3_E.3.B__ZONE5TO0002Med-MediSpreadsheet2.xls

XLS spreadsheet 317 KB Posted

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Zone Program Integrity Contractor (ZPIC)
Solicitation number
RFP-CMS-2007-0027
Issued by

About this file

RFP-CMS-2007-0027 Amendment 000001 E.3.B

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Amendment000002.zip ZIP file
3_E.3.A__ZONE4TO0002Med-MediSpreadsheet.xls XLS spreadsheet
AttachmentJ.6.AZone7TO1SOW.doc DOC document
Amendment01pages2-8.doc DOC document
AttachmentJ.3.AZPICZone4M-MTOSOWAmendment1.doc DOC document
AttachmentB-ZPIC-Pre-Proposal-slidesAmendment1.ppt PPT presentation
AttachmentJ.1.AZPICUSOWAPPA-KAmendment1.doc DOC document
AttachmentJ.1.BZPICUSOWAPPL-endAmendment1.doc DOC document
AttachmentJ.5.AZPICZone5M-MTOSOWAmendment1.doc DOC document
AttachmentC-Amendment1-SECTIONK.doc DOC document
AttachmentJ.7.AZPICZone7M-MTOSOWAmendment1.doc DOC document
AttachmentJ.4.AZone5TO1SOW.doc DOC document
Amend1.pdf PDF
3_E.3.C__ZONE7TO0002Med-MediSpreadsheet.xls XLS spreadsheet
AttachmentA-Amendment1-Q As.doc DOC document
AttachmentJ.1ZPICUSOWAmendment1.doc DOC document
AttachmentJ.2.AZone4TO1SOW.doc DOC document
J.12__Coversheet.doc DOC document
J.5__ZPIC_Zone5_Medi-MediRFPTO0002.doc DOC document
1_J.2__ZPICZone4RFP-ABDMEHHHTO0001.doc DOC document
J.1.B__ZPICUSOWAppendices-Ltoend.doc DOC document
1_SF33Page1RFP-CMS-2007-0027.pdf PDF
J.3.A__ZPICZone4M-MTOSOW.doc DOC document
J.7.B__Zone7Medi-MediZPICAwardFeePlan.doc DOC document
J.7.A__ZPICZone7M-MTOSOW.doc DOC document
J.8__BillingInstructions.doc DOC document
E.1__ZPICProposalChecklist.doc DOC document
J.1__ZoneProgramIntegrityContractorIDIQUSOW.doc DOC document
E.3.A__ZONE4TO0002Med-MediSpreadsheet.xls XLS spreadsheet
1_CoverletterRFP-CMS-2007-0027.doc DOC document
Amendment2toPre-SolNoticePreproposalNotice_ZPICCycleOne.doc DOC document
J.12__SmallBusinessSubcontractingPlan.pdf PDF
J.7__ZPIC_Zone7_Medi-MediRFPTO0002.doc DOC document
E.3.C__ZONE7TO0002Med-MediSpreadsheet.xls XLS spreadsheet
J.6__ZPIC_Zone7RFP_-ABDMEHHHTO0001.doc DOC document
1_J.2.B__ZPICZone4AwardFeePlan.doc DOC document
E.3.B__ZONE5TO0002Med-MediSpreadsheet2.xls XLS spreadsheet
J.4.A__ZPICZone5ABDMEHHHTOSOW.doc DOC document
J.3__ZPICZone4Medi-MediRFPTO0002.doc DOC document
J.4__ZPIC_Zone5RFP_-ABDMEHHHTO0001.doc DOC document
J.5.A__ZPICZone5M-MTOSOW.doc DOC document
J.10__BuildingLocation.doc DOC document
E.4__PreproposalNotice_ZPICCycleOne.doc DOC document
1_RFP-CMS-2007-0027.doc DOC document
J.9__PastPerformanceQuestionnaire.doc DOC document
J.11__SubcontractChecklist.doc DOC document
E.2__ZPICTO0001ABDMEHHHSpreadsheet.XLS XLS spreadsheet
J.1.A__ZPICUSOWAppendices-A-K.doc DOC document
J.5.B__Zone5Medi-MediZPICAwardFeePlan.doc DOC document
J.6.A__ZPICZone7ABDMEHHHSOW.doc DOC document
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Text version

Instructions

Instructions:
1) Offerors shall label each spreadsheet with the Offeror Name, Zone, CLIN, Period of Performance and Title
2) Offerors shall include an ODC spreadsheet and a Travel spreadsheet for each CLIN
3) Offerors shall list their productive hours on the "Summary of Costs" tab/sheet.
4) Offerors shall list the percentages for overhead rates/indirect costs and fees on the spreadsheet.
5) Please review any additional instruction under "Business Proposal Spreadsheet Instructions"

&LRFP-CMS-2007-0027

Exhibit E.3.B

Zone 5 Summary of Costs

1st Year Roll-up
Zone 5 Medicaid & Medicare
TasksTotal FTEsALARGALAMSNCSCTNVAWVMedi Medi Totals
Annual FTEHoursRatesTotalHoursRatesTotalHoursRatesTotalHoursRatesTotalHoursRatesTotalHoursRatesTotalHoursRatesTotalHoursRatesTotalHoursRatesTotalHoursRatesTotalHoursRatesTotal
COST ELEMENTS
Direct Labor
Subtotal Direct Labor
Overhead
Total Direct Labor and Overhead
Travel (See separate schedule)
Hardware/Software
Other Miscellaneous Cost
Total Other Direct Costs
SUBTOTAL ALL DIRECT COSTS
Material Handling (MHX)
G&A
Subtotal Costs (Basis for Fee Application)
Fee (Fixed=%; Award=%)
Total Cost

Push to Print Forms Push to Print Forms Push to Print Forms Push to Print Forms Push to Print Forms Push to Print Forms Push to Print Forms Push to Print Forms Push to Print Forms Push to Print Forms Push to Print Forms Push to Print Forms Push to Print Forms Push to Print Forms Push to Print Forms Push to Print Forms

AL

Alabama Medicaid & Medicare
(May 1, 2010 - April 30, 2011)
TasksTotal FTEsAdministrationData / IT SystemsData MatchingData AnalysisFraud Case DevelopmentTotal
Annual FTEHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRatesTotal
COST ELEMENTS
Direct Labor
Subtotal Direct Labor
Overhead
Total Direct Labor and Overhead
Travel (See separate schedule)
Hardware/Software
Other Miscellaneous Cost
Total Other Direct Costs
SUBTOTAL ALL DIRECT COSTS
Material Handling (MHX)
Org 107 G&A
Subtotal Costs (Basis for Fee Application)
Fee
Total Cost

Push to Print Forms

AL Option YR 1

Alabama Medicaid & Medicare
(May 1, 2011 - April 30, 2012)
TasksTotal FTEsAdministrationData / IT SystemsData MatchingData AnalysisFraud Case DevelopmentTotal
Annual FTEHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRatesTotal
COST ELEMENTS
Direct Labor
Subtotal Direct Labor
Overheadat %
Total Direct Labor and Overhead
Travel (See separate schedule)
Hardware/Software
Other Miscellaneous Cost
Total Other Direct Costs
SUBTOTAL ALL DIRECT COSTS
Material Handling (MHX)at %
G&Aat %
Subtotal Costs (Basis for Fee Application)
Fee (Base Fee %) (Award Fee %)at %
Total Cost

Push to Print Forms

AL Option YR 2

Alabama Medicaid & Medicare
(May 1, 2012 - April 30, 2013)
TasksTotal FTEsAdministrationData / IT SystemsData MatchingData AnalysisFraud Case DevelopmentTotal
Annual FTEHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRatesTotal
COST ELEMENTS
Direct Labor
Subtotal Direct Labor
Overheadat %
Total Direct Labor and Overhead
Travel (See separate schedule)
Hardware/Software
Other Miscellaneous Cost
Total Other Direct Costs
SUBTOTAL ALL DIRECT COSTS
Material Handling (MHX)at %
G&Aat %
Subtotal Costs (Basis for Fee Application)
Fee (Base Fee %) (Award Fee %)at %
Total Cost

Push to Print Forms Push to Print Forms

AR

Arkansas Medicaid & Medicare
(June 1, 2008 - April 30, 2009)
TasksTotal FTEsAdministrationData / IT SystemsData MatchingData AnalysisFraud Case DevelopmentTotal
Annual FTEHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRatesTotal
COST ELEMENTS
Direct Labor
Subtotal Direct Labor
Overheadat %
Total Direct Labor and Overhead
Travel (See separate schedule)
Hardware/Software
Other Miscellaneous Cost
Total Other Direct Costs
SUBTOTAL ALL DIRECT COSTS
Material Handling (MHX)at %
G&Aat %
Subtotal Costs (Basis for Fee Application)
Fee (Base Fee %) (Award Fee %)at %
Total Cost

Push to Print Forms

AR Option YR 1

Arkansas Medicaid & Medicare
(May 1, 2009 - April 30, 2010)
TasksTotal FTEsAdministrationData / IT SystemsData MatchingData AnalysisFraud Case DevelopmentTotal
Annual FTEHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRatesTotal
COST ELEMENTS
Direct Labor
Subtotal Direct Labor
Overheadat %
Total Direct Labor and Overhead
Travel (See separate schedule)
Hardware/Software
Other Miscellaneous Cost
Total Other Direct Costs
SUBTOTAL ALL DIRECT COSTS
Material Handling (MHX)at %
G&Aat %
Subtotal Costs (Basis for Fee Application)
Fee (Base Fee %) (Award Fee %)at %
Total Cost

Push to Print Forms Push to Print Forms

AR Option YR 2

Arkansas Medicaid & Medicare
(May 1, 2010 - April 30, 2011)
TasksTotal FTEsAdministrationData / IT SystemsData MatchingData AnalysisFraud Case DevelopmentTotal
Annual FTEHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRatesTotal
COST ELEMENTS
Direct Labor
Subtotal Direct Labor
Overheadat %
Total Direct Labor and Overhead
Travel (See separate schedule)
Hardware/Software
Other Miscellaneous Cost
Total Other Direct Costs
SUBTOTAL ALL DIRECT COSTS
Material Handling (MHX)at %
G&Aat %
Subtotal Costs (Basis for Fee Application)
Fee (Base Fee %) (Award Fee %)at %
Total Cost

Push to Print Forms Push to Print Forms

AR Option YR 3

Arkansas Medicaid & Medicare
(May 1, 2011 - April 30, 2012)
TasksTotal FTEsAdministrationData / IT SystemsData MatchingData AnalysisFraud Case DevelopmentTotal
Annual FTEHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRatesTotal
COST ELEMENTS
Direct Labor
Subtotal Direct Labor
Overheadat %
Total Direct Labor and Overhead
Travel (See separate schedule)
Hardware/Software
Other Miscellaneous Cost
Total Other Direct Costs
SUBTOTAL ALL DIRECT COSTS
Material Handling (MHX)at %
G&Aat %
Subtotal Costs (Basis for Fee Application)
Fee (Base Fee %) (Award Fee %)at %
Total Cost

Push to Print Forms Push to Print Forms

AR Option YR 4

Arkansas Medicaid & Medicare
(May 1, 2012 - April 30, 2013)
TasksTotal FTEsAdministrationData / IT SystemsData MatchingData AnalysisFraud Case DevelopmentTotal
Annual FTEHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRatesTotal
COST ELEMENTS
Direct Labor
Subtotal Direct Labor
Overheadat %
Total Direct Labor and Overhead
Travel (See separate schedule)
Hardware/Software
Other Miscellaneous Cost
Total Other Direct Costs
SUBTOTAL ALL DIRECT COSTS
Material Handling (MHX)at %
G&Aat %
Subtotal Costs (Basis for Fee Application)
Fee (Base Fee %) (Award Fee %)at %
Total Cost

Push to Print Forms Push to Print Forms

GA

Georgia Medicaid & Medicare
(June 1, 2008 - April 30, 2009)
TasksTotal FTEsAdministrationData / IT SystemsData MatchingData AnalysisFraud Case DevelopmentTotal
Annual FTEHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRatesTotal
COST ELEMENTS
Direct Labor
Subtotal Direct Labor
Overheadat %
Total Direct Labor and Overhead
Travel (See separate schedule)
Hardware/Software
Other Miscellaneous Cost
Total Other Direct Costs
SUBTOTAL ALL DIRECT COSTS
Material Handling (MHX)at %
Org 107 G&Aat %
Subtotal Costs (Basis for Fee Application)
Fee (Base Fee %) (Award Fee %)at %
Total Cost

Push to Print Forms

GA Option YR 1

Georgia Medicaid & Medicare
(May 1, 2009 - April 30, 2010)
TasksTotal FTEsAdministrationData / IT SystemsData MatchingData AnalysisFraud Case DevelopmentTotal
Annual FTEHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRatesTotal
COST ELEMENTS
Direct Labor
Subtotal Direct Labor
Overheadat %
Total Direct Labor and Overhead
Travel (See separate schedule)
Hardware/Software
Other Miscellaneous Cost
Total Other Direct Costs
SUBTOTAL ALL DIRECT COSTS
Material Handling (MHX)at %
Org 107 G&Aat %
Subtotal Costs (Basis for Fee Application)
Fee (Base Fee %) (Award Fee %)at %
Total Cost

Push to Print Forms Push to Print Forms

GA Option YR 2

Georgia Medicaid & Medicare
(May 1, 2010 - April 30, 2011)
TasksTotal FTEsAdministrationData / IT SystemsData MatchingData AnalysisFraud Case DevelopmentTotal
Annual FTEHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRatesTotal
COST ELEMENTS
Direct Labor
Subtotal Direct Labor
Overheadat %
Total Direct Labor and Overhead
Travel (See separate schedule)
Hardware/Software
Other Miscellaneous Cost
Total Other Direct Costs
SUBTOTAL ALL DIRECT COSTS
Material Handling (MHX)at %
Org 107 G&Aat %
Subtotal Costs (Basis for Fee Application)
Fee (Base Fee %) (Award Fee %)at %
Total Cost

Push to Print Forms Push to Print Forms

GA Option YR 3

Georgia Medicaid & Medicare
(May 1, 2011 - April 30, 2012)
TasksTotal FTEsAdministrationData / IT SystemsData MatchingData AnalysisFraud Case DevelopmentTotal
Annual FTEHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRatesTotal
COST ELEMENTS
Direct Labor
Subtotal Direct Labor
Overheadat %
Total Direct Labor and Overhead
Travel (See separate schedule)
Hardware/Software
Other Miscellaneous Cost
Total Other Direct Costs
SUBTOTAL ALL DIRECT COSTS
Material Handling (MHX)at %
Org 107 G&Aat %
Subtotal Costs (Basis for Fee Application)
Fee (Base Fee %) (Award Fee %)at %
Total Cost

Push to Print Forms Push to Print Forms

GA Option YR 4

Georgia Medicaid & Medicare
(May 1, 2012 - April 30, 2013)
TasksTotal FTEsAdministrationData / IT SystemsData MatchingData AnalysisFraud Case DevelopmentTotal
Annual FTEHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRatesTotal
COST ELEMENTS
Direct Labor
Subtotal Direct Labor
Overheadat %
Total Direct Labor and Overhead
Travel (See separate schedule)
Hardware/Software
Other Miscellaneous Cost
Total Other Direct Costs
SUBTOTAL ALL DIRECT COSTS
Material Handling (MHX)at %
Org 107 G&Aat %
Subtotal Costs (Basis for Fee Application)
Fee (Base Fee %) (Award Fee %)at %
Total Cost

Push to Print Forms Push to Print Forms

LA

Louisiana Medicaid & Medicare
(May 1, 2009 - April 30, 2010)
TasksTotal FTEsAdministrationData / IT SystemsData MatchingData AnalysisFraud Case DevelopmentTotal
Annual FTEHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRatesTotal
COST ELEMENTS
Direct Labor
Subtotal Direct Labor
Overheadat %
Total Direct Labor and Overhead
Travel (See separate schedule)
Hardware/Software
Other Miscellaneous Cost
Total Other Direct Costs
SUBTOTAL ALL DIRECT COSTS
Material Handling (MHX)at %
Org 107 G&Aat %
Subtotal Costs (Basis for Fee Application)
Fee (Base Fee %) (Award Fee %)at %
Total Cost

Push to Print Forms

LA Option YR 1

Louisiana Medicaid & Medicare
(May 1, 2010 - April 30, 2011)
TasksTotal FTEsAdministrationData / IT SystemsData MatchingData AnalysisFraud Case DevelopmentTotal
Annual FTEHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRatesTotal
COST ELEMENTS
Direct Labor
Subtotal Direct Labor
Overheadat %
Total Direct Labor and Overhead
Travel (See separate schedule)
Hardware/Software
Other Miscellaneous Cost
Total Other Direct Costs
SUBTOTAL ALL DIRECT COSTS
Material Handling (MHX)at %
Org 107 G&Aat %
Subtotal Costs (Basis for Fee Application)
Fee (Base Fee %) (Award Fee %)at %
Total Cost

Push to Print Forms Push to Print Forms

LA Option YR 2

Louisiana Medicaid & Medicare
(May 1, 2011 - April 30, 2012)
TasksTotal FTEsAdministrationData / IT SystemsData MatchingData AnalysisFraud Case DevelopmentTotal
Annual FTEHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRatesTotal
COST ELEMENTS
Direct Labor
Subtotal Direct Labor
Overheadat %
Total Direct Labor and Overhead
Travel (See separate schedule)
Hardware/Software
Other Miscellaneous Cost
Total Other Direct Costs
SUBTOTAL ALL DIRECT COSTS
Material Handling (MHX)at %
Org 107 G&Aat %
Subtotal Costs (Basis for Fee Application)
Fee (Base Fee %) (Award Fee %)at %
Total Cost

Push to Print Forms Push to Print Forms

LA Option YR 3

Louisiana Medicaid & Medicare
(May 1, 2012 - April 30, 2013)
TasksTotal FTEsAdministrationData / IT SystemsData MatchingData AnalysisFraud Case DevelopmentTotal
Annual FTEHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRatesTotal
COST ELEMENTS
Direct Labor
Subtotal Direct Labor
Overheadat %
Total Direct Labor and Overhead
Travel (See separate schedule)
Hardware/Software
Other Miscellaneous Cost
Total Other Direct Costs
SUBTOTAL ALL DIRECT COSTS
Material Handling (MHX)at %
Org 107 G&Aat %
Subtotal Costs (Basis for Fee Application)
Fee (Base Fee %) (Award Fee %)at %
Total Cost

Push to Print Forms Push to Print Forms

MS

Mississippi Medicaid & Medicare
(May 1, 2010 - April 30, 2011)
TasksTotal FTEsAdministrationData / IT SystemsData MatchingData AnalysisFraud Case DevelopmentTotal
Annual FTEHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRatesTotal
COST ELEMENTS
Direct Labor
Subtotal Direct Labor
Overheadat %
Total Direct Labor and Overhead
Travel (See separate schedule)
Hardware/Software
Other Miscellaneous Cost
Total Other Direct Costs
SUBTOTAL ALL DIRECT COSTS
Material Handling (MHX)at %
Org 107 G&Aat %
Subtotal Costs (Basis for Fee Application)
Fee (Base Fee %) (Award Fee %)at %
Total Cost

Push to Print Forms

MS Option YR 1

Mississippi Medicaid & Medicare
(May 1, 2011 - April 30, 2012)
TasksTotal FTEsAdministrationData / IT SystemsData MatchingData AnalysisFraud Case DevelopmentTotal
Annual FTEHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRatesTotal
COST ELEMENTS
Direct Labor
Subtotal Direct Labor
Overheadat %
Total Direct Labor and Overhead
Travel (See separate schedule)
Hardware/Software
Other Miscellaneous Cost
Total Other Direct Costs
SUBTOTAL ALL DIRECT COSTS
Material Handling (MHX)at %
Org 107 G&Aat %
Subtotal Costs (Basis for Fee Application)
Fee (Base Fee %) (Award Fee %)at %
Total Cost

Push to Print Forms Push to Print Forms

MS Option YR 2

Mississippi Medicaid & Medicare
(May 1, 2012 - April 30, 2013)
TasksTotal FTEsAdministrationData / IT SystemsData MatchingData AnalysisFraud Case DevelopmentTotal
Annual FTEHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRatesTotal
COST ELEMENTS
Direct Labor
Subtotal Direct Labor
Overheadat %
Total Direct Labor and Overhead
Travel (See separate schedule)
Hardware/Software
Other Miscellaneous Cost
Total Other Direct Costs
SUBTOTAL ALL DIRECT COSTS
Material Handling (MHX)at %
Org 107 G&Aat %
Subtotal Costs (Basis for Fee Application)
Fee (Base Fee %) (Award Fee %)at %
Total Cost

Push to Print Forms Push to Print Forms

NC

North Carolina Medicaid & Medicare
(May 1, 2009 - April 30, 2010)
TasksTotal FTEsAdministrationData / IT SystemsData MatchingData AnalysisFraud Case DevelopmentTotal
Annual FTEHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRatesTotal
COST ELEMENTS
Direct Labor
Subtotal Direct Labor
Overheadat %
Total Direct Labor and Overhead
Travel (See separate schedule)
Hardware/Software
Other Miscellaneous Cost
Total Other Direct Costs
SUBTOTAL ALL DIRECT COSTS
Material Handling (MHX)at %
Org 107 G&Aat %
Subtotal Costs (Basis for Fee Application)
Fee (Base Fee %) (Award Fee %)at %
Total Cost

Push to Print Forms

NC Option YR 1

North Carolina Medicaid & Medicare
(May 1, 2010 - April 30, 2011)
TasksTotal FTEsAdministrationData / IT SystemsData MatchingData AnalysisFraud Case DevelopmentTotal
Annual FTEHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRatesTotal
COST ELEMENTS
Direct Labor
Subtotal Direct Labor
Overheadat %
Total Direct Labor and Overhead
Travel (See separate schedule)
Hardware/Software
Other Miscellaneous Cost
Total Other Direct Costs
SUBTOTAL ALL DIRECT COSTS
Material Handling (MHX)at %
Org 107 G&Aat %
Subtotal Costs (Basis for Fee Application)
Fee (Base Fee %) (Award Fee %)at %
Total Cost

Push to Print Forms Push to Print Forms

NC Option YR 2

North Carolina Medicaid & Medicare
(May 1, 2011 - April 30, 2012)
TasksTotal FTEsAdministrationData / IT SystemsData MatchingData AnalysisFraud Case DevelopmentTotal
Annual FTEHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRatesTotal
COST ELEMENTS
Direct Labor
Subtotal Direct Labor
Overheadat %
Total Direct Labor and Overhead
Travel (See separate schedule)
Hardware/Software
Other Miscellaneous Cost
Total Other Direct Costs
SUBTOTAL ALL DIRECT COSTS
Material Handling (MHX)at %
Org 107 G&Aat %
Subtotal Costs (Basis for Fee Application)
Fee (Base Fee %) (Award Fee %)at %
Total Cost

Push to Print Forms Push to Print Forms

NC Option YR 3

North Carolina Medicaid & Medicare
(May 1, 2012 - April 30, 2013)
TasksTotal FTEsAdministrationData / IT SystemsData MatchingData AnalysisFraud Case DevelopmentTotal
Annual FTEHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRatesTotal
COST ELEMENTS
Direct Labor
Subtotal Direct Labor
Overheadat %
Total Direct Labor and Overhead
Travel (See separate schedule)
Hardware/Software
Other Miscellaneous Cost
Total Other Direct Costs
SUBTOTAL ALL DIRECT COSTS
Material Handling (MHX)at %
Org 107 G&Aat %
Subtotal Costs (Basis for Fee Application)
Fee (Base Fee %) (Award Fee %)at %
Total Cost

Push to Print Forms Push to Print Forms

SC

South Carolina Medicaid & Medicare
(May 1, 2009 - April 30, 2010)
TasksTotal FTEsAdministrationData / IT SystemsData MatchingData AnalysisFraud Case DevelopmentTotal
Annual FTEHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRatesTotal
COST ELEMENTS
Direct Labor
Subtotal Direct Labor
Overheadat %
Total Direct Labor and Overhead
Travel (See separate schedule)
Hardware/Software
Other Miscellaneous Cost
Total Other Direct Costs
SUBTOTAL ALL DIRECT COSTS
Material Handling (MHX)at %
Org 107 G&Aat %
Subtotal Costs (Basis for Fee Application)
Fee (Base Fee %) (Award Fee %)at %
Total Cost

Push to Print Forms

SC Option YR 1

South Carolina Medicaid & Medicare
(May 1, 2010 - April 30, 2011)
TasksTotal FTEsAdministrationData / IT SystemsData MatchingData AnalysisFraud Case DevelopmentTotal
Annual FTEHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRatesTotal
COST ELEMENTS
Direct Labor
Subtotal Direct Labor
Overheadat %
Total Direct Labor and Overhead
Travel (See separate schedule)
Hardware/Software
Other Miscellaneous Cost
Total Other Direct Costs
SUBTOTAL ALL DIRECT COSTS
Material Handling (MHX)at %
Org 107 G&Aat %
Subtotal Costs (Basis for Fee Application)
Fee (Base Fee %) (Award Fee %)at %
Total Cost

Push to Print Forms Push to Print Forms

SC Option YR 2

South Carolina Medicaid & Medicare
(May 1, 2011 - April 30, 2012)
TasksTotal FTEsAdministrationData / IT SystemsData MatchingData AnalysisFraud Case DevelopmentTotal
Annual FTEHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRatesTotal
COST ELEMENTS
Direct Labor
Subtotal Direct Labor
Overheadat %
Total Direct Labor and Overhead
Travel (See separate schedule)
Hardware/Software
Other Miscellaneous Cost
Total Other Direct Costs
SUBTOTAL ALL DIRECT COSTS
Material Handling (MHX)at %
Org 107 G&Aat %
Subtotal Costs (Basis for Fee Application)
Fee (Base Fee %) (Award Fee %)at %
Total Cost

Push to Print Forms Push to Print Forms

SC Option YR 3

South Carolina Medicaid & Medicare
(May 1, 2012 - April 30, 2013)
TasksTotal FTEsAdministrationData / IT SystemsData MatchingData AnalysisFraud Case DevelopmentTotal
Annual FTEHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRatesTotal
COST ELEMENTS
Direct Labor
Subtotal Direct Labor
Overheadat %
Total Direct Labor and Overhead
Travel (See separate schedule)
Hardware/Software
Other Miscellaneous Cost
Total Other Direct Costs
SUBTOTAL ALL DIRECT COSTS
Material Handling (MHX)at %
Org 107 G&Aat %
Subtotal Costs (Basis for Fee Application)
Fee (Base Fee %) (Award Fee %)at %
Total Cost

Push to Print Forms Push to Print Forms

TN

Tennessee Medicaid & Medicare
(May 1, 2009 - April 30, 2010)
TasksTotal FTEsAdministrationData / IT SystemsData MatchingData AnalysisFraud Case DevelopmentTotal
Annual FTEHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRatesTotal
COST ELEMENTS
Direct Labor
Subtotal Direct Labor
Overheadat %
Total Direct Labor and Overhead
Travel (See separate schedule)
Hardware/Software
Other Miscellaneous Cost
Total Other Direct Costs
SUBTOTAL ALL DIRECT COSTS
Material Handling (MHX)at %
Org 107 G&Aat %
Subtotal Costs (Basis for Fee Application)
Fee (Base Fee %) (Award Fee %)at %
Total Cost

Push to Print Forms Push to Print Forms

TN Option YR 1

Tennessee Medicaid & Medicare
(May 1, 2010 - April 30, 2011)
TasksTotal FTEsAdministrationData / IT SystemsData MatchingData AnalysisFraud Case DevelopmentTotal
Annual FTEHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRatesTotal
COST ELEMENTS
Direct Labor
Subtotal Direct Labor
Overheadat %
Total Direct Labor and Overhead
Travel (See separate schedule)
Hardware/Software
Other Miscellaneous Cost
Total Other Direct Costs
SUBTOTAL ALL DIRECT COSTS
Material Handling (MHX)at %
Org 107 G&Aat %
Subtotal Costs (Basis for Fee Application)
Fee (Base Fee %) (Award Fee %)at %
Total Cost

Push to Print Forms Push to Print Forms

TN Option YR 2

Tennessee Medicaid & Medicare
(May 1, 2011 - April 30, 2012)
TasksTotal FTEsAdministrationData / IT SystemsData MatchingData AnalysisFraud Case DevelopmentTotal
Annual FTEHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRatesTotal
COST ELEMENTS
Direct Labor
Subtotal Direct Labor
Overheadat %
Total Direct Labor and Overhead
Travel (See separate schedule)
Hardware/Software
Other Miscellaneous Cost
Total Other Direct Costs
SUBTOTAL ALL DIRECT COSTS
Material Handling (MHX)at %
Org 107 G&Aat %
Subtotal Costs (Basis for Fee Application)
Fee (Base Fee %) (Award Fee %)at %
Total Cost

Push to Print Forms Push to Print Forms

TN Option YR 3

Tennessee Medicaid & Medicare
(May 1, 2012 - April 30, 2013)
TasksTotal FTEsAdministrationData / IT SystemsData MatchingData AnalysisFraud Case DevelopmentTotal
Annual FTEHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRatesTotal
COST ELEMENTS
Direct Labor
Subtotal Direct Labor
Overheadat %
Total Direct Labor and Overhead
Travel (See separate schedule)
Hardware/Software
Other Miscellaneous Cost
Total Other Direct Costs
SUBTOTAL ALL DIRECT COSTS
Material Handling (MHX)at %
Org 107 G&Aat %
Subtotal Costs (Basis for Fee Application)
Fee (Base Fee %) (Award Fee %)at %
Total Cost

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VA

Virginia Medicaid & Medicare
(May 1, 2009 - April 30, 2010)
TasksTotal FTEsAdministrationData / IT SystemsData MatchingData AnalysisFraud Case DevelopmentTotal
Annual FTEHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRatesTotal
COST ELEMENTS
Direct Labor
Subtotal Direct Labor
Overheadat %
Total Direct Labor and Overhead
Travel (See separate schedule)
Hardware/Software
Other Miscellaneous Cost
Total Other Direct Costs
SUBTOTAL ALL DIRECT COSTS
Material Handling (MHX)at %
Org 107 G&Aat %
Subtotal Costs (Basis for Fee Application)
Fee (Base Fee %) (Award Fee %)at %
Total Cost

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VA Option YR 1

Virginia Medicaid & Medicare
(May 1, 2010 - April 30, 2011)
TasksTotal FTEsAdministrationData / IT SystemsData MatchingData AnalysisFraud Case DevelopmentTotal
Annual FTEHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRatesTotal
COST ELEMENTS
Direct Labor
Subtotal Direct Labor
Overheadat %
Total Direct Labor and Overhead
Travel (See separate schedule)
Hardware/Software
Other Miscellaneous Cost
Total Other Direct Costs
SUBTOTAL ALL DIRECT COSTS
Material Handling (MHX)at %
Org 107 G&Aat %
Subtotal Costs (Basis for Fee Application)
Fee (Base Fee %) (Award Fee %)at %
Total Cost

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VA Option YR 2

Virginia Medicaid & Medicare
(May 1, 2011 - April 30, 2012)
TasksTotal FTEsAdministrationData / IT SystemsData MatchingData AnalysisFraud Case DevelopmentTotal
Annual FTEHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRatesTotal
COST ELEMENTS
Direct Labor
Subtotal Direct Labor
Overheadat %
Total Direct Labor and Overhead
Travel (See separate schedule)
Hardware/Software
Other Miscellaneous Cost
Total Other Direct Costs
SUBTOTAL ALL DIRECT COSTS
Material Handling (MHX)at %
Org 107 G&Aat %
Subtotal Costs (Basis for Fee Application)
Fee (Base Fee %) (Award Fee %)at %
Total Cost

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VA Option YR 3

Virginia Medicaid & Medicare
(May 1, 2012 - April 30, 2013)
TasksTotal FTEsAdministrationData / IT SystemsData MatchingData AnalysisFraud Case DevelopmentTotal
Annual FTEHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRatesTotal
COST ELEMENTS
Direct Labor
Subtotal Direct Labor
Overheadat %
Total Direct Labor and Overhead
Travel (See separate schedule)
Hardware/Software
Other Miscellaneous Cost
Total Other Direct Costs
SUBTOTAL ALL DIRECT COSTS
Material Handling (MHX)at %
Org 107 G&Aat %
Subtotal Costs (Basis for Fee Application)
Fee (Base Fee %) (Award Fee %)at %
Total Cost

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WV

West Virginia Medicaid & Medicare
(May 1, 2010 - April 30, 2011)
TasksTotal FTEsAdministrationData / IT SystemsData MatchingData AnalysisFraud Case DevelopmentTotal
Annual FTEHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRatesTotal
COST ELEMENTS
Direct Labor
Subtotal Direct Labor
Overhead
Total Direct Labor and Overhead
Travel (See separate schedule)
Hardware/Software
Other Miscellaneous Cost
Total Other Direct Costs
SUBTOTAL ALL DIRECT COSTS
Material Handling (MHX)
Org 107 G&A
Subtotal Costs (Basis for Fee Application)
Fee
Total Cost

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WV Option YR 1

West Virginia Medicaid & Medicare
(May 1, 2011 - April 30, 2012)
TasksTotal FTEsAdministrationData / IT SystemsData MatchingData AnalysisFraud Case DevelopmentTotal
Annual FTEHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRatesTotal
COST ELEMENTS
Direct Labor
Subtotal Direct Labor
Overheadat %
Total Direct Labor and Overhead
Travel (See separate schedule)
Hardware/Software
Other Miscellaneous Cost
Total Other Direct Costs
SUBTOTAL ALL DIRECT COSTS
Material Handling (MHX)at %
G&Aat %
Subtotal Costs (Basis for Fee Application)
Fee (Base Fee %) (Award Fee %)at %
Total Cost

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WV Option YR 2

West Virginia Medicaid & Medicare
(May 1, 2012 - April 30, 2013)
TasksTotal FTEsAdministrationData / IT SystemsData MatchingData AnalysisFraud Case DevelopmentTotal
Annual FTEHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRateTotalHoursRatesTotal
COST ELEMENTS
Direct Labor
Subtotal Direct Labor
Overheadat %
Total Direct Labor and Overhead
Travel (See separate schedule)
Hardware/Software
Other Miscellaneous Cost
Total Other Direct Costs
SUBTOTAL ALL DIRECT COSTS
Material Handling (MHX)at %
G&Aat %
Subtotal Costs (Basis for Fee Application)
Fee (Base Fee %) (Award Fee %)at %
Total Cost

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Travel

Reason for Trip From To Number of People Times per year Airfare Hotel Number of Nights Total Hotel (Plus Appl. Tax if Known) Meals & Incidentals Per Diem Per FTR Total Per Diem (3/4 for 1st & last day) Car Rental Home Airport Parking Total

ODCs

Cost ElementAmountAmountTOTAL
ODCs
$0.00
Hardware/Software
TOTAL ODCs

File details come from the government source that posted it. Updated .