

AWARD (To be completed by government)

CODE

09/15/2017 X

MACG - DWMAC

CMS,OAGM,MACG,DWMAC

7500 SECURITY BLVD., MS: B3-30-03

BALTIMORE MD 21244-1850

1100 ES 11/15/2017

Evan Seltzer 410 evan.seltzer@cms.hhs.gov

786-5701

X

X

X

X

X

X

X

X

X

X

X

X

X

PAGE(S)

BRENDA CLARK

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition is unusable

STANDARD FORM 33 (Rev. 9-97)

Prescribed by GSA - FAR (48 CFR) 53.214(c)

See Section L.10

A/B MAC Jurisdiction 8

Page | i

TABLE OF CONTENTS

SECTION B - SUPPLIES OR SERVICES AND PRICES/COSTS

B.1 BRIEF DESCRIPTION OF SERVICES

B.2 CONTRACT TYPE

B.3 AWARD FEE

B.4 ESTIMATED COST AND AWARD FEE

B.5 TASK DIRECTIVES

B.6 SCHEDULE OF SUPPLIES AND SERVICES

SECTION C - DESCRIPTION/SPECIFICATIONS/WORK STATEMENT

C.1 STATEMENT OF WORK

SECTION D – PACKAGING AND MARKING

D.1 PACKAGING AND MARKING

SECTION E – INSPECTION AND ACCEPTANCE

E.1 APPROVALS BY THE CONTRACTING OFFICER REPRESENTATIVE

E.2 INSPECTION OF SERVICES – COST REIMBURSEMENT

SECTION F – DELIVERABLES OR PERFORMANCE

F.1 FAR CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

F.2 PERIOD OF PERFORMANCE (JAN 2014)

F.3 DELIVERABLES

SECTION G – CONTRACT ADMINISTRATION DATA

G.1 ACCOUNTING AND APPROPRIATION DATA

G.2 PAYMENT, SELECTED ITEMS OF COST REIMBURSEMENT CONTRACTS

G.3 DISSEMINATION, PUBLICATION & DISTRIBUTION OF INFORMATION

G.4 SUBCONTRACTING REPORTING

G.5 SUBCONRACTING PROGRAM FOR SMALL AND SMALL

DISADVANTAGED BUSINESSES

G.6 SUBCONTRACT CONSENT

G.7 SERVICE OF CONULTANTS/SUBCONRACTORS

G.8 GOVERNMENT REPRENTATIONS AND RESPONSIBLITIES (JUL 2016)

G.9 CONTRACT PROPERTY ADMINISTRATION

G.10 GOVERNMENT FURNISHED INFORMATION AND SYSTEMS ACCESS

G.11 CONTRACTOR FURNISHED PROPERTY

G.12 PAYMENTS – VOUCHERS (COST REIMBURSEMEN CONTRACT – OCT

2015)

Page | ii

G.13 SEPARATION OF MEDICARE INTEGRITY PROGRAM MANAGEMENT

FUNDING

G.14 SEPARATION OF TRUST FUND EXPENDITURES/ACCOUNTING FROM

ADMINISTRATIVE EXPEDITURES/ACCOUNTING

G.15 COMPLIMENTARY CREDITS

G.16 CORRESPONDENCE PROCEDURES

G.17 DATA TO BE DELIVERED

G.18 AWARD FEE EVALUATION PLAN

G.19 INDIRECT RATES

G.20 USE OF GOVERNMENT DATA (REPORTS/FILES/COMPUTER TAPES OR

DISCS)

G.21 INCORPORATION OF REPRESENTATIONS AND CERTIFICATIONS

G.22 CONTRACTOR PAST PERFORMANCE EVLUATIONS(S) (OCT 2014)

G.23 CONTRACTOR WORK PERFORMED OUTSIDE THE UNITED STATES AND

ITS TERRITORIES (APR 2016)

SECTION H – SPECIAL CONTRACT REQUIREMENTS

H.1 BUSINESS ETHICS, CONFLICT OF INTEREST AND COMPLIANCE (DEC

2015)

H.2 CONDITIONS OF PERFORMANCE

H.3 HHSAR 352.237-75 KEY PERSONNEL (DEC 2015)

H.4 APPROVAL OF CONTRACT ACQUIRED INFORMATION TECHNCOLOGY

(IT)

H.5 HIPAA BUSINESS ASSOCIATE CLAUSE (OCT 2014)

H.6 SECTION 508 – ACCESSIBILITY OF ELECTRONIC AND INFORMAITON

TECHNCOLOGY

H.7 WAGE DETERMINATION

H.8 INDEMNIFICATION

H.9 DISCLOSURE OF INFORMATION

H.10 PARTICIPATION IN DEMONSTRATIONS

H.11 SEPARATION OF CERTIFICATION AND DISBURSEMENT

H.12 SURETY BONDS

H.13 LIABILITY FOR MEDICARE BENEFIT PAYMENTS – CERTIFYING

OFFICER

H.14 LIABILITY FOR MEDICARE BENEFIT PAYMENTS – DISBURSING

OFFICER

H.15 LIABILITY FOR MEDICARE BENEFFIT PAYMENTS – MEDICARE

ADMINISTRATIVE CONTRACTOR

H.16 LIABILITY FOR UNCOLLECTED OVERPAYMENTS

H.17 MEDICARE RECORDS RETENTION

H.18 SECURITY INCIDENT AND REPORTABLE EVENT REPORTING

H.19 SYSTEMS OF RECORDS

H.20 CMS SECURITY CLAUSE (APR 2016)

H.21 PRIVACY ACT ‘SYSTEMS NOTICE

H.22 CMS INFORMATION SECURITY (APR 2013)

Page | iii

H.23 REPORTING CHANGES IN CONTRACTOR TEAM ARRANGEMENTS, AND

ACQUISITIONS/DIVESTITURES

H.24 OPEN GOVERNMENT PROACTIVE PREDISCLOSOURE NOTIFICATION

(OCT 2013)

H.25 CONTRACT RENEWAL

SECTION I – CONTRACT CLAUSES

I.1 FAR 52.252-2 CLAUSES INCOPORATED BY REFERENCE (FEB 1998)

I.2 DEPARTMENT OF HEALTH & HUMAN SERVICES ACQUISITION

REGULATIONS (HHSAR) CLUASES INCORPORATED BY REFERENCE

(JAN 2016)

I.3 FAR 52.204-21 BASIC SAFEGUARDING OF COVERED CONTRATOR

INFORMATION SYSTEMS (JUN 2016)

I.4 FAR 52.215-19 NOTIFICATION OF OWNERSHIP CHANGES (OCT 1997)

I.5 FAR 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR

2000)

I.6 FAR 52.222-2 PAYMENT FOR OVERTIME PREMIUMS (JUL 1990)

I.7 FAR 52.222-35 EQUAL OPORTUNITY FOR VETERANS (OCT 2015)

I.8 FAR 52.222-36 EQUAL OPPORTUNITY FOR WORKERS WITH

DISABILITIES

I.9 HHSAR 352.211-3 PAPERWORK REDUCTION ACT (DEC 2015)

I.10 HHSAR 352.203–70 ANTI-LOBBYING (DEC 2015)

I.11 HHSAR 352.224-70 PRIVACY ACT (DEC 2015)

I.12 HHSAR 352.228-7 INSURANCE—LIABILITY TO THIRD PERSONS (DEC

1991)

I.13 HHSAR 352.239-74 ELECTRONIC INFORMATION AND TECHNOLOGY

ACCESSIBILITY (December 18, 2015)

SECTION J - LIST OF ATTACHMENTS

J.01 STATEMENT OF WORK (SOW)

J.01.A. LIST OF KEY DEFINITIONS

J.01.B. LIST OF KEY ACRONYMS

J.01.C. FFS-SHARED-SYS-BASE

J.01.D. CASH COLLECTIONS HIGLAS

J.01.E. RESERVED

J.01.F. DATA RELEASE POLICIES

J.01.G. PERFORMANCE STANDARDS

J.02 DELIVERABLE SCHEDULE

J.03 SMALL BUSINESS SUBCONTRACTING PLAN

J.04 HHS CONTRACTING GUIDE FOR GOVERNMENT PROPERTY

J.05 GOVERNMENT FURNISHED INFORMATION AND SYSTEMS ACCESS

J.06 CONTRACTOR FURNISHED PROPERTY

J.07 AWARD FEE PLAN AND SELF-ASSESSMENT TEMPLATE

J.08 MAC SECURITY INCIDENT AND REPORTABLE EVENTS

Page | iv

J.09 NON DISCLOSURE STATEMENT

J.10 CONTRACTOR BUSINESS ETHICS COI AND COMPLIANCE

PROGRAM REQUIREMENTS

J.11 PERSONAL CONFLICTS OF INTEREST FINANCIAL DISCLOSURE

J.12 COST TEMPLATE SUMMARY SHEET

J.13 CLIN 0001 COST PROPOSAL TEMPLATE – IMPLEMENTATION

J.14 CLIN 0002 COST PROPOSAL TEMPLATE – BASE YEAR

J.15 CLIN 0003 COST PROPOSAL TEMPLATE – OPTION YEAR 1

J.16 CLIN 0004 COST PROPOSAL TEMPLATE – OPTION YEAR 2

J.17 CLIN 0005 COST PROPOSAL TEMPLATE – OPTION YEAR 3

J.18 CLIN 0006 COST PROPOSAL TEMPLATE – OPTION YEAR 4

J.19 CLIN 0007 COST PROPOSAL TEMPLATE – OPTION YEAR 5

J.20 CLIN 0008 COST PROPOSAL TEMPLATE – OPTION YEAR 6

J.21 CLIN 0009 COST PROPOSAL TEMPLATE – OUTGOING

CONTRACTOR WORKLOAD TRANSITION ACTIVITIES CLOSEOUT

J.22 BASIS OF ESTIMATE

J.23 GOVERNMENT PROVIDED PROPOSAL ASSUMPTIONS

J.24 ATTESTATIONS

J.25 PAST PERFORMANCE QUESTIONAIRE

SECTION K – REPRESENTATIONS, CERTIFICATIONS, AND OTHER

STATEMENTS OF OFFERORS OR QUOTERS

K.1 TO BE COMPLETED BY THE OFFEROR: [THE REPRESENTATIONS AND

CERTIFICATIONS MUST BE EXECUTED BY AN INDIVIDUAL

AUTHORIZED TO BIND THE OFFEROR]

K.2 52.204-8 ANNUAL REPRESENTATIONS AND CERTIFICATIONS (JAN 2017)

K.3 FAR 52.204-17 OWNERSHIP OR CONTROL OF OFFEROR (JUL 2016)

K.4 FAR 52.204-19 INCORPORATE BY REFERENCE OF REPRESENTATIONS

AND CERTIFICATIONS (DEC 2014)

K.5 FAR 52.209-5 CERTIFICATION REGARDING RESPONSIBILITY MATTERS

(OCT 2015)

K.6 FAR 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS

(JUL 2013)

K.7 FAR 52.209-11 REPRESENTATION BY CORPORATIONS REGARDING

DELINQUENT TAX LIABILITY OR A FELONY CONVICTION UNDER

FEDERAL LAW (FEB 2016)

K.8 FAR 52.215-6 PLACE OF PERFORMANCE (OCT 1997)

K.9 FAR 52.230-1 COST ACCOUNTING STANDARDS NOTICES AND

CERTIFICATION (OCT 2015)

K.10 FAR 52.230-7 PROPOSAL DISCLOSURE – COST ACCOUNTING PRACTICE

CHANGES (APR 2005)

K.11 FAR 52.222-57 REPRESENTATION REGARDING COMPLIANCE WITH

LABOR LAWS (EXECUTIVE ORDER 13673) (DEC 2016)

Page | v

SECTION L – INSTRUCTIONS, CONDITIONS AND NOTICES TO OFFERORS

L.1 INTRODUCTION

L.2 FAR 52.252-1, SOLICITATION PROVISIONS INCORPORATED BY

REFERENCE (FEB 1998)

L.3 DEPARTMENT OF HEALTH & HUMAN SERVICES ACQUISITION

REGULATIONS (HHSAR) PROVISIONS INCORPORATED BY REFERENCE

L.4 FAR 52.215-20, REQUIREMENTS FOR CERTIFIED COST OR PRICING

DATA AND DATA OTHER THAN CERTIFIED COST OR PRICING DATA,

(OCT 2010), ALTERNATE IV, OCT 2010

L.5 FAR 52.216-1, TYPE OF CONTRACT, APR 1984

L.6 FAR 52.233-2, SERVICE OF PROTEST, SEP 2006

L.7 INTENT TO SUBMIT A PROPOSAL

L.8 SOLICITATION QUESTIONS

L.9 COMMUNICATIONS PRIOR TO CONTRACT AWARD

L.10 PROPOSAL SUBMISSION, DELIVERY AND ORGANIZATION

L.11 PROPOSAL INSTRUCTIONS: VOLUME I, ADMINISTRATIVE

REQUIREMENTS AND RESPONSIBILITY DETERMINATION

L.12 PROPOSAL INSTRUCTIONS: VOLUME II, PROPOSAL ASSUMPTIONS

L.13 PROPOSAL INSTRUCTIONS: VOLUME III, TECHNICAL PROPOSAL

INSTRUCTIONS

L.14 PROPOSAL INSTRUCTIONS: VOLUME IV, BUSINESS PROPOSAL

L.15 PROPOSAL INSTRUCTIONS: VOLUME V, CONFLICT OF INTEREST

L.16 SECTION 508 ACCESSIBILITY OF ELECTRONIC AND INFORMATION

TECHNOLOGY (EIT) TO FEDERAL EMPLOYEES AND THE GENERAL

PUBLIC WITH DISABILITIES

SECTION M – EVALUATION FACTORS FOR AWARD

M.1 FAR 52.252-1, SOLICITATION PROVISIONS INCORPORATED BY

REFERENCE (FEB 1998)

M.2 BEST VALUE CONTINUUM

M.3 TECHNICAL EVALUATION FACTORS

M.4 PAST PERFORMANCE EVALUATION FACTOR

M.5 TECHNICAL APPROACH EVALUATION FACTOR

M.6 BUSINESS ETHICS, CONFLICTS OF INTEREST AND COMPLIANCE

EVALUATION FACTOR

M.7 BUSINESS PROPOSAL EVALUATION

M.8 REVIEW OF ATTESTATIONS

M.9 RESPONSIBILITY DETERMINATION

M.10 CONTRACT AWARD LIMITATIONS

Page | 2

SECTION B - SUPPLIES OR SERVICES AND PRICES/COSTS

B.1 BRIEF DESCRIPTION OF SERVICES

The purpose of this contract is to obtain a Medicare Administrative Contractor (hereinafter referred to as “the contractor” or “MAC”) to provide specified health insurance benefit administration services, including Medicare claims processing and payment services, in support of the Medicare program (also known as the Medicare fee-for-service, or FFS, program) for Jurisdiction 8. Jurisdiction 8 comprises the following states: Indiana and

Michigan.

B.2 CONTRACT TYPE

The Centers for Medicare and 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 on an evaluation by the

Government of the contractor’s performance in accordance with the Performance Evaluation

Award Fee Plan and Self-Assessment Template (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).

*Note: A sample Performance Evaluation Award Fee Plan and Self-Assessment Template

(Attachment J.07) is provided. The final Performance Evaluation Award Fee Plan and Self-

Assessment Template will be provided at time of contract award.

B.4 ESTIMATED COST AND AWARD FEE

The estimated cost of this contract is $TBD. The base fee is $TBD. The fixed fee is $TBD.

The maximum available award fee is $TBD. Total cost plus base fee, fixed fee and award fee is $TBD.

Page | 3

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 1(APR 1984)).

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 (CLIN)

ESTIMATED

COST

BASE

FEE

AWARD

FEE

FIXED

FEE

TOTAL

ESTIMATED

CPAF

ESTIMATED

COMP

CREDITS*

TOTAL

CPAF NET

COMP

CREDITS

CLIN 0001 –

IMPLEMENTATION

TOTAL CLIN 0001 A/B

MAC

IMPLEMENTATION

TBD TBD TBD TBD

CONTRACT LINE ITEM

NUMBER

ESTIMATED

COST

BASE

FEE

AWARD

FEE

FIXED

FEE

TOTAL

ESTIMATED

CPAF

ESTIMATED

COMP

CREDITS*

TOTAL

CPAF NET

COMP

CREDITS

CLIN 0002 – A/B MAC

SERVICES/BASE

PERIOD OPERATIONS

OPTION

0002AA Program

Management Part A & B

(CPAF**)

TBD TBD TBD TBD TBD TBD

0002AB Medicare Integrity

Program Part A & B

(CPAF**)

TBD TBD TBD TBD TBD TBD

0002AC Recovery Audit

Contract Part A & B

(CPFF***)

TBD TBD TBD TBD TBD

TOTAL CLIN 0002 – A/B

MAC SERVICES/BASE

PERIOD OPERATIONS

OPTION

TBD TBD TBD TBD TBD TBD TBD

ESTIMATED

COST

BASE

FEE

AWARD

FEE

FIXED

FEE

TOTAL

ESTIMATED

CPAF

ESTIMATED

COMP

CREDITS*

TOTAL

CPAF NET

COMP

CREDITS

Page | 4

CLIN 0003 – A/B MAC

SERVICES/OPTION

YEAR 1 TBD – TBD

0003AA Program

(CPAF**)

TBD TBD TBD TBD TBD TBD

0003AB Medicare Integrity

Program Part A & B

(CPAF**)

TBD TBD TBD TBD TBD TBD

0003AC Recovery Audit

Contract Part A & B

(CPFF***)

TBD TBD TBD TBD TBD

TOTAL CLIN 0003 – A/B

MAC

SERVICES/OPTION

YEAR 1

ESTIMATED

COST

BASE

FEE

AWARD

FEE

FIXED

FEE

TOTAL

ESTIMATED

CPAF

ESTIMATED

COMP

CREDITS*

TOTAL

CPAF NET

COMP

CREDITS

CLIN 0004 – A/B MAC

YEAR 2 TBD – TBD

0004AA Program

(CPAF**)

TBD TBD TBD TBD TBD TBD

0004AB Medicare Integrity

Program Part A & B

(CPAF**)

TBD TBD TBD TBD TBD TBD

0004AC Recovery Audit

Contract Part A & B

(CPFF***)

TBD TBD TBD TBD TBD

TOTAL CLIN 0004 – A/B

MAC

SERVICES/OPTION

YEAR 2

ESTIMATED

COST

BASE

FEE

AWARD

FEE

FIXED

FEE

TOTAL

ESTIMATED

CPAF

ESTIMATED

COMP

CREDITS*

TOTAL

CPAF NET

COMP

CREDITS

CLIN 0005 – A/B MAC

YEAR 3 TBD – TBD

0005AA Program

(CPAF**)

TBD TBD TBD TBD TBD TBD

0005AB Medicare Integrity

Program Part A & B

(CPAF**)

TBD TBD TBD TBD TBD TBD

0005AC Recovery Audit

Contract Part A & B

(CPFF***)

TBD TBD TBD TBD TBD

Page | 5

TOTAL CLIN 0005 – A/B

MAC

SERVICES/OPTION

YEAR 3

ESTIMATED

COST

BASE

FEE

AWARD

FEE

FIXED

FEE

TOTAL

ESTIMATED

CPAF

ESTIMATED

COMP

CREDITS*

TOTAL

CPAF NET

COMP

CREDITS

CLIN 0006 – A/B MAC

YEAR 4 TBD – TBD

0006AA Program

(CPAF**)

TBD TBD TBD TBD TBD TBD

0006AB Medicare Integrity

Program Part A & B

(CPAF**)

TBD TBD TBD TBD TBD TBD

0006AC Recovery Audit

Contract Part A & B

(CPFF***)

TBD TBD TBD TBD TBD

TOTAL CLIN 0006 – A/B

MAC

SERVICES/OPTION

YEAR 4

ESTIMATED

COST

BASE

FEE

AWARD

FEE

FIXED

FEE

TOTAL

ESTIMATED

CPAF

ESTIMATED

COMP

CREDITS*

TOTAL

CPAF NET

COMP

CREDITS

CLIN 0007 – A/B MAC

YEAR 5 TBD – TBD

0007AA Program

(CPAF**)

TBD TBD TBD TBD TBD TBD

0007AB Medicare Integrity

Program Part A & B

(CPAF**)

TBD TBD TBD TBD TBD TBD

0007AC Recovery Audit

Contract Part A & B

(CPFF***)

TBD TBD TBD TBD TBD

TOTAL CLIN 0007 – A/B

MAC

SERVICES/OPTION

YEAR 5

ESTIMATED

COST

BASE

FEE

AWARD

FEE

FIXED

FEE

TOTAL

ESTIMATED

CPAF

ESTIMATED

COMP

CREDITS*

TOTAL

CPAF NET

COMP

CREDITS

CLIN 0008 – A/B MAC

YEAR 6 TBD – TBD

Page | 6

0008AA Program

Management Part A & B

(CPAF**)

TBD TBD TBD TBD TBD TBD

0008AB Medicare Integrity

Program Part A & B

(CPAF**)

TBD TBD TBD TBD TBD TBD

0008AC Recovery Audit

Contract Part A & B

(CPFF***)

TBD TBD TBD TBD TBD

TOTAL CLIN 0008 – A/B

MAC

SERVICES/OPTION

YEAR 6

ESTIMATED

COST

BASE

FEE

AWARD

FEE

FIXED

FEE

TOTAL

ESTIMATED

CPAF

ESTIMATED

COMP

CREDITS*

TOTAL

CPAF NET

COMP

CREDITS

TOTAL CLIN 0009 – A/B

MAC OUTGOING

CONTRACTOR

WORKLOAD

TRANSITION

ACTIVITIES

TBD TBD TBD TBD

TOTAL J8 A/B MAC

TBD TBD TBD TBD TBD TBD TBD

*Refer to section G.15, Complementary Credits.

**Cost Plus Award Fee (CPAF) SLIN

***Cost Plus Fixed Fee (CPFF) SLIN

Page | 7

SECTION C - DESCRIPTION/SPECIFICATIONS/WORK STATEMENT

C.1 STATEMENT OF WORK

The Statement of Work (SOW) is provided under Section J as Attachment J.01 and shall be made a part of the contract. The SOW takes precedence over the Internet Only Manuals (IOM) and Paper-Based Manuals unless otherwise specified.

Page | 8

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.

Page | 9

SECTION E - INSPECTION AND ACCEPTANCE

Federal Acquisition Regulation (FAR) Clauses:

52.246-5 INSPECTION OF SERVICES – COST REIMBURSEMENT (APR 1984)

E.1 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.

E.2 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 (APR 1984)."

Page | 10

SECTION F - DELIVERIES OR PERFORMANCE

F.1 FAR CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

This contract incorporates one (1) 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: FAR

Clauses (https://www.acquisition.gov/?q=browsefar)

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 date of contract award through 12 months, plus six (6) one (1) year options as follows:

CLIN DESCRIPTION PERIOD OF PERFORMANCE

0001 Implementation four months for Part A and six months for Part

B, from date of contract award*

0002 Option - Base Period Operations eight months for Part A and six months for

Part B

0003 Option - Year 1 Operations 12 months from exercise of option

0004 Option - Year 2 Operations 12 months from exercise of option

0005 Option - Year 3 Operations 12 months from exercise of option

0006 Option - Year 4 Operations 12 months from exercise of option

0007 Option - Year 5 Operations 12 months from exercise of option

0008 Option - Year 6 Operations 12 months from exercise of option

0009 Option - Outgoing Contractor

Workload Transition Activities

Not to exceed 6 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: The option periods delineated above are subject to the FAR option clauses incorporated in

Section I of this contract.

https://www.acquisition.gov/?q=browsefar

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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. Except for deliverables containing Protected Health Information (PHI), deliverables shall be submitted to the Centers for Medicare & Medicaid Services Analysis Reporting and Tracking

(CMS ART) system. Deliverables containing PHI, as defined in the Health Insurance

Portability and Accountability Act (HIPAA), cannot be submitted in CMS ART and shall be submitted electronically using the Deliverable electronic mailbox. For deliverables containing PHI, the email shall include the deliverable title and reference number (if applicable) in the subject line. The contractor will copy the Contracting Officer’s

Representative (COR) and Contract Specialist (CS) on all electronic and/or written correspondence. Once the deliverable is received, the Contractor will receive an automatic reply confirmation.

D. For the PHI deliverables, if unable to send electronically, the contractor is to send a notice to the J8 MAC Deliverable electronic mailbox (J8_MAC_Deliverables@cms.hhs.gov) stating the deliverable is being mailed in hardcopy, with an expected delivery date. The contractor will mail the hardcopy of the deliverable (excluding implementation deliverables) to the

COR.

E. Hardcopy Implementation deliverables should be sent to the J8 Implementation Lead.

Refer to JSM Number 10337 for further instructions.

F. 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 (e-mail 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.

Page | 12

Addressees:

CONTRACTING OFFICER’S REPRESENTATIVE (COR)

TBD

CONTRACTING OFFICER (CO)

Centers for Medicare & Medicaid Services

Office of Acquisition and Grants Management

Medicare Administrative Contracts Group

Attn: Brenda Clark, Mail Stop B2-14-21

7500 Security Boulevard

Baltimore, MD 21244-1850

(410) 786-5165

Email: Brenda.Clark@cms.hhs.gov

CONTRACT SPECIALIST (CS)

Office of Acquisition and Grants Management

Division of Southern Medicare Administrative Contracts

Attn: Evan Seltzer, Mail Stop B2-14-21

7500 Security Boulevard

Baltimore, MD 21244-1850

(410) 786-0933

Email: Evan.Seltzer@cms.hhs.gov

For the PHI Deliverables, the mailbox address is as follows:

Deliverables email: J8_MAC_Deliverables@cms.hhs.gov

All electronic files shall be submitted in a format that is 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.

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SECTION G - CONTRACT ADMINISTRATION DATA

G.1 ACCOUNTING AND APPROPRIATION DATA

(To be incorporated at time of award)

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 (JUN 2013). 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.

Page | 14

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 8.”

Sponsored by the Centers for Medicare & Medicaid Services, Department of Health &

Human Services."

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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, shall be submitted semi-annually for the periods of October 1 through March 31 and April 1 through September 30. The Summary

Subcontracting Report (SSR), formerly, SF 295 shall be submitted annually for the period of

October 1 through September 30. The report(s) shall be delivered not more than thirty (30) calendar days following the close of each period covered.

G.5 SUBCONTRACTING PROGRAM FOR SMALL AND SMALL

DISADVANTAGED BUSINESSES

The contractor hereby agrees to implement the conditions of the subcontracting plan submitted and approved by the Contracting Officer for this contract. The Small Business and Small

Disadvantaged Business Subcontracting Plan is hereby incorporated and made a part hereof as

Attachment J.03 of 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 (OCT 2010)" to the Contracting Officer. The Contracting Officer shall review the request for subcontract approval and 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 (OCT 2010).”

B. The Contractor shall be reimbursed at the rates(s) set forth below for services provided by consultants in connection with this contract:

http://www.esrs.gov/ https://www.esrs.gov/

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Name Rate Per Hour Number of Hours Total Cost Not to Exceed

G.8 GOVERNMENT REPRESENTATIVES AND RESPONSIBILITIES (JUL 2016)

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:

Office of Acquisition & Grants Management

Division of Western Medicare Administrative Contracts

ATTN: Brenda Clark

7500 Security Blvd.

Mail-stop: B2-14-21

Baltimore, MD 21244-1850

Phone: 410-786-5165

Email Address: Brenda.Clark@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:

Division of Western Medicare Administrative Contracts

ATTN: Evan Seltzer

7500 Security Blvd.

Page | 17

Mail-stop: B2-14-21

Phone: 410-786-0933

Email Address: Evan.Seltzer@cms.hhs.gov

c. Contracting Officer’s Representative

The Contracting Officer’s Representative (COR), as defined in FAR 2.101, Definitions, is:

Division of TBD

ATTN: TBD

7500 Security Blvd.

Mail-stop: TBD

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.

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.

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;

Page | 18

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 Material and Labor Hour;

FAR 52.243-4, Changes; or, FAR 52.243-5, Changes and Changed Conditions.

All technical direction shall be issued in writing by the COR or, if issued verbally, shall be confirmed in writing by the COR within five (5) business days after issuance.

The Contractor shall proceed promptly with the performance of technical direction duly issued by the COR within the scope of his/her authority.

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.

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 Department of Health & Human

Services (DHHS) 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:

Office of Operations Management, Administrative Services Group

Division of Printing, Mail, and Logistics

Attn: TBD

7500 Security Boulevard, M/S SL-13-12

Page | 19

Baltimore, Maryland 21244-1850

(410) XXX-XXXX

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 INFORMATION AND SYSTEMS ACCESS

Pursuant to FAR Part 45 – GOVERNMENT PROPERTY and FAR Clause 52.245-1, Government Property (JAN 2017), of this contract, the Government will furnish for performance of the work required herein a list of information and systems access, which is provided in

Attachment J.05 which 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 – VOUCHERS (Cost Reimbursement Contract – OCT 2015)

a. GENERAL: The Contractor may submit to the Government a voucher or Standard

Form 1034, Public Voucher for Purchases and Services Other Than Personal, for payment in accordance with the instructions below.

b. METHOD OF PAYMENT: CMS shall only make an electronic payment for reimbursement of voucher submissions in accordance with FAR 52.232-33, Payments by Electronic Funds Transfer – System for Award Management. In order to receive payments, the contractor shall register in the System for Award Management (SAM) database, in accordance with FAR 52.204-7, System for Award Management.

c. ADDRESS CHANGES: The contractor shall notify CMS’ Division of Accounting

Operations of all banking and address changes in SAM via the following email address: CCRChanges@cms.hhs.gov.

d. CONTENT OF VOUCHER - Vouchers shall include, at a minimum:

Contractor’s name and address mailto:CCRChanges@cms.hhs.gov

Page | 20

Contractor’s Tax Identification Number (TIN)

Contractor’s DUNS Number

Voucher Number to include the designation of the Contract Payment Category Type as follows:

o Contract Payment Category Type IV

Contract and Order Number, as applicable;

Contract line item number (CLIN) and/or Subcontract line item number (SLIN);

Description, quantity, unit of measure, unit price and extended price/cost of the items actually delivered or services rendered, i.e., Labor category and labor hours x labor rate = total direct labor dollars, subcontractor costs, travel, other direct costs, overhead rate(s), etc.;

Shipping and payment terms;

Terms of any discount for prompt payment offered;

Other substantiating documentation or information as required by the contract;

Name, title, phone number and complete mailing address of responsible official to whom payment is to be sent;

Name, title, phone number of person to notified in the event of a defective voucher;

and, Period of performance for delivery date of goods or services provided.

VOUCHER REVIEW/APPROVAL PROCESSING TIME FRAMES

Contract Payment Category Types ($ = Total Contract Value)

Days = Calendar Days

TYPE I TYPE II TYPE III TYPE IV

Type IA Type IB Type IIIA Type IIIB

TEAM

MEMBER

All Small Businesses (No $ Limit)

All QIOs (No $ Limit)

All Other Contracts

(No $ Limit)

Simplified Acquisitions

$3K to $150K (Small

Businesses)

Simplified Acquisitions $3K to $6.5M

(Large Businesses)

All Large Business

Prime Contracts with Small Business Subcontractors

OFM/DAO 7 Days 7 Days 14 Days 7 Days 22 Days 12 Days

COR 4 Days 0 Days 8 Days 8 Days 8 Days 8 Days

CS/CO 4 Days 8 Days 8 Days N/A N/A 8 Days

Total Processing

Time

15 Days Not-to-

Exceed 30 Days

15 Days Not-to-

Exceed 30 Days 30 Days

15 Days Not-to-Exceed

30 Days 30 Days

28 Days Not-to-Exceed

30 Days

Page | 21

e. MAILINGS: Vouchers shall be submitted as follows:

1. ELECTRONIC MAIL: The contractor shall submit an electronic copy of the voucher to both of the following individuals:

Contract Specialist – TBD

COR - TBD

2. REGULAR MAIL: An original hard copy of the voucher shall be submitted to the address below:

Department of Health & Human Services

OFM/Division of Accounting Operations

P.O. Box 7520

Baltimore, MD 21207-0520

3. OVERNIGHT MAIL: If the contractor chooses to use an overnight mail carrier, the original hard copy of the voucher shall be submitted to the address below:

Department of Health & Human Services

OFM/Division of Accounting Operations

7500 Security Boulevard/Mailstop: C3-11-03

f. PAYMENTS: The Government shall make provisional payments on all vouchers

(pending the completion of a final audit of the Contractor's cost records) in accordance with:

FAR 52.216-7, Allowable Cost & Payment, and

FAR 52.232-1, Payments, and

Upon acceptance by the Contracting Officer’s Representative (COR) of the required supplies/services in accordance with the applicable FAR Inspection and Acceptance clause and the Contracting Officer’s approval.

Reimbursement for vouchers submitted under this contract shall be made not later than thirty

(30) calendar days after receipt of an acceptable voucher from the Contractor requested at the paying office designated above. Any discrepancies determined as a result of the audit could delay the processing of the voucher and may result in the voucher being returned to the

Contractor for corrections.

g. INTEREST ON OVERDUE PAYMENT

The Prompt Payment Act, Public Law 97-177 (96 Stat.85.31 U.S.C. 1801) is applicable to

Page | 22 payments under this contract and requires the payment of interest on payments made more than 30 calendar days after receipt of an voucher by the Division of Accounting Operations.

Determinations of interest due will be made in accordance with the provisions of the Prompt

Payment Act and Office of Management and Budget Circular A-125.

G.13 SEPARATION OF MEDICARE INTEGRITY PROGRAM AND PROGRAM

MANAGEMENT FUNDING

Funding for Medicare Integrity Program activities under Section 1893 of the Social Security Act is derived from a different source than funding for the other functions (called “Program

Management functions”) which the Contractor performs pursuant to the authority of Section

1874A of the Social Security Act. Therefore, separate accounts shall be designated for Medicare

Integrity Program activities and the Program Management functions which the Contractor performs pursuant to the authority of Section 1874A. The Contractor shall separately account for costs incurred to perform Medicare Integrity Program activities and its Program Management functions under this contract. In no event shall the Contractor apply funding which is designated for Medicare Integrity Program activities to costs incurred in performing its Program

Management functions authorized by Section 1874A; similarly, the Contractor shall not apply funding designated for costs incurred in performing its Program Management functions under

Section 1874A to Medicare Integrity Program activities.

G.14 SEPARATION OF TRUST FUND EXPENDITURES/ACCOUNTING FROM

ADMINISTRATIVE EXPENDITURES/ACCOUNTING

Any costs which are properly chargeable by a provider of services, physician, or supplier as benefit costs in accordance with Title XVIII of the Social Security Act, its implementing regulations and this contract, shall not be chargeable to this contract as administrative costs (i.e., either Medicare Integrity Program or Program Management costs). The Contractor shall separately account for benefit payments made by it from costs incurred to perform its Medicare

Integrity Program activities and its Program Management functions under this contract.

G.15 COMPLEMENTARY CREDITS

The contractor shall separately account for complementary credits and reflect the current and cumulative totals on their monthly invoice. The estimated amounts for complementary credits shall be shown as a reduction to the total costs amount (i.e. after application of any fees) within each applicable CLIN. Complementary credits for crossover claims will be accounted for on a cash basis.

G.16 CORRESPONDENCE PROCEDURES

To promote timely and effective administration, correspondence (except for invoices), submitted under this contact shall be subject to the following procedures:

Page | 23

A. Technical Correspondence - Technical correspondence (as used herein, this term excludes correspondence which proposes or otherwise involves waivers, deviations or modifications to the requirements, terms or conditions of this contract) shall be addressed to the COR with an informational copy of the basic correspondence to the

Contracting Officer.

B. Other Correspondence - All other correspondence shall be addressed to the Contracting

Officer with an informational copy of the basic correspondence to the COR.

C. Subject Lines - All correspondence shall contain a subject line, commencing with the contract number and assigning consecutive numbers (serial numbers to permit accountability), as illustrated below:

EXAMPLE: Contract No. - 500-00-XXXX

Sequence # - XX (YEAR) – XXXX

Subject - Request for Subcontract Consent

G.17 DATA TO BE DELIVERED

Any working papers, interim reports, data provided by the Government or first produced by the

Contractor (including subcontractors) under the contract or collected or otherwise obtained by the Contractor under the contract, or results obtained or developed by the Contractor

(subcontractors) pursuant to the fulfillment of this contract are to be delivered, documented, and formatted as directed by the Contracting Officer.

In addition, information and/or data, which are held by the Contractor related to the operation of their business and/or institution and which are obtained without the use of Federal funds, shall be considered proprietary or confidential and are not required to be delivered under this contract.

AWARD FEE EVALUATION PLAN

A sample Award Fee Plan and Self-Assessment Template upon which the determination of award fee is based is identified herein as Attachment J.07. The award fee plan contains details with respect to how the Contractor will be evaluated periodically for its performance. The general criteria upon which the Contractor will be evaluated on can be found in the aforementioned Attachment J.07. The final award fee plan will be provided at time of contract award.

The Contractor may submit self-evaluations of performance for each period under consideration.

The Performance Evaluation Board in reaching its determination will consider these self-evaluations.

G.18 INDIRECT RATES

1. Required Submission of a Provisional Billing Rate Proposal

Pursuant to FAR Clause 52.216-7(e) and FAR Subpart 42.7, the Cognizant Federal Agency

(CFA) or cognizant auditor will establish provisional billing rates by means of issuing a

Page | 24 single, annual (consistent with the contractor’s accounting or fiscal year) Provisional Billing

Rate Agreement. Until final annual indirect cost rates are established pursuant to FAR

52.216-7(d), the Government will reimburse the contractor’s allowable indirect costs using the provisional billing rates established in the Provisional Billing Rate Agreement.

To facilitate the issuance of a timely Provisional Billing Rate Agreement, the contractor is required to submit an annual Provisional Billing Rate Proposal to

ACQUISITIONDACCINCURREDCOSTSUBMISSION@cms.hhs.gov, no later than two months prior to the start of the contractor’s fiscal year (FY). For example, if a contractor’s

FY 2017 accounting period is January 1, 2017 through December 31, 2017 the contractor must submit its FY 2017 Provisional Billing Rate Proposal no later than October 31, 2016.

The contractor’s Provisional Billing Rate Proposal must include:

Proposed billing rate calculations (pool and base) with brief rationale

Prior FY pool and base

Current FY to date…