CCI Solicitation amendment 000001.docx

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Attached to
National Correct Coding Initiative Federal contract opportunity
Solicitation number
RFP-CMS-2011-0010
Issued by
Department of Health and Human Services Centers for Medicare and Medicaid Services

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Section B-M (Amendment 000001)

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NCCI.V17.0.CCI.CR.1.1.2011.R2097CP.pdf PDF
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J.5 Virus_Detection_Certification.doc DOC document
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finalNCCIcodingpolicymanual_083110.zip ZIP file
Attachment J.3 PastPerformanceQuestionnaire.docx DOCX document
RFP-2011-0010 SF33.pdf PDF
Attachment J.1 CCI SOW.docx DOCX document
Attachment J.2 Cost Template E-1.xlsx XLSX spreadsheet
Coverletter RFP-CMS-2011-0010.pdf PDF
Attachment J.4 Responsibility Questionnaire.docx DOCX document
RFP-CMS-2011-0010 Section B-M.docx DOCX document
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TABLE OF CONTENTS

SECTION B - SUPPLIES OR SERVICES, AND PRICES

B.1BRIEF DESCRIPTION OF SERVICES
B.2TYPE OF CONTRACT
B.3SCHEDULE OF SERVICES

SECTION C DESCRIPTION/SPECIFICATION/WORK STATEMENT

C.1 STATEMENT OF WORK

SECTION D – PACKAGING AND MARKING

D.1 PACKAGING, MARKING AND SHIPPING

SECTION E INSPECTION AND ACCEPTANCE

E.152.252-2 CLAUSES INCORPORATED BY REFERENCE
E.2INSPECTION AND ACCEPTANCE
E.3APPROVALS BY THE CONTRACTING OFFICER TECHNICAL REPRESENTATIVE (COTR)

SECTION F DELIVERIES OR PERFORMANCE

F.1PERIOD OF PERFORMANCE
F.2ITEMS TO BE FURNISHED AND DELIVERY SCHEDULE
F.3TIME AND PLACE OF DELIVERABLES
F.4FAR 52.252-2 CLAUSES INCORPORATED BY REFERENCE

SECTION G CONTRACT ADMINISTRATION DATA

G.1ACCOUNTING AND APPROPRIATION DATA
G.2INVOICE AND PAYMENT (STANDARD)
G.3METHOD OF PAYMENT
G.4CONTRACTING OFFICER TECHNICAL REPRESENTATIVE (COTR)
G.5TECHNICAL DIRECTION
G.6CONTRACTING OFFICER RESPONSIBILITY
G.7PROGRAM DIRECTOR/PROJECT MANAGER
G.8HHSAR 352.242-70 KEY PERSONNEL
G.9USE OF GOVERNMENT – DATA (REPORTS/FILES/COMPUTER TAPES OR DISCS)
G.10DATA TO BE DELIVERED
G.11MODIFICATION OF AUTHORITY
G.12DISSEMINATION, PUBLICATION & DISTRIBUTION OF INFORMATION
G.13SERVICE OF CONSULTANT/ SUBCONTRACTORS
G.14AUDIT OF HOURS
G.15CORRESPONDENCE PROCEDURES
G.16DESIGNATION OF PROPERTY ADMINISTRATOR
G.17GOVERNMENT-FURNISHED PROPERTY

SECTION H - SPECIAL CONTRACT REQUIRMENTS

H.1 CONTRACT RENEWAL

H.2HHSAR 352.227-70 PUBLICATIONS AND PUBLICITY
H.3HHSAR 352.201-70 PAPERWORK REDUCTION ACT
H.4HHSAR 352.203-70 ANTI-LOBBYING
H.5HHSAR 352.242-71 TOBACCO-FREE FACILITIES
H.6CMS CLAUSE 01 SECTION 508- ACCESSIBILITY OF ELECTRONIC AND INFORMATION TECHNOLOGY
H.7CMS CLAUSE 03 POST AWARD EVALUATION OF CONTRACTOR PERFORMANCE
H.8H.10 CMS CLAUSE 04 APPROVAL OF CONTRACT ACQUIRED INFORMATION TECHNOLOGY
H.9CMS CLAUSE 07 CODE OF CONDUCT
H.10CMS CLAUSE 08 HIPPA BUSINESS ASSOCIATE PROVISION II
H.11CMS CLAUSE 09a-01 SECURITY CLAUSE, BACKGROUND INVESTIGATIONS FOR CONTRACT PERSONNEL
H.12CMS CLAUSE 11 CMS INFORMATION SECURITY
H.13ORGANIZATIONAL CONFLICTS OF INTEREST
H.14REHABILITATION ACT, SECTION 508, ACCESSIBILITY STANDARDS
H.15CONDITIONS FOR PERFORMANCE
H.16ADP SYSTEMS

SECTION I - CONTRACT CLAUSES

I.1CLAUSES INCORPORATED BY REFERENCE
I.2DEPARTMENT OF HEALTH AND HUMAN SERVICES ACQUISITION REGULATIONS
I.352.215-19 NOTIFICATION OF OWNERSHIP CHANGES
I.452.217-8 OPTION TO EXTEND SERVICES
I.552.219-28 POST-AWARD SMALL BUSINESS PROGRAM RE-REPRESENTATION
I.652.237-3 CONTINUITY OF SERVICES

SECTION J – LIST OF DOCUMENTS, EXHIBITYS AND OTHER ATTACHMENTS

J.1 STATEMENT OF WORK

J.2COST PROPOSAL TEMPLATE
J.3PAST PERFORMANCE QUESTIONNAIRE
J.4RESPONSIBILITY DETERMINATION QUETIONNAIRE
J.5Virus Detection Certification

SECTION K – REPRESENTATIONS AND CERTIFICATIONS

K.152.204-8 ANNUAL REPRESENTATIONS AND CERTIFICATIONS
K.2ORGANIZATIONAL CONFLICT OF INTEREST REPRESENTATION (SERVICES)
K.352.234-3 NOTICE OF EARNED VALUE MANAGEMENT SYSTEMS - POST AWARD IBR

SECTION l - INSTRUCTIONS, CONDITIONS & NOTICES TO OFFERORS OR QUOTERS

L.152.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE
L.252.215-1 INSTRUCTIONS TO OFFERORS - COMPETITIVE ACQUISITION
L.352.215-20 REQUIREMENTS FOR COST OR PRICING DATA OR INFORMATION OTHER THAN COST OR PRICING DATA
L.452.216-1 TYPE OF CONTRACT
L.552.233.2 SERVICE OF PROTEST
L.6SECTION 508 ACCESSIBILITY OF ELECTRONIC AND INFORMATION TECHNOLOGY COMPLIANCE
L.7INSTRUCTIONS TO OFFERORS - CENTRAL CONTRACTOR REGISTRATION (CCr)
L.8COMMUNICATIONS PRIOR TO CONTRACT AWARD
L.9 WORK WITHIN THE UNITED STATES
L.10 NAICS CODE AND SMALL BUSINESS SIZE STANDARD
L.11 PROPOSAL SUBMISSION INSTRUCTIONS

SECTION M – EVALUATION FACTORS FOR AWARD

M.1 52.252-2 CLAUSES INCORPORATED BY REFERENCE
M.2GENERAL EVALUATION PROCESS AND SOURCE SELECTION APPROACH
M.3TECHNICAL EVALUATION CRITERIA
M.4EVALUATION OF VOLUME II - BUSINESS PROPOSAL

SECTION B - SUPPLIES OR SERVICES, AND PRICES

B.1 BRIEF DESCRIPTION OF SERVICES

The purpose of this contract is to maintain and further expand correct coding edits to ensure proper coding for part B and hospital outpatient services, enable the Center for Medicaid, CHIP, and Survey & Certification (CMCS) and the States in meeting the requirements of section 6507 of the Patient Protection and Affordable Care Act (PPACA) and continue maintenance of the associated manuals and continuation of the ongoing tasks, such as education to the provider community, replying to correspondence, etc. The contractor shall also provide the necessary personnel, equipment, materials, support/maintenance, supplies and services to perform the requirements set forth in the Statement of Work at section J, attachment J.1.

B.2 TYPE OF CONTRACT

This is a Firm Fixed Price Contract. The total price if this contract is TBD for the period of April 11, 2011 through April 10, 2012 which includes CLIN 0001. The period of performance for this contract is April 11, 2011 through April 10, 2012 with eight (8) one year option periods.

B.3 SCHEDULE OF SERVICES

The total negotiated Firm Fixed Price for this contract is TBD. The contractor should be paid in accordance with the schedule set forth below:

CLIN
Description
Delivery Date
Total
Period of Performance
0001
Medicare – Base Year
TBD
4/11/11 - 4/10/12
0001aa
Project Plan

TBD

0001ab
Transition Plan

TBD

0001ac
CCI Quarterly Files - Task 4

TBD

0001ad
CCI Quarterly Files - Task 4

TBD

0001ae
CCI Quarterly Files - Task 4

TBD

0001af
CCI Quarterly Files - Task 4

TBD

0001ag
MUE Quarterly Files - Task 10

TBD

0001ah
MUE Quarterly Files - Task 10

TBD

0001ai
MUE Quarterly Files - Task 10

TBD

0001aj
MUE Quarterly Files - Task 10

TBD

0001ak
MUE Publication Files/Quarterly

TBD

0001al
MUE Publication Files/Quarterly

TBD

0001am
MUE Publication Files/Quarterly

TBD

0001an
MUE Publication Files/Quarterly

TBD

0001ao
Correspondence log

TBD

0001ap
Final Report

TBD

0001aq
Add-on Code Edit Report

TBD

0001ar
Coding Policy Manual - Task 6

TBD

0001as
Correspondence Language Manual - Task 7

TBD

0001at
MUE J/C/Q Codes(drug/drug related) - Task 11

TBD

0001au
NCCI Edits Derived from NHO/Special Initiatives - Task 12

TBD

0001av
CCI Education to Providers - Task 8

TBD

0001aw
Monthly Progress Report - Task 14

TBD

0001AX
MUE Vulnerability Report

TBD

CLIN
Description
Delivery Date
Total
Period of Performance
0002
Medicaid – OPTION (Base Year)
TBD
4/11/12 - 4/10/13
0002aa
Project Plan

TBD

0002ab
Transition Plan

TBD

0002ac
Report on Add-On

TBD

0002ad
Change Report on CCI edits and MUEs

TBD

0002ae
MUE Report for Medicaid

TBD

0002af
Report on Advance Planning Documents (APDs)

TBD

0002ag
Medicaid Coding Policy Manual

TBD

0002ah
Medicaid Correspondence Manual

TBD

CLIN
Description
Delivery Date
Total
Period of Performance
0003
Medicare – OPTION YEAR 1
TBD
4/11/12 - 4/10/13
0003aa
Project Plan

TBD

0003ab
Transition Plan

TBD

0003abc
CCI Quarterly Files - Task 4

TBD

0003acd
CCI Quarterly Files - Task 4

TBD

0003ade
CCI Quarterly Files - Task 4

TBD

0003aef
CCI Quarterly Files - Task 4

TBD

0003afg
MUE Quarterly Files - Task 10

TBD

0003agh
MUE Quarterly Files - Task 10

TBD

0003ahi
MUE Quarterly Files - Task 10

TBD

0003aij
MUE Quarterly Files - Task 10

TBD

0003ajk
MUE Publication Files/Quarterly

TBD

0003akl
MUE Publication Files/Quarterly

TBD

0003alm
MUE Publication Files/Quarterly

TBD

0003amn
MUE Publication Files/Quarterly

TBD

0003ano
Correspondence log

TBD

0003aop
Final Report

TBD

0003apq
Add-on Code Edit Report

TBD

0003aqr
Coding Policy Manual - Task 6

TBD

0003ars
Correspondence Language Manual - Task 7

TBD

0003ast
MUE J/C/Q Codes(drug/drug related) - Task 11

TBD

0003atu
NCCI Edits Derived from NHO/Special Initiatives - Task 12

TBD

0003auv
CCI Education to Providers - Task 8

TBD

0003avw
Monthly Progress Report - Task 14

TBD

0003aw
MUE Vulnerability Report

TBD

CLIN
Description
Delivery Date
Total
Period of Performance
0004
Medicaid – OPTION YEAR 1
TBD
4/11/12 - 4/10/13
0004aa
Project Plan

TBD

0004ab
Transition Plan

TBD

0004abc
Report on Add-On

TBD

0004acd
Change Report on CCI edits and MUEs

TBD

0004ade
MUE Report for Medicaid

TBD

0004aef
Report on Advance Planning Documents (APDs)

TBD

0004afg
Medicaid Coding Policy Manual

TBD

0004agh
Medicaid Correspondence Manual

TBD

CLIN
Description
Delivery Date
Total
Period of Performance
0005
Medicare – OPTION YEAR 2
TBD
4/11/13 - 4/10/14
0005aa
Project Plan

TBD

0005ab
Transition Plan

TBD

0005abc
CCI Quarterly Files - Task 4

TBD

0005acd
CCI Quarterly Files - Task 4

TBD

0005ade
CCI Quarterly Files - Task 4

TBD

0005aef
CCI Quarterly Files - Task 4

TBD

0005afg
MUE Quarterly Files - Task 10

TBD

0005agh
MUE Quarterly Files - Task 10

TBD

0005ahi
MUE Quarterly Files - Task 10

TBD

0005aij
MUE Quarterly Files - Task 10

TBD

0005ajk
MUE Publication Files/Quarterly

TBD

0005akl
MUE Publication Files/Quarterly

TBD

0005alm
MUE Publication Files/Quarterly

TBD

0005amn
MUE Publication Files/Quarterly

TBD

0005ano
Correspondence log

TBD

0005aop
Final Report

TBD

0005apq
Add-on Code Edit Report

TBD

0005aqr
Coding Policy Manual - Task 6

TBD

0005ars
Correspondence Language Manual - Task 7

TBD

0005ast
MUE J/C/Q Codes(drug/drug related) - Task 11

TBD

0005atu
NCCI Edits Derived from NHO/Special Initiatives - Task 12

TBD

0005auv
CCI Education to Providers - Task 8

TBD

0005avw
Monthly Progress Report - Task 14

TBD

0005aw
MUE Vulnerability Report

TBD

CLIN
Description
Delivery Date
Total
Period of Performance
0006
Medicaid – OPTION YEAR 2
TBD
4/11/13 - 4/10/14
0006aa
Project Plan

TBD

0006ab
Transition Plan

TBD

0006abc
Report on Add-On

TBD

0006acd
Change Report on CCI edits and MUEs

TBD

0006ade
MUE Report for Medicaid

TBD

0006aef
Report on Advance Planning Documents (APDs)

TBD

0006afg
Medicaid Coding Policy Manual

TBD

0006agh
Medicaid Correspondence Manual

TBD

CLIN
Description
Delivery Date
Total
Period of Performance
0007
Medicaid – OPTION YEAR 3
TBD
4/11/14 - 4/10/15
0007aa
Project Plan

TBD

0007ab
Transition Plan

TBD

0007abc
CCI Quarterly Files - Task 4

TBD

0007adc
CCI Quarterly Files - Task 4

TBD

0007aed
CCI Quarterly Files - Task 4

TBD

0007afe
CCI Quarterly Files - Task 4

TBD

0007afg
MUE Quarterly Files - Task 10

TBD

0007agh
MUE Quarterly Files - Task 10

TBD

0007ahi
MUE Quarterly Files - Task 10

TBD

0007aij
MUE Quarterly Files - Task 10

TBD

0007ajk
MUE Publication Files/Quarterly

TBD

0007akl
MUE Publication Files/Quarterly

TBD

0007alm
MUE Publication Files/Quarterly

TBD

0007amn
MUE Publication Files/Quarterly

TBD

0007ano
Correspondence log

TBD

0007aop
Final Report

TBD

0007apq
Add-on Code Edit Report

TBD

0007aqr
Coding Policy Manual - Task 6

TBD

0007ars
Correspondence Language Manual - Task 7

TBD

0007ast
MUE J/C/Q Codes(drug/drug related) - Task 11

TBD

0007atu
NCCI Edits Derived from NHO/Special Initiatives - Task 12

TBD

0007auv
CCI Education to Providers - Task 8

TBD

0007avw
Monthly Progress Report - Task 14

TBD

0007aw
MUE Vulnerability Report

TBD

CLIN
Description
Delivery Date
Total
Period of Performance
0008
Medicaid – OPTION YEAR 3
TBD
4/11/14 - 4/10/15
0008aa
Project Plan

TBD

0008ab
Transition Plan

TBD

0008abc
Report on Add-On

TBD

0008acd
Change Report on CCI edits and MUEs

TBD

0008ade
MUE Report for Medicaid

TBD

0008aef
Report on Advance Planning Documents (APDs)

TBD

0008afg
Medicaid Coding Policy Manual

TBD

0008agh
Medicaid Correspondence Manual

TBD

CLIN
Description
Delivery Date
Total
Period of Performance
0009
Medicare – OPTION YEAR 4
TBD
4/11/15 - 4/10/16
0009aa
Project Plan

TBD

0009ab
Transition Plan

TBD

0009abc
CCI Quarterly Files - Task 4

TBD

0009acd
CCI Quarterly Files - Task 4

TBD

0009ade
CCI Quarterly Files - Task 4

TBD

0009aef
CCI Quarterly Files - Task 4

TBD

0009agf
MUE Quarterly Files - Task 10

TBD

0009agh
MUE Quarterly Files - Task 10

TBD

0009ahi
MUE Quarterly Files - Task 10

TBD

0009aji
MUE Quarterly Files - Task 10

TBD

0009ajk
MUE Publication Files/Quarterly

TBD

0009akl
MUE Publication Files/Quarterly

TBD

0009alm
MUE Publication Files/Quarterly

TBD

0009amn
MUE Publication Files/Quarterly

TBD

0009ano
Correspondence log

TBD

0009aop
Final Report

TBD

0009apq
Add-on Code Edit Report

TBD

0009aqr
Coding Policy Manual - Task 6

TBD

0009ars
Correspondence Language Manual - Task 7

TBD

0009ast
MUE J/C/Q Codes(drug/drug related) - Task 11

TBD

0009atu
NCCI Edits Derived from NHO/Special Initiatives - Task 12

TBD

0009auv
CCI Education to Providers - Task 8

TBD

0009avw
Monthly Progress Report - Task 14

TBD

0009aw
MUE Vulnerability Report

TBD

CLIN
Description
Delivery Date
Total
Period of Performance
0010
Medicaid – OPTION YEAR 4
TBD
4/11/15 - 4/10/16
0010aa
Project Plan

TBD

0010ab
Transition Plan

TBD

0010abc
Report on Add-On

TBD

0010acd
Change Report on CCI edits and MUEs

TBD

0010ade
MUE Report for Medicaid

TBD

0010aef
Report on Advance Planning Documents (APDs)

TBD

0010afg
Medicaid Coding Policy Manual

TBD

0010agh
Medicaid Correspondence Manual

TBD

SECTION C DESCRIPTION/SPECIFICATION/WORK STATEMENT

C. 1 STATEMENT OF WORK

Independently and not as an agent of the Government, the Contractor shall furnish all the necessary services, qualified personnel, material, equipment, and facilities, not otherwise provided by the Government, as needed to perform the Statement of Work, SECTION J, ATTACHMENT J.1 attached hereto and made a part of this contract.

SECTION D PACKAGING AND MARKING

D. 1 PACKAGING, MARKING AND SHIPPING

All deliverables required under this contract shall be packaged, marked and shipped in accordance with Government specifications. The Contractor shall guarantee that all required materials shall be delivered in immediate usable and acceptable condition.

SECTION E INSPECTION AND ACCEPTANCE

E. 1 52.252-2 CLAUSES INCORPORATED BY REFERENCE. (FEB 1998)

This contract incorporates one 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/these address(es): [www.arnet.gov]

NUMBER
TITLE
DATE
52.246-2
Inspection of Supplies -- Fixed-Price.
Aug 1996
52.246-4
Inspection of Services -- Fixed-Price.
Aug 1999

E.2 INSPECTION AND ACCEPTANCE

(a) All work under 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 Contracting Officer’s Technical Representative (COTR) is a duly authorized representative of the Government and is responsible for inspection and acceptance of all items to be delivered under this contract.

(c) Inspection and acceptance of the Contractor's performance shall be in accordance with the applicable FAR clauses in Section E.1 above.

E.3 APPROVALS BY THE CONTRACTING OFFICE TECHNICAL REPRESENTATIVE (COTR)

All items to be delivered to the COTR will be deemed to have been approved sixty (60) calendar days after date of delivery, except as otherwise specified in this contract, if written approval or disapproval has not been given within such period. The COTRs approval or revision to the items submitted shall be within the general scope of work stated in this contract.

SECTION F DELIVERIES OR PERFORMANCE

F. 1 PERIOD OF PERFORMANCE

This is a twelve (12) month contract. The period of performance for the base year is April 11, 2011 – April 10, 2012.

F.2 ITEMS TO BE FURNISHED AND DELIVERY SCHEDULE

This contract shall furnish the items required under this contract in accordance with the reporting instructions and delivery schedule set forth in Section J, attachment J.1, SOW Attachment A.

F.3 TIME AND PLACE OF DELIVERABLES

The supplies/services to be furnished shall be delivered in accordance with the delivery schedule as specified in the Section J, Attachment J.1, Sow Attachment A.

Satisfactory performance of the contract shall be deemed to occur upon delivery and acceptance by the Contracting Officer, or the duly authorized representative, in accordance with the stated delivery schedule of the contract.

F.4 FAR 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

This contract incorporates one 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/these address(es): [www.arnet.gov]

Federal Acquisition Regulation (FAR) Clauses

52.242-15 STOP WORK ORDER (AUG 1989

52.242-17 GOVERNMENT DELAY OF WORK (APR 1984)

52.247-34 F.O.B. DESTINATION (NOV 1991)

SECTION G CONTRACT ADMINISTRATION DATA

G. 1 ACCOUNTING AND APPROPRIATION DATA

Appropriation
Object Class
EIN
CAN
Amount
Award
TBD
TBD
TBD
TBD
TBD

G.2 INVOICING AND PAYMENT (STANDARD)

A. Submission of Invoices and Payment Office

Invoices/vouchers shall be prepared and submitted with an original and four copies in accordance with Section B.3 of the contract.

The following information shall be included on the invoice:

Contractor’s name and address Invoice date and number Contract Number including other authorization for delivery of property and/or services Description, cost or price, and quantity of property and/or services actually delivered or rendered Contract Line Item Number (CLIN) Period of Performance Billed Other substantiating documentation or information as required by the contract (this information may be provided with the voucher/invoice or in other monthly reports as mutually agreed to.

Name, title, phone number of person to notify in event of defective invoice.

If overnight delivery is desired:

Department of Health and Human Services Centers for Medicare and Medicaid Services OFM/Division of Accounting Operations 7500 Security Boulevard/C3-11-03 Baltimore, MD 21244-1850

One (1) copy shall be sent to the COTR.

Invoice Payment Payments will only be made by electronic funds transfer (EFT) using the Contractor’s EFT information from the Central Contractor Registration (CCR) database. In the event that during the performance of this contract, the Contractor elects to designate a different financial institution for receipt of payment using the electronic funds transfer procedures, the contractor shall notify CMS’s Division of Accounting Operations of all EFT and address changes made in CCR via the following email address: CCRChanges@cms.hhs.gov. The contractor’s email notification must contain the contractor’s name, DUNS or DUNS+4 number, contract and/or order number, and the name, title, and telephone number of the Contractor’s official representative authorized to provide their information.

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

G.3 METHOD OF PAYMENT

a. In accordance with FAR 52.204-7, the contractor must register in the Central Contractor Registration (CCR) database. Failure to register in CCR may prohibit CMS from making awards to your organization.

b. The contractor shall notify CMS’ Division of Accounting Operations of all EFT and address changes in CCR via the following email address: CCRChanges@cms.hhs.gov

G.4 CONTRACTING OFFICERS TECHNICAL REPRESENTATIVE (COTR)

The following COTR’s will represent the Government for the purpose of this contract:

Valeria Allen – Medicare
Paul Youket - Medicare

The COTR is responsible for: (1) monitoring the Contractor's technical progress, including the surveillance and assessment of performance and compliance with all substantive project objectives; (2) interpreting the statement of work and any other technical performance requirements; (3) performing technical evaluation as required; (4) performing technical inspections and acceptances required by this contract; (5) assisting in the resolution of technical problems encountered during performance; and (6) providing technical direction in accordance with Section G-3; and, (7) reviewing of invoices/vouchers.

The COTR does not have authority to act as agent of the Government under this contract. Only the Contracting Officer has authority to: (1) direct or negotiate any changes in the statement of work; (2) modify or extend the period of performance; (3) change the delivery schedule; (4) authorize reimbursement to the Contractor any costs incurred during the performance of this contract; or (5) otherwise change any terms and conditions of this contract.

The Government may unilaterally change its COTR designation.

G.5 TECHNICAL DIRECTION

a. Performance of the work under this contract shall be subject to the technical direction of the COTR. The term “technical direction” is defined to include, without limitation, the following:

· Directions to the Contractor which redirect 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 statement of work.

· Provision of information to the Contractor which assists in the interpretation of drawings, specifications, or technical portions of the work description.

· Review and, where required by the contract, approval of technical reports, drawings, specifications, and technical information to be delivered by the Contractor to the Government under the contract.

b. Technical direction must be within the general Scope of Work stated in the contract. The COTR does not have the authority to and may not issue any technical directions which:

(1) Constitutes an assignment of additional work outside the general Scope of Work of the contract.

(2) Constitutes a change as defined in the contract clause entitled "Changes - Cost Reimbursement."

(3) In any manner cause an increase or decrease in the total estimated contract cost, fixed-fee, or the time required for contract performance.

(4) Change any of the expressed terms, conditions, or specifications of the contract.

c. All technical direction shall be issued in writing by the COTR or shall be confirmed by him/her in writing within 5 working days after issuance.

d. The Contractor shall proceed promptly with the performance of technical direction duly issued by the COTR in the manner prescribed by this article and within his/her authority under the provisions of this article.

e. If, in the opinion of the Contractor, any instruction or direction issued by the COTR is within one of the categories as defined in (l) through (4) above, the Contractor shall not proceed but shall notify the Contracting Officer in writing within 5 working days after the receipt of any such instruction or direction and shall request the Contracting Officer to modify the contract, accordingly. Upon receiving such notification from the Contractor, the Contracting Officer shall issue an appropriate contract modification or advise the Contractor in writing that, in his/her opinion, the technical direction is within the scope of this contract. The Contractor shall thereupon proceed immediately with the instructions or direction or upon the contract action to be taken with respect thereto and shall be subject to the provision of the contract clause entitled "Disputes."

G.6 CONTRACTING OFFICER RESPONSIBILITY

In accordance with FAR 52.201-1 Definitions, The term Contracting Officer means a person with the authority to enter into, administer, and/or terminate contracts and make related determinations and findings. The term includes certain authorized representatives of the Contracting Officer acting within the limits of their authority delegated by the Contracting Officer (See G.5 above).

Notwithstanding any of the other provisions of this Contract, the Contracting Officer shall be the ONLY individual authorized to:

a. Enter into and commit/bind the Government by contract for supplies or services;

b. Accept nonconforming work or waive any requirement of this Contract;

c. Authorize reimbursement to the Contractor for any costs incurred during the performance of the Contract, and

d. Modify any term or condition of this Contract, i.e., make any changes in the Statement of Work; modify/extend the period of performance; change the delivery schedule.

G.7 PROGRAM DIRECTOR/MEDICAL DIRECTOR/PHYSICIAN

TBD will serve as the Program Director/Medical Director/Physician. It will be his/her responsibility to obtain the staff necessary and to direct the work for the conduct of this project. The Government reserves the right to approve any necessary successor to be designated as Program Director/Medical Director/Physician.

G.8 HHSAR 352.242-70 KEY PERSONNEL (JAN 2006)

The key personnel specified in this contract are considered to be essential to work performance. At least 30 days prior to diverting any of the specified individuals to other programs or contracts (or as soon as possible, if an individual must be replaced, for example, as a result of leaving the employ of the Contractor), the Contractor shall notify the Contracting Officer and shall submit comprehensive justification for the diversion or replacement request (including proposed substitutions for key personnel) to permit evaluation by the Government of the impact on performance under this contract. The Contractor shall not divert or otherwise replace any key personnel without the written consent of the Contracting Officer. The Government may modify the contract to add or delete key personnel at the request of the contractor or Government.

KEY PERSONNEL
POSITION
TBD
Program Director / Medical Director / Physician
TBD
Associate Medical Director / Physician
TBD
Lead Coding Specialist (RHIA, RHIT, CCS-P, or CPC minimum)
TBD
Information Specialist / Quality Assurance / Compliance Coordinator
TBD
Medicaid Specialist

G.9 USE OF GOVERNMENT - DATA (REPORTS/FILES/COMPUTER TAPES OR DISCS)

Any data given to the Contractor by the Government shall be used only for the performance of the contract unless the Contracting Officer specifically permits another use, in writing. Should the Contracting Officer permit the Contractor the use of Government-supplied data for a purpose other than solely for performance of this contract and, if such use could result in a commercially viable product, the Contracting Officer and the Contractor must negotiate a financial benefit to the Government. This benefit should most often be in the form of a reduction in the price of the contract; however, the Contracting Officer may negotiate any other benefits he/she determines is adequate compensation for the use of these data.

Upon the request of the Contracting Officer, or the expiration date of this contract, whichever shall come first, the Contractor shall return or destroy all data given to the Contractor by the Government. However, the Contracting Officer may direct that the data be retained by the Contractor for a specific period of time, which period shall be subject to agreement by the Contractor. Whether the data are to be returned, retained, or destroyed shall be the decision of the Contracting Officer with the exception that the Contractor may refuse to retain the data. The Contractor shall retain no data, copies of data, or parts thereof, in any form, when the Contracting Officer directs that the data be returned or destroyed. If the data are to be destroyed, the Contractor shall directly furnish evidence of such destruction in a form the Contracting Officer shall determine is adequate.

G.10 DATA TO BE DELIVERED

a. Any working papers, interim reports, data given by the government or first produced by the Contractor under the contract or collected or otherwise obtained by the Contractor under the contract, or results obtained or developed by the Contractor (subcontractor or consultants) pursuant to the fulfillment of this contract are to be delivered, documented, and formatted as directed by the Contracting Officer.

b. 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 DATA" and are not "subject data" to be delivered under this contract.

G.11 MODIFICATION AUTHORITY

Notwithstanding any of the other provisions of this contract, the Contracting Officer shall be the ONLY individual authorized to:

- Accept nonconforming work;

- Waive any requirements of this contract; or

- Modify any term or condition of this contract.

G.12 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.

(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. Also, 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 "Disputes" clause.

(e) Any presentation of any report, statistical or analytical material based on information obtained from this contract shall be subject to review by the COTR 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.

(f) The COTR 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 COTR shall immediately inform the Contractor, in writing, of the nature of the problem. If the Contractor disagrees, the COTR 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, _______________________________,” Sponsored by the Centers for Medicare & Medicaid Services, Department of Health & Human Services."

Any deviation from the above legend shall be approved, in writing, by the Contracting Officer.

G.13 SERVICE OF CONSULTANTS/SUBCONTRACTORS

a. For the purposes of this contract, consultants are considered subcontractors.

The Contractor shall follow the procedures established in:

Federal Acquisition Regulation (FAR) Clauses:

52.244-2Subcontracts (JUN 2007)
52.244-5Competition in Subcontracting (DEC 1996)
52.244-6Subcontracts for Commercial Items and Commercial Components (MAR 2007)

When requesting Contracting Officer consent to subcontract for Consultants and/or other subcontracts.

The following subcontractor has been approved for this contract:

TBD

G.14 AUDIT OF HOURS

a. In addition to the examination of costs, as detailed in FAR Clause No. 52.215-02 entitled "Audit-Negotiation," the Contracting Officer or his representatives will have the right to examine all books, records, documents and other data of the Contractor relating to this contract for the purpose of evaluating the accuracy and completeness of the hours which the Contractor has recorded on his invoices as expended toward satisfaction of the requirements of this contract.

b. The materials described above shall be made available at the office of the Contractor, at all reasonable times, for inspection, audit or reproduction until:

(1) The expiration of three (3) years from the date of final payment under this contract,

(2) The expiration of three (3) years from the date of final settlement resulting from a termination or a partial termination of this contract.

G.15 CORRESPONDENCE PROCEDURES

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

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

c. Subject Lines - All correspondence shall contain a subject line, commencing with the contract number as illustrated below:

EXAMPLE: Contract No. HHSM-500-2011-0000XX Request for Subcontract Consent

G.16 DESIGNATION OF PROPERTY ADMINISTRATOR

The CMS Property Administrator, Administrative Services Group, Office of Property and Space Management at (410) 786-6462, is hereby designated the property administration function for this contract. The Contractor agrees to furnish information regarding Government Property to the Property Administrator in the manner and to the extent required by the Property Administrator, his duly designated successors, and in accordance with FAR Part 45 and Department of Health & Human Services (DHHS) Manual entitled, Contractor's Guide for Control of Government Property, (2007). This manual may be accessed at http://knownet.hhs.gov/log/AgencyPolicy/HHSLogPolicy/contractorsguide.htm

G.17 GOVERNMENT-FURNISHED PROPERTY

The Government will provide the following items(s) of Government property to the Contractor for use in the performance of this contract. The property shall be used and maintained by the Contractor in accordance with the HHS Contractors' Guide for Control of Government Property. The Contractor shall be responsible and accountable for all government property; either furnished or acquired, and also is required to keep the Government's official records of Government property in their possession and control.

The following item(s) of Government property are hereby furnished to the Contractor: None

Correct Coding Initiative Solicitation #: RFP-CMS-2011-0010

SECTION H - SPECIAL CONTRACT REQUIREMENTS

H.1 CONTRACT RENEWAL

a. Pursuant to 42 CFR 400 and 421, “Medicare Integrity Program” if this contract is funded by Medicare Integrity Program appropriated funding, the Contracting Officer may renew this contract annually by giving the Contractor written notice, within 90 days of the expiration date of this contract (after exercise of all option or renewal years), of its intent to do so. The contract renewal period of performance will be established at the time a renewal determination is made.

b. The Contracting Officer may renew this contract under this provision without competition if

1. The Contractor continues to meet the requirements set forth in Subpart D of 42 CFR Part 421, FAR and HHSAR;

2. The Contractor meets or exceeds all of the performance requirements established in this contract; and

3. It is in the best interest of the Government.

If the Contracting Officer does not renew this contract, the contract will end in accordance with its terms and the Contractor does not have the right to a hearing or judicial review of the non-renewal decision.

The Contractor may notify the Contracting Officer of its intent to not renew its contract under this provision (after all option periods expire) by providing written notice 120 days prior to the expiration of the contract.

H.2 HHSAR 352.227-70 PUBLICATIONS AND PUBLICITY (JAN 06)

a) Unless otherwise specified in this contract and the Confidentiality of Information clause is included, the Contractor is encouraged to publish the results of its work under this contract. A copy of each article submitted by the Contractor for publication shall be promptly sent to the COTR. The Contractor shall also inform the COTR when the article or other publication is published, and furnish a copy of it as finally published.

(b) The Contractor shall include in any publication resulting from work performed under this contract a disclaimer reading as follows:

‘‘The views expressed in written conference materials or publications and by speakers and moderators at HHS-sponsored conferences, do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.’’

(c) Unless authorized by the COTR, the contractor shall not display the HHS logo on any conference materials or publications.

H.3 HHSAR 352.201-70 PAPERWORK REDUCTION ACT (JAN 06)

(a) This contract involves a requirement to collect or record information calling either for answers to identical questions from 10 or more persons other than Federal employees, or information from Federal employees which is outside the scope of their employment, for use by the Federal government or disclosure to third parties; therefore, the Paperwork Reduction Act of 1995 (Pub. L. 104–13) (New Window) shall apply to this contract. No plan, questionnaire, interview guide or other similar device for collecting information (whether repetitive or single time) may be used without first obtaining clearance from the Office of Management and Budget (OMB). Contractors and COTRs should be guided by the provisions of 5 CFR Part 1320 (New Window), Controlling Paperwork Burdens on the Public , and seek the advice of the HHS operating division or Office of the Secretary Reports Clearance Officer to determine the procedures for acquiring OMB clearance.

(b) The Contractor shall not expend any funds or begin any data collection until OMB Clearance is received. Once OMB Clearance is received from the COTR, the Contracting Officer shall provide the Contractor with written notification authorizing the expenditure of funds and the collection of data. The Contractor must allow at least 120 days for OMB clearance. Excessive delays caused by the Government which arise out of causes beyond the control and without the fault or negligence of the Contractor will be considered in accordance with the Excusable Delays or Default clause of this contract.

H.4 HHSAR 352.203-70 Anti-Lobbying (JAN 06)

Pursuant to the current HHS annual appropriations act, except for normal and recognized executive-legislative relationships, the Contractor shall not use any HHS contract funds for (i) publicity or propaganda purposes; (ii) the preparation, distribution, or use of any kit, pamphlet, booklet, publication, radio, television or video presentation designed to support or defeat legislation pending before the Congress or any State legislature, except in presentation to the Congress or any State legislature itself; or (iii) payment of salary or expenses of the Contractor, or any agent acting for the Contractor, related to any activity designed to influence legislation or appropriations pending before the Congress or any State legislature.

H.5 HHSAR 352.242-71 Tobacco-free facilities (JAN 06)

In accordance with Department of Health and Human Services (HHS) policy, the Contractor and its staff are prohibited from using tobacco products of any kind (e.g., cigarettes, cigars, pipes, and smokeless tobacco) while on any HHS property, including use in personal or company vehicles operated by Contractor employees while on an HHS property. This policy also applies to all subcontracts awarded under the contract or order. The term ‘‘HHS properties’’ includes all properties owned, controlled and/or leased by HHS when totally occupied by HHS, including all indoor and outdoor areas of such properties. Where HHS only partially occupies such properties, it includes all HHS-occupied interior space. Where HHS leases space in a multi-occupant building or complex, the tobacco-free HHS policy will apply to the maximum area permitted by law and compliance with the provisions of any current lease agreements. The Contractor shall ensure that each of its employees, and any subcontractor staff, is made aware of, understand, and comply with this policy.

H.6 CMS CLAUSE 01 Section 508 - Accessibility of Electronic and Information Technology (MAR 1, 2004)

A. This contract is subject to Section 508 of the Rehabilitation Act of 1973 (29 U.S.C. 794d) as amended by the workforce Investment Act of 1998 (P.L. 105-220). Specifically, subsection 508(a)(1) requires that when the Federal Government procures Electronic and Information Technology (EIT), the EIT must allow Federal employees and individuals of the public with disabilities comparable access to and use of information and data that is provided to Federal employees and individuals of the public without disabilities.

B. The EIT accessibility standards at 36 CFR Part 1194 were developed by the Architectural and Transportation Barriers Compliance Board ("Access Board") and apply to contracts and task/delivery orders, awarded under indefinite quantity contracts on or after June 25, 2001.

C. Each Electronic and Information Technology (EIT) product or service furnished under this contract shall comply with the Electronic and Information Technology Accessibility Standards (36 CFR 1194), as specified in the contract, as a minimum. If the Contracting Officer determines any furnished product or service is not in compliance with the contract, the Contracting Officer will promptly inform the Contractor in writing. The Contractor shall, without charge to the Government, repair or replace the non-compliant products or services within the period of time to be specified by the Government in writing. If such repair or replacement is not completed within the time specified, the Government shall have the following recourses:

1. Cancellation of the contract, delivery or task order, purchase or line item without termination liabilities; or

2. In the case of custom Electronic and Information Technology (EIT) being developed by a contractor for the Government, the Government shall have the right to have any necessary changes made or repairs performed by itself or by another firm for the noncompliant EIT, with the contractor liable for reimbursement to the Government for any expenses incurred thereby.

D. The contractor must ensure that all EIT products that are less than fully compliant with the accessibility standards are provided pursuant to extensive market research and are the most current compliant products or services available to satisfy the contract requirements.

E. For every EIT product or service accepted under this contact by the Government that does not comply with 36 CFR 1194, the contractor shall, at the discretion of the Government, make every effort to replace or upgrade it with a compliant equivalent product or service, if commercially available and cost neutral, on either a contract specified refresh cycle for the product or service, or on a contract effective option/renewal date; whichever shall occur first.

H.7 CONTRACTOR PERFORMANCE EVALUATION(S)

In accordance with Federal Acquisition Regulation (FAR) 42.15, CMS will complete annual and final contractor performance evaluations. Annual evaluations will be prepared to coincide with the anniversary date of the contract. Additional interim performance evaluations may be prepared at Contracting Officer discretion, as necessary. Final performance evaluations will be completed upon contract expiration.

CMS will utilize the Contractor Performance Assessment Reporting System (CPARS) in order to execute annual and final contractor performance evaluations. CPARS is a secure Internet website located at http://www.cpars.csd.disa.mil/cparsmain.htm. CMS will register the contractor in CPARS upon receipt of the name and email address of two (2) individuals who will be responsible for serving as the Contractor’s primary and alternate CPARS contacts. Once CMS registers the contractor in CPARS, the Contractor will receive an automated CPARS email message that contains User IDs and instructions for creating a password.

Once a performance evaluation is issued, the Contractor’s primary and alternate CPARS contact will receive an email instructing them to logon to CPARS in order to review the performance evaluation. The Contractor has 30 days from the date of performance evaluation issuance in which to review the evaluation. If the Contractor is in agreement with the performance evaluation outcome, the evaluation becomes final. Should the Contractor be in disagreement with the performance evaluation outcome, rebuttal comments must be submitted via the CPARS within 30 days from date the evaluation was issued by CMS. Any disagreement between the Contracting Officer and the Contractor will be referred to the Deputy Director, CMS Office of Acquisition and Grants Management, whose decision will be final.

Copies of each performance evaluation and contractor responses, if any, will be retained as part of the official contract file and will be used to support future award decisions. Evaluations will also be stored for a 3-year period in the Past Performance Information Retrieval System (PPIRS) at www.ppirs.gov.

Contractors may obtain CPARS training material and register for on-line training at http://www.cpars.csd.disa.mil/allapps/cpcbtdlf.htm. There is no fee for registration or use of the CPARS.

H.8 CMS CLAUSE 04 APPROVAL OF CONTRACT ACQUIRED INFORMATION TECHNOLOGY (IT) (MAR 1, 2004)

A. The Contractor must obtain the Contracting Officer's written approval prior to the acquisition of any IT investments (see FAR Part 2.101, for definition of IT) to ensure compatibility and successful integration with CMS's infrastructure/architecture.

B. In the performance of a system life cycle development project, the Contractor must submit to the COTR the technical specifications for each of the following incremental phase of the projected life cycle prior to the commencement of work:

1. Design and Engineering
2. Development, and
3. Testing

C. Upon written approval from the Contracting Officer, the Contractor shall commence work under the approved technical specification for the authorized incremental phase.

D. In either instance of an approved IT investment acquisition, or an incremental phase of a system life cycle development project, the contract shall be modified accordingly and the Contractor shall proceed.

E. CMS may disallow any contractor incurred cost that would not be allocated to the approved IT investment acquisition.

H.9 CMS CLAUSE 07 CODE OF CONDUCT (JUN 25, 2004)

SMOKING

Effective June 9, 2004, smoking is not permitted anywhere on the CMS single site campus. This includes all areas outside the building, such as off-site facility, entranceways, sidewalks and parking areas. Smoking will not be permitted anywhere in Regional Offices or Washington, D.C. Office locations unless permitted by GSA guidelines or local landlord requirements. Contractor employees are subject to the same restrictions as government personnel. Fines up to $50 per occurrence will be issued and enforced by the Federal Protective Service.

DRESS

The preferred dress codes at CMS facilities are professional attire, business attire or business casual attire.

H.10 CMS CLAUSE 08 HIPAA Business Associate Provision II (NOV 3, 2004)

Definitions:

All terms used herein and not otherwise defined shall have the same meaning as in the Health Insurance Portability and Accountability Act of 1996 ("HIPAA," 42 U.S.C. sec. 1320d) and the corresponding implementing regulations. Provisions governing the Contractor's duties and obligations under the Privacy Act (including data use agreements) are covered elsewhere in the contract. "Business Associate'' shall mean the Contractor. "Covered Entity" shall mean CMS' Medicare Fee for Service program and/or Medicare's Prescription Drug Discount Care and Transitional Assistance Programs. "Secretary" shall mean the Secretary of the Department of Health and Human Services or the Secretary's designee.

Obligations and Activities of Business Associate

(a) Business Associate agrees to not use or disclose Protected Health Information ("PHI"), as defined in 45 C.F.R. § 160.103, created or received by Business Associate from or on behalf of Covered Entity other than as permitted or required by this Contract or as required by law.

(b) Business Associate agrees to use safeguards to prevent use or disclosure of PHI created or received by Business Associate from or on behalf of Covered Entity other than as provided for by this Contract. Furthermore, Business Associate agrees to use appropriate administrative, physical and technical safeguards that reasonably and appropriately protect the confidentiality, integrity and availability of the electronic protected health information ("EPHI"), as defined in 45 C.F.R. 160.103, it creates, receives, maintains or transmits on behalf of the Covered Entity to prevent use or disclosure of such EPHI.

(c) Business Associate agrees to mitigate, to the extent practicable, any harmful effect that is…

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