Amendment 00001 JA.docx

RFP-CMS-2010-0004 DME MAC Jurisdiction A Amendment 000001

The purpose of this amendment is to incorporate the following changes to the solicitation. As a result, the solicitation is amended as follows:

A. SECTION C – DESCRIPTION/SPECIFICSTIONS/WORK STATEMENT, C.1 STATEMENT OF WORK, Attachment J.1, Section C.1.1.1., Implementation Project Plan, page 27, states the following sentence:

“The contractor shall submit the Implementation Project Plan as part of its proposal.”

Offerors do not have to submit an Implementation Project Plan as part of their proposal.

NOTE: A revised SOW will be provided in a subsequent amendment to address the Implementation Project Plan.

B. SECTION J – LIST OF ATTACHMENTS, is revised as follows:

1. Attachment J.11 through J.15 Cost Proposal Templates – There may be inaccuracies with the formulas contained in the cost templates. Offerors may correct any errors related to formulas that are discovered in the use of these templates.

1. Attachment J.25, Travel Template, is provided as an attachment to this amendment.

C. SECTION L – INSTRUCTIONS, CONDITIONS AND NOTICES TO OFFERORS

1. L.11 PROPOSAL ASSUMPTIONS, pages 80-85, are deleted in their entirety and replaced as follows:

Offerors shall use the following assumptions when developing their proposal:

a. Implementation Cutover Date

The Offeror shall use the Implementation cutover date developed by CMS (see table below) when developing its proposed CLIN 0001 costs associated with its Jurisdiction Implementation Project Plan. Completion of the movement of the Jurisdiction to the incoming DME MAC shall occur within four (4) months of award.

At the implementation cutover date the outgoing Durable Medical Equipment Medicare Administrative Contractor (DME MAC) ceases Medicare operations and the incoming DME MAC begins to perform Medicare business functions for that jurisdiction.

b. It is anticipated that the DME MAC contract award for Jurisdiction A shall be made on July 31, 2010.

c. Joint Operating Agreements between functional contractors impacting the DME MACs shall be executed prior to the operational start date. The operational start date is defined as the date that the DME MAC assumes all Medicare functions from an outgoing DME MAC and is capable of processing Medicare claims for that jurisdiction.

d. For estimating purposes, the annual workloads in the tables below shall be used by all Offerors in preparing their technical and business proposals.

(8 months)

PM Bills/Claims

PM Appeals

PM Beneficiary Inquiries

PM Provider Customer Service

Note: The number provided represents the provider population for the specified Jurisdiction. It is up to the Offeror to determine the workload appropriate for each type of provider outreach and education activity. There are no minimum requirements for this function, so the offeror must develop their own strategy for how they can best service the provider population.

PM Provider Inquiries

PM Non-MSP collections (including RAC)

MIP Medical Review (MR)

Note: These workloads approximate the historical workloads that have been incurred within this jurisdiction and are intended as a guide for cost estimation purposes. The proposal cost estimate should reflect the projected workload categories and volumes that result from the Offeror's Medicare Review Strategy. However, the sum of the two workload elements marked above with an (X) that is, Prepay Complex Probe Reviews and Prepay Complex Reviews, shall not be adjusted by more than 5% upwards or downwards in each contract period. For instance, the sum of the proposed levels for Prepay Complex Probe Reviews and Prepay Complex Reviews during the first option period shall equal to 37,868, plus or minus 5%. While the Offeror may adjust the balance of these two workload elements to reflect its Medical Review Strategy, the total of the two workload elements must fall within this range. This fixed assumption shall be incorporated into the Offeror’s Medical Review Strategy and accompanying elements within the cost proposal. The Offeror has discretion to adjust other workload elements from the above figures based on its Medical Review Strategy.

The historic workloads provided do not include automated reviews. Historically, automated reviews for this jurisdiction have totaled 75,000 per year. The Offeror shall include its own automated review workload estimates as part of its Medical Review strategy. At a minimum, the Offeror’s Medical Review strategy shall proposed automated reviews by the following categories: Automated Reviews developed based on the contractor’s LCDs; Medically Unlikely Edits; Not Correct Coding Initiative Edits; and Not National Coverage Determination Edits.

MIP MSP Prepay

MIP Benefit Integrity

# of PSC Support Services Provided

MIP Provider Customer Service

Note: The number provided represents the provider population for the specified Jurisdiction. It is up to the offeror to determine the workload appropriate for each type of provider outreach and education activity. There are no minimum requirements for this function, so the offeror must develop their own strategy for how they can best service the provider population.

MIP MSP Postpay

** Pending workloads represent the carryover from the outgoing contractor (Base Period).

e. Change Requests

In Fiscal Year (FY) 2009, the CMS issued approximately 412 draft change requests (CRs) to Medicare Contractors, Shared System Maintainers (SSMs), and the Common Working File (CWF) Maintenance Contractor for review and comment. (This is otherwise known as the Point of Contact (POC) Review period, which is described in detail in section C.4, Participation in Change Management Process, of the SOW.) Approximately 400 of the draft CRs were issued in final for implementation. Approximately 68 percent of those issued CRs resulted in changes to the Shared Systems and the Common Working File.

(1) For proposal purposes only, Offerors shall assume that the estimated workload associated with reviewing and commenting on draft CRs is as follows:

(i) 475 draft CRs will be issued during the base Period of the contract for review and comment.

(2) For proposal purposes only, Offerors shall also assume that the estimated workload with implementing finalized issued CRs is as follows:

(i) CMS will issue in final 245 CRs annually that will require shared system changes.

(ii) CMS will issue in final 115 CRs annually that will not require shared system changes.

2. L.13 WRITTEN TECHNICAL PROPOSAL ORGANIZATION, page 87, is revised to include C.1.3 Cost Templates without Cost Data for Implementation, Base Period and Option Period One and renumber Key Personnel to C.1.4. As a result the section reads as follows.

The Offeror shall identify, in the header or the footer throughout the proposal, the Offeror’s name and the jurisdiction for which the Offeror is submitting the proposal. Offerors must adhere to the page limits defined below. Pages provided beyond the limit will be discarded and not reviewed or evaluated. Volume I must NOT contain reference to price/cost.

a. Volume I – Written Technical Proposal (limit of 60 pages) The Offeror’s technical written proposal shall be organized as follows:

3. L.14 VOLUME I – WRITTEN TECHNICAL PROPOSAL INSTRUCTIONS (limit of 60 pages), pages 91-92, is revised to include C.1.3 Cost Templates without Cost Data for Implementation, Base Period and Option Period One and renumber Key Personnel to C.1.4. As a result the section reads as follows

Tab C.1.3: Cost Templates without Cost Data for Implementation, Base Period and Option Period One – CD Only (not included in 60 page limit) The Offeror shall provide its proposed labor mix for performing the requirements of the SOW. At a minimum, the Offeror shall provide summary schedules broken down by SOW Task and SLINs for the Implementation, Base Period and Option Period One. At a minimum, the Offeror shall provide its direct labor (and any service center labor, if applicable) by labor category, number of hours, and FTEs.

* Note: Tab C.3 MUST provide the cost elements ONLY and be VOID of all cost (i.e. labor rates, overhead rates, fee, etc.) and price information (final price).

Tab C.1.4: Key Personnel (resumes limited to 3 pages each and letters of commitment limited to one (1) page each (not included in 60-page limit) The Offeror shall identify and provide resumes for all key personnel identified in the SOW. The Offeror shall provide a letter of commitment for all key personnel not currently employed by the Offeror or subcontractor. Letters of Commitment shall include the date of availability, how long the individual’s commitment is binding, and is signed by the individual and the Offeror’s corporate authorized official. Resumes and Letters of Commitment shall be provided as a separate appendix that is not included in the technical proposal page limit; resumes should not exceed three pages each. Each resume shall begin with a summary of the experience and expertise directly applicable to this contract, including, where applicable, the number and level of expertise of all personnel managed. Each resume shall contain sufficient detail to clearly indicate the person is qualified for the position proposed (i.e., length of time for which the experience applies, the number and level of personnel managed, the directly applicable Medicare experience, the directly applicable technical experience, etc.). Each resume shall contain the following, at a minimum:

(a) Name and position.

(b) Educational background, including academic degrees and the year conferred.

(c) Technical training, including program year completions.

(d) Years of applicable experience.

(e) Citizenship.

(f) History of applicable employment experience only identifying the technical qualifications relevant to the SOW and labor categories.

(g) History of other experience and professional accomplishments that the Offeror may wish to present to demonstrate qualifications of the proposed individual.

4. L.16 GENERAL BUSINESS PROPOSAL INSTRUCTION, VOLUME IIA – Business Proposal Cost Template Instructions, Travel, pages 97-98, is revised to include instructions for Attachment J.25 Travel Template. As a result this section reads as follows.

a. VOLUME IIA - Business Proposal Cost Template Instructions The business proposal cost spreadsheets must be readable.

The Offeror shall use the business proposal templates and instructions (Attachments J.9 through J.16) for all business proposal spreadsheet submissions. The business proposal spreadsheet templates indicate the levels of proposed costs that are to be provided to the extent that an Offeror’s accounting system is able to capture cost data for that particular section.

The business proposal spreadsheets shall be submitted for each CLIN, including options. The business proposal spreadsheets shall also be provided on CD-ROM (six (6) copies).

The Offeror shall use the business proposal spreadsheets for all pricing and include the following:

1. Labor for Prime and Subcontractors: Offeror shall provide labor rates for all labor categories that are expected to be used in the performance of the DME MAC contract. Such labor rates shall be projected for the base period and all option periods.

2. Travel: All travel costs proposed shall be reimbursed on a cost reimbursement basis in accordance with the Federal Travel Regulation (FTR). Offeror is required to submit a breakdown of proposed travel expenses consisting of the following: “From” and “To” cities, number, types and purpose of trips, number of travelers, duration of trip for each destination, mileage, per diem, air fare, and miscellaneous expenses. Offeror shall complete Attachment J.25 for each CLIN of the contract when submitting its travel detail.

3. Other Direct Costs (ODCs): These include materials, equipment, etc. The Offeror shall consolidate ODCs into one line item. However, a separate schedule should be provided to breakdown ODCs. The schedule shall provide a detailed itemization of each ODC.

4. Subcontracts: All proposed subcontractors shall submit complete business proposal spreadsheets in the same format as the Offeror’s business proposal spreadsheets. Subcontractors may submit business proposal spreadsheets showing the breakdown of costs to CMS in a separately sealed package.

5. Indirect Rates: The Offeror shall provide the indirect rates as applicable along with the relative percentages on the business proposal spreadsheets. For Business Proposal pricing purposes, your organization shall develop its proposed indirect rates for this proposal using a business base that includes current actual workload and the award of the JA DME MAC contract only. At this time, please provide the indirect rates only that will be applied during the time of request for Revised Final Proposal Revision. Provide a break-out of the business base included in the rates.

6. Fee: The Offeror shall provide each fee separately on the business proposal spreadsheets.

7. Summary Rollup of All Costs: In addition to the individual contract line item summaries the Offeror shall include a summary sheet inclusive of all costs.

8. Basis of Estimate (CD Only): To provide CMS with an understanding of the Offeror's basis of estimate, the offeror shall complete Attachment J.7, Basis of Estimate for the Base Period and Option Period One. The detailed instructions for this template are included in Attachment J.7. The Offeror shall complete and submit Attachment J.7 in excel format (2007 version).

D. All other terms and conditions of this solicitation remain unchanged.

Attachments J.25 Travel Template