NCCI Contract Rebid Vendor Questions Medicare Medicaid 2.1.11.doc

Vendor Questions – RFP-CMS-2011-0010

Correct Coding Initiative

GENERAL

1. Question: Is the current incumbent Correct Coding Solutions eligible to re-compete? Meaning are they still considered a small business?

Answer: CMS will not comment on the eligibility of any one specific offeror.

2. Question: The RFP first mentions eight (8) 12-month options periods on page 5, section B.2, then later, on page 55, section L, , the RFP refers to four (4) 12-month options periods Can you confirm the number of options periods?

Answer: The RFP has been amended

3. Question: The “Schedule of Services”, Section B3 ends in the middle of Option Year 4. Should we assume that Option years four through 8 are identical to option years 1-3?

Answer: Section B3 is accurate, CLINs 1,3,5,7, and 9 are for Medicare. CLINs 2,4,6,8 and 10 are for Medicaid.

4. Question: Are we required to send a Past Performance Questionnaire for every past performance cited in our response to the RFP?

Answer: A past performance questionnaire should be submitted for all relevant work.

5. Question: Are we required to maintain the same alignment of contractors to services in option years as the base year? In other words, if a teaming partner wanted to work on something another partner worked on in the base year, are we allowed to do that work in outlying option years or are we wedded to the base year configuration all the way through all contract options?

Answer: No, the offeror is not required to use the same team throughout the contract, however, the offeror should explain how these changes could or would impact its technical solution.

6. Question: RFQ Solicitation No. 778-1-2305-05: IMPLEMENTATION OF THE NATIONAL CORRECT CODING INITIATIVE IN MEDICAID was posted on January 13. Does this mean that the Medicaid tasks identified in this solicitation as optional will now be part of a separate contract?

Answer: Medicaid funding for this solicitation, RFP-CMS-2011-0010, has been secured. The Medicaid tasks and deliverables identified in this solicitation as optional are no longer optional. Consequently, the contractor selected for this solicitation will be responsible for performing both the Medicare and the Medicaid tasks specified and for submitting both the Medicare and the Medicaid deliverables specified. The contractor selected for solicitation 778-1-2305 will be responsible for performing the tasks specified and for submitting the deliverables specified in that solicitation.

7. RFQ Solicitation No. 778-1-2305-05: IMPLEMENTATION OF THE NATIONAL CORRECT CODING INITIATIVE IN MEDICAID is a Request for Quote (RFQ). However, the Correct Coding Initiative Solicitation #: RFP –CMS- 20-0011 references Medicaid as an optional task. Should the bidder price the Medicaid NCCI in both the RFP and the RFQ?

Answer: This RFP is separate from RFQ 778-1-2305-05. Please see response to question #6 above.

8. Question: Is the bidder responsible for proposing new edit pairs, i.e. new CCI edits?

Answer: Yes, if the 2011 new CPT codes are available or if you have access to the new CPT codes.

9. Question: Is the bidder responsible for proposing changes (modifications or deletions) to existing edit pairs?

Answer: Yes, the bidder is responsible for proposing changes, modifications or deletions to existing edit pairs. These suggestions can come from CMS, providers, physicians and others.

10. Question: There is no reference as to the locale for the work to be conducted under this contract. Can we assume the work will be conducted at the contractor’s locale?

Answer: Yes, the work is to be performed at the contractor’s location.

COVER LETTER

11. Question: Cover Letter - We intend to bid as a Contractor Teaming Arrangement (CTA) of small businesses such that a minimum of 50% of the cost of work and work is covered within the CTA, is it acceptable to the Government? If yes, then we will be able to provide the CTA document as a part of the Business Proposal to the Government, if required (not as a part of the page count). The reason we propose to provide this document to the Government is so that you may see how the CTA is functioning as a seamless single entity, demonstrating a low risk proposition to the Government.

Answer: The Government would have to be able to confirm that the CTA would be classified as a small business under the solicitation NAICS code in order to be considered eligible.

SECTION B

12. Question: RFP-CMS-2011-0010 Section B.2 Type of Contract: Page 5, second sentence states “The period of performance for this contract is April 11, 2011 through April 10, 2012 with eight (8) one year option period”. Does this mean four (4) one year option periods for Medicare and another four (4) one year option periods for Medicaid? Proposal Assumptions on page 55 of the RFP state “The Government anticipates an initial period of performance of 12 months from the date of award, followed by four (4) 12-month option periods.”

Answer: Yes, there will be four one year option periods for the Medicare related work and 4 one year option periods for the Medicaid related work. Page 55 has been corrected.

13. Question:

RFP Section B.2 Type of Contract, p.5

RFP states: “The period of performance for this contract is April 11, 2011 through April 10, 2012 with eight (8) one year option periods.”

RFP Section F.1 Period of Performance, p.14

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

Question: Please clarify base year dates and number of option years and dates for this contract.

Answer: The base year is April 11, 2011 – April 10, 2012, CLIN 0001 and CLIN 0002 will be in effect at the time of contract award. There will be eight (8) 12- month optional CLINs.

SECTION C:

14. Question: Section C – Tasks 21, 22 and 23 - What kind of rules engine is presently running?

Answer: It depends, that is, States have their own IT infrastructure and the corresponding rules engine(s). The current NCCI file formats are ASCII.TXT, Excel 2007 (.xlsx), and tab-delimited text (.txt) with column headings.

Each of the five NCCI methodologies implemented by both the Medicare and the Medicaid programs consists of the following four components:

- a set of edits;

- definitions of types of claims subject to the edits;

- a set of claims adjudication rules for applying the edits; and

- a set of rules for addressing provider / supplier appeals of denied payments for services based on the edits.

The NCCI edits are defined as edits applied to services performed by the same provider for the same beneficiary on the same date of service. They consist of two types of edits:

1) NCCI edits, or procedure-to-procedure edits, that define pairs of Healthcare Common Procedure Coding System (HCPCS) / Current Procedural Terminology (CPT) codes that should not be reported together for a variety of reasons and

2) Medically Unlikely Edits (MUEs), or units-of-service edits, that define for each HCPCS / CPT code the number of units of service beyond which the reported number of units of service is unlikely to be correct (e.g., claims for excision of more than one gallbladder).

15. Question: Section C – Tasks 22 and 23 what technology platform is used for the current system?

Answer: The NCCI files are provided by CMS in three file formats: ASCII.TXT, Excel 2007 (.xlsx), and tab-delimited text (.txt) with column headings. The NCCI contractor selected will be expected to provide the NCCI files in the same manner as we currently receive them.

16. Question: Section C – Tasks 21, 22 and 23 what kind of system is the Medicare (and State Medicaid) running?

Answer: State systems for processing Medicaid claims (Medicaid Management Information Systems (MMISs)) vary widely. Each State’s MMIS is unique to that State.

17. Question: Section C – Background - Did CCS, LLC, build the current system or was it transitioned from the previous vendor?

Answer: The process of the development and maintenance of the NCCI edits and systems are owned by CMS. Any systems and contracted work under a previous contract were transitioned from the incumbent contractor.

18. Question: Section C – Tasks 22 - Where do the CCI files currently reside?

Answer: After the NCCI Contractor finalizes both the CCI and MUE final files, all files are located on the CMS mainframe to download for CMS contractors only.

19. Question: Section C – Tasks 22 - Can you provide process and architecture diagrams for the current system?

Answer: No. This is not available.

20. Question: Section C – Purpose -Why are we replacing edits quarterly when Codes change annually?

Answer: The process for the development and implementation of the NCCI edits is a very time consuming process with a large number of codes that must be reviewed, researched, and the appropriate and most rational decision has to be made on each code. Each code has to be researched and each proposed edit has to be forwarded to CMS’ constituents (AMA, NHO, Specialty societies, etc.) who have an interest in the NCCI Program for their comments regarding CMS’ proposed edits decision This commenting period occurs during the period prior to each quarter. Therefore, due to the extensive amount of codes and the multi-faceted edit development process, new codes are phased in throughout that year.

21. Question: Section C – Tasks 22 and 23 - Does an MUE database currently exist?

Answer: Yes.

22. Question: Section C – Tasks 21, 22 and 23 - Are we just building and maintaining the rules engine? (NCCI and MUE)

Answer: The contractor will be responsible for formulating the Medicaid NCCI edit files in the following file formats: ASCII.TXT, Excel 2007 (.xlsx), and tab-delimited text (.txt) with column headings.

Each of the five NCCI methodologies implemented by both the Medicare and the Medicaid programs consists of the following four components:

- a set of edits;

- definitions of types of claims subject to the edits;

- a set of claims adjudication rules for applying the edits; and

- a set of rules for addressing provider / supplier appeals of denied payments for services based on the edits.

The NCCI edits are defined as edits applied to services performed by the same provider for the same beneficiary on the same date of service. They consist of two types of edits:

1) NCCI edits, or procedure-to-procedure edits, that define pairs of Healthcare Common Procedure Coding System (HCPCS) / Current Procedural Terminology (CPT) codes that should not be reported together for a variety of reasons and

2) Medically Unlikely Edits (MUEs), or units-of-service edits, that define for each HCPCS / CPT code the number of units of service beyond which the reported number of units of service is unlikely to be correct (e.g., claims for excision of more than one gallbladder).

23. Question: Section II.A Task 4: Correct Coding Edits (Procedure-to-Procedure) – Page 5, The start date of the contract is 4/11/11; is the first deliverable by the replacement contractor going to be the 7/1/11 release of CCI meaning that the first test file must be delivered to CMS by 5/2/11 (60 days prior) and the final file delivered to CMS by 5/17/2011 (45 days prior)?

Answer: This is correct. The incumbent contractor will already be in the development and processing stage of this version. There is a 60 day transition period from the date of award (4/11/11), and the incumbent contractor will work to assist and transition the new contractor in developing and processing these deliverables on the deliverable dates as required by CMS, as stated.

24. Question: Section II.A Task 4: Correct Coding Edits (Procedure-to-Procedure) – Page 5, What is an example of a "narrative policy statement"? There is not a field in the current file with this name. Is it an identification of Mutually Exclusive vs. Category 1/2? Or, is this the source of the edit (i.e., the governing body such as the AMA)? Is there a character limitation for this field?

Answer: Narrative policy statements can be found in the NCCI Policy Manual that is currently listed on the CMS website

25. Question: Section II.A Task 4: Correct Coding Edits (Procedure-to-Procedure) – Page 5, Will the incumbent transition the existing database used to track the edits/corrections used to produce the CCI to the new contractor?

Answer: Yes. The NCCI Program is owned by CMS. The incumbent contractor will release all properties associated with the CMS NCCI Program to CMS and the awardee.

26. Question: Section II.A Task 5: Correspondence – Page 5, The second sentences refers to the Comment Review and Response form (EXHIBIT I). Could you please provide the form as Exhibit I on page 32 is the Monthly Report Form?

Answer: Exhibit 1 is the Monthly Report Form and related to Comment Review and Response form (which is an internal form or log sheet developed by the contractor, at CMS’ request).

27. Question: Section II.A Task 5: Correspondence – Page 5, What is the expected turnaround time for inquiry responses to be sent back to the requestor? Is there a limitation on who is allowed to submit queries directly to the Contractor (meaning other entities such as software vendors, commercial payers, etc.)?

Answer: Any organization or person can send or submit an inquiry to the NCCI Contractor and CMS. Currently, the normal or reasonable turn around time that the incumbent contractor responds to inquiries is 1-7 days (within a week of receipt of the inquiry unless extensive and more complex research is required). Therefore, CMS provides a blanket statement such as “CMS has 30 days from the receipt of the inquiry to respond, depending on the extent of the issue and the research required. Therefore, in some cases, the review and research could go beyond the 30 days.

28. Question: Section II.A Task 5: Correspondence – Page 5, The Contractor is to provide an annual report to carriers summarizing change requests. Will the incumbent contractor provide the FINAL draft to CMS for the July 7/1/11 deliverable date or is the draft that they must submit by 4/1/11 considered the final draft?

Answer: As stated in question # 23, there is a 60 day transition period from the date of award (4/11/11), and the incumbent contractor will work to assist and transition the new contractor in developing and processing these deliverables on the deliverable dates as required by CMS, as stated.

29. Question: Section II.A Task 5: Correspondence – Page 5, Will the incumbent transition the tool currently in use to control correspondence to the new contractor?

Answer: This is a contractor internal log or form, which was requested and required by CMS. Therefore, since CMS owns the NCCI Program, the incumbent contractor will transition this log/form to the new contractor.

30. Question: Section II.A Task 5 and Task 32: Correspondence – Page 5, Can you provide the volume of telephone, email, U.S. Mail inquiries ad all other correspondence currently handled by the incumbent?

Answer: No

31. Question: Section II.A Task 7: Correspondence Language Manual – Page 6, The first sentence refers to Appendix E. Could you please provide a copy of the correspondence language manual?

Answer: Currently, there is an outdated CLM in the IOM, Pub 100-9, Chapter 5. Due to a proposed reconstruction or revamping of this chapter, CMS cannot provide the current CLM.

32. Question: Section II.A Task 9: Final Report – What is included in the final report? Is this a summary of the previous year’s activities and lessons learned?

Answer: Yes (activities, lessons learned and accomplishments) for the year.

33. Question: Section II.A Task 10: Medically Unlikely Edits – Page 7, Will the claims data received from Western Integrity Center (WIC) contain PHI?

Answer: No.

34. Question: Section II.A Task 10: Medically Unlikely Units & Task 11: Medically Unlikely Units for HCPCS J codes for drugs and drug-related HCPCS C and Q Codes – Pages 7-8, "The contractor shall analyze claims data for the redevelopment of the originally proposed Medically Unlikely Edits. The contractor receives claims data from the Western Integrity Center (WIC)..." What is the frequency with which the claims data is provided by WIC? What is the volume of claim lines provided with each delivery? Is the same claims data used for both Tasks 10 & 11?

Answer: Data is usually requested once per month from the NCCI contractor to the Data Contractor for the MUE (Task 10 and/or Task 11), depending on what codes the MUE Workgroup is reviewing. Data can be requested on a ad hoc basis for a special project or an immediate need.

35. Question: Section II.A Task 10: Medically Unlikely Units – Page 7, Will the incumbent transition the exiting database used to track the edits/corrections used to produce the MUEs to the new contractor?

Answer: Yes. The NCCI Program is owned by CMS. The incumbent contractor will release all properties associated with the CMS NCCI Program to CMS and the awardee.

36. Question: Section II.A Task 11: Medically Unlikely Units (MUEs) for HCPCS J Codes for Drugs and Drug-Related HCPCS C and Q Codes – Page 8, Will CMS and/or the incumbent provide samples and/or templates of the reports, graphs, and charts currently in use to present the effects of the MUEs?

Answer: Yes. The NCCI Program is owned by CMS. The incumbent contractor will release all properties associated with the CMS NCCI Program to CMS and the awardee.

37. Question: Section II.A Task 13 and Task 24: Add-On Code Edits – Page 8 and 13, Can you provide an estimated number of annual add-on codes?

Answer: We cannot provide an estimated number of annual add-on codes for the Medicaid program. Only two sets of Medicaid NCCI files have been provided to State Medicaid programs thus far: one for October 1, 2010, and one for January 1, 2011. We do not know how many add-on codes were in these two sets of files. The numbers are likely to be relatively small because the Medicaid NCCI program has just begun. The Medicaid NCCI add-on codes are derived from the Medicare NCCI add-on codes. The vendor selected for this contract will be expected to develop additional add-on codes for the Medicaid NCCI methodologies that are not contained in the Medicare NCCI methodologies. The number of NCCI add-on codes developed for the Medicaid program should increase significantly during the performance period of this contract. The number of past Medicaid NCCI add-on codes is not a valid indicator of the expected number of future Medicaid NCCI add-on codes.

38. Question: Section II.A Task 21: Medicaid NCCI Methodologies – Page 11, What is the frequency of the extract from the Medicaid Statistical Information System (MSIS)? What is the volume of claim lines provided with each delivery?

Answer: This is a new activity for the Medicaid NCCI program. MMIS extracts have not been previously created for this purpose. CMS will directly provide the MSIS extracts to the contractor according to the frequency and volume of claim lines needed by the contractor to meet the requirements of the contract.

39. Question: Section II.A Task 26: Quarterly MUE Reports for the Medicaid Program – Page 13, Will CMS and/or the incumbent provide samples and/or templates of the reports, graphs, and charts currently in use to present the effects of the MUEs?

Answer: There are currently no quarterly MUE Reports for the Medicaid program. This will be a new deliverable for the Medicaid program. It should be comparable to the quarterly MUE reports for the Medicare program.

40. Question: RFP Attachment J.1 SOW Section V, Period of Performance, p.26

RFP States: The period of performance for this contract is a 15-day transition period (if necessary) and an 11.5-month fully operational period, plus four (4) one-year option periods.

RFP Section L.11.D Proposal Assumptions, third bullet, p.55

RFP States: “Transition: For the first 30 days of the contract, the awardee should assume there will be some transition activities from the incumbent contractor.”

Question: Please clarify whether or not the Transition Period is 15 or 30 days.

Answer: The transition period is 60 days.

41. Question: RFP Attachment J.1 SOW, Section 2.A Task 4: Correct Coding Edits (Procedure-to-Procedure), paragraph 3, p.5

RFP states: “Testing shall take place no later than 1 month prior to the quarterly reporting periods in an effort to have the edits go live and be effective in the systems on January 1, April 1, July 1, and October 1 of each year. “

Question: Will the contractor be responsible for setting up and maintaining a test environment or will another contractor be responsible for this? Will the contractor be given access to the Part B standards system for the purpose of establishing an environment to test CCI edits? If none of the above, what test environment will the contractor have access to in order to test CCI edit changes?

Answer: The awardee will be responsible for the setting up and maintenance of an internal test environment. No, the NCCI contractor will not have access to the Part B standards system for establishing a test environment. This is done internally at the NCCI contractor’s location by IT person/staff.

42. Question: RFP Attachment J.1 SOW, Section 2.A Task 5: Correspondence, paragraph 1, p.5

RFP states: “The contractor shall respond to correspondence and telephone calls related to the CCI as needed. Currently, the CCI contractor is providing CMS with a copy of all responses to correspondence, via U.S. Mail. Effective, February/March 2011, the contractor shall respond to correspondence, retaining copies and logs of all incoming and outgoing correspondence (emails, U.S. Mail, telephone, etc.), but will no longer need to send a copy to CMS. “

Question: Please provide the current volume of correspondence broken down by the number of emails, phone calls, and letters received? What are the required days/hours of telephone coverage? This information is needed to competitively price a FFP contract.

Answer: The NCCI Contractor shall respond to correspondence, as usual, retaining copies and logs of all incoming and outgoing correspondence; but is no longer required to send a copy (copies) to CMS, unless CMS requests a copy of a particular inquiry. It also depends on the edit pair in question, There are no limits or any required number of emails and letters concerning these edits. Neither are there any limits on the number of any type of telephone calls concerning NCCI. Telephone and email coverage is required throughout the daily work hours. All questions and inquiries must be in writing, via mail and/or email.

At this time, CMS cannot provide a breakdown by number or volume. The volume is an extremely high volume, especially as it relates to the MUE. Correspondence, emails, phone calls, etc., are received on a daily/weekly basis for NCCI (CCI and MUE).

43. Question: RFP Attachment J.1 SOW, Section 2.A Task 6: Coding Policy Manual, p.6

RFP states: “The contractor shall maintain Appendix D, Coding Policy Manual, on a continuous basis and provide a final electronic copy of the Manual for publication no later than August 31 of each year. A draft electronic copy of the manual shall be delivered to CMS for review and comment on July 31 of each year. The manual shall identify changes in CPT code descriptors, CMS coding policy and units of service decisions, CMS Program Transmittals, CMS Manual instructions, Federal Register notices or other items as directed by CMS. In addition, the contractor shall make revisions, additions and changes to the relevant chapters, and index of the coding policy manual prepared under another contract.”

Question: Is there a separate Coding Policy Manual other than the one listed above? If so, please specify who originated and maintains this other coding policy manual? If the second manual is developed under another contract, please provide the name of the contract and link to the second coding policy manual.

Answer: The Medicaid NCCI Coding Policy Manual can be accessed on the CMS Medicaid NCCI website at http://www.cms.gov/MedicaidNCCICoding/. CCS, LLC, began adapting Medicare’s Coding Policy Manual for the Medicaid program and maintained both manuals. The awardee will be responsible for continuing to adapt Medicare’s Coding Policy Manual for the Medicaid program, for adding content pertaining only to the Medicaid program, and for maintaining both manuals.

The NCCI Medicare/Medicaid Coding Policy Manual is maintained and updated by the NCCI Contractor. There is no other contractor responsible for maintaining this manual.

44. Question: RFP Attachment J.1 SOW, Section 2.A Task 8: Correct Coding Initiative Education to Provider Community, paragraph 1, p.6

RFP states: “The contractor shall attend meetings and speak to the AMA (the contractor shall only present to the AMA, if so directed by the CMS workgroup), carrier medical directors, and others as directed by CMS in order to provide information/education about the CCI.”

Question: Are travel costs part of the FFP, or will they be reimbursed separately? Please provide more specific assumptions for providing pricing for travel, such as location and frequency of trips per year. This information is needed to appropriately price a FFP contract.

Answer: Travel shall be proposed as part of the Firm Fixed Price. The RFP has been amended to include travel assumptions.

45. Question: RFP Attachment J.1 SOW, Section 2.A Task 10: Medically Unlikely Edits, paragraph 4, p.7

RFP states: “The contractor shall also conduct testing of the edit changes on a quarterly basis.”

Question: Will the contractor be responsible for setting up and maintaining a test environment or will another contractor be responsible for this? Will the contractor be given access to the Part B standards system for the purpose of establishing an environment to test MUE edits? If none of the above, what test environment will the contractor have access to in order to test MUE edit changes?

Answer: As stated in #37, the awardee will be responsible for the setting up and maintenance of an internal test environment. No, the NCCI contractor will not have access to the Part B standards system for establishing a test environment. This is done internally at the NCCI contractor’s location by IT person/staff.

46. Question: RFP Attachment J.1 SOW, Section 2.D, Personnel Requirements, p. 22

RFP states: “Program Director/Medical Director/Physician, Associate Medical Director/Physician”

Question: Please clarify if it is necessary to have 2 physicians on staff? If so why?

Answer: Yes, the associate does not have to be a full time employee as mentioned however due to the work of the MUE, a physician is needed for the pharmacology review and other services including backup to the primary.

47. Question: RFP Attachment J.1 SOW, Section 2.D, Personnel Requirements, p. 22

RFP States: “Information Specialist/Quality Assurance/Compliance Coordinator”

Question: Directly under the first line of Section D, line 4 reads, “Information Specialist/Quality Assurance/Compliance Coordinator”. The description further down the page refers to “Quality Assurance / Information Systems Manager”. Please clarify if this is intended to be an Information Specialist or Information Systems Manager. Also, is Compliance Coordinator meant to be a part of the experience section? If so, please clarify the nature of compliance that is being referred to in the title of Compliance Coordinator.

Answer: Information Systems Manager is the correct title. The SOW has been corrected.

48. RFP Attachment J.1 SOW, Section V, Period of Performance – Appendices to this SOW, p.26

RFP States: “Appendices to this SOW

Appendix A - Deliverable Schedule (attached)

Appendix B – CCI / MUE Edits, V17.1 (CCI) and V5.1 (MUE)

Appendix C – CCI / MUE Change Reports, V17.1 (CCI) and V5.1 (MUE)

Appendix D - Coding Policy Manual

Appendix E - Correspondence Language Manual

Corresponding documents and files for Medicaid can be found through the CMS Medicaid NCCI webpage, http://www.cms.gov/MedicaidNCCICoding/.

Question: Where can Appendices B-E be found for Medicare? Please provide them for bidding purposes.

Answer: The Appendices are provided in amendment 000001 to the solicitation.

SECTION G:

49. Question: RFP-CMS-2011-0010 Section G.8 Key Personnel: Are the Program Director/Medical Director/Physician and Association Medical Director/Physician required to be 100% fully dedicated to the NCCI initiative? Or, is the expectation that these two individuals are available as required for their input and education of other staff members?

Answer: Program Director/Medical Director/Physician is required to be 100% fully dedicated to the NCCI Program Initiative. The Associate Medical Director is 60% dedication.

50. Question: RFP-CMS-2011-0010 Section G.8 Key Personnel: Can the Key personal for RFP-CMS-2011-0010 also serve as key personal for Solicitation# 778-1-2305-05?

Answer: Yes

SECTION K:

51. Question: RFP Section K.3, 52.234-3 Notice of Earned Value Management System – Post Award IBR (July 2006), p. 47

RFP states: “(a) The offeror shall provide documentation that the Cognizant Federal Agency has determined that the proposed earned value management system (EVMS) complies with the EVMS guidelines in ANSI/EIA Standard - 748 (current version at time of solicitation). “ Question: Why is the government requiring an Earned Value Management Solution (EVMS) on a FFP contract? Normally, cost control on a FFP contract falls onto the contractor performing the work. If risk is a consideration of requiring EVM, then is FFP the appropriate contract type?

Answer: The EVMS requirement has been removed.

SECTION L:

52. Question: Reference L.11 B - Will the Government consider extending the response date by two weeks?

Answer: No

53. Question: L.11 D THIRD BULLET - Will the Government be favorable towards a incumbent hire plan? If yes, will the Government provide the contact details of the incumbent personnel? Government is requested to inform other than the key personnel as cited in L.11 F – Factor 3 how many FTE and PTE are currently employed by the incumbent. Responses to these question are a MUST as it will make a difference to the cost proposal. Again 30 days transition, does the Government mean working days or the first month? Will the incumbent transition plan be provided to the awardee by the Government or will the Government instruct the incumbent to work with the transitioning in plan that the awardee will propose?

Answer: There is a 60 day transition period. The incumbent contractor will transition the work to the new contractor over a 60 day period. CMS will require the incumbent to provide a transition plan for the 60 day period.

It is the discretion of each offeror to choose who they propose for this RFP. The Government will not be providing the names of the current incumbent nor will we be providing the number of FTEs or PTEs. The key personnel are listed in the SOW.

54. Question: L.11 F – Factor 4 – How many maximum past performance references can be made available from the sub-contractors?

Answer: Five is the maximum number of past performance questionnaires CMS will accept from each subcontractor.

55. Question: L.11 G – Volume 2 – Business Proposal 3 E SUBCONTRACTOR INFORMATION – Will the Government accept this information directly from the Sub-contractor in a sealed cover addressed to the Contracting Specialist or will we need to include as a part of the offer? The reason this question is being asked is because the subcontractors prefer to send it directly to the Government so as to ensure the information is confidential. For the bidder the sub-contractor costs become Other Direct Costs (ODC’s). Is this acceptable to the Government?

Answer: Yes, the Government will accept sealed information from the subcontractors provided it is received on or before the proposal due date.

56. Question: RFP-CMS-2011-0010 Section B-M.docx, Section L.11 PROPOSAL SUBMISSION INSTRUCTIONS, G. Volume II - Business Proposal, 3) Other Administrative Data, e. Subcontractor Information: The RFP text says: “Each subcontractor shall submit a complete cost proposal in the same format as the prime Contractor’s cost proposal.”

Please confirm if the subcontractor is to include all items listed in items 1) through 5) of G. Volume II - Business Proposal:

1) Contract Forms, and Representations and Certifications

2) Indirect Cost Rate Agreement and Rate History

3) Other Administrative Data

4) Cost Spreadsheets (See template at Attachment J.2)

5) Conflict of Interest Answer: Yes

57. Question: RFP-CMS-2011-0010 Section B-M.docx, Section L.11 PROPOSAL SUBMISSION INSTRUCTIONS, G. Volume II - Business Proposal: Can subcontractors submit their cost proposals separately from the Prime in a sealed package?

Answer: Yes

58. Question: RFP Section L.4 Volume I – Technical Proposal, Factor 2, second bullet, p.57

RFP states: “Explain, in detail, how it would create a correct coding initiative edit for Medicare and for Medicaid to include the appropriate rationale for the creation and development of this type of edit. Provide a specific example for both Medicare and Medicaid, in detail, as to how it would create a CCI edit to include, the steps, processes, rationale and resources utilized in the development of this edit.”

Question: Is it the government’s intent for one CCI edit to be presented that is applicable to BOTH Medicare and Medicaid, or is the government looking for one CCI edit for Medicare and one CCI edit for Medicaid for a total of two presented CCI edits?

Answer: CMS requires that the offeror provide a separate CCI edit for Medicare and a separate CCI edit for Medicaid. CMS also requires that the offeror provide a separate MUE for Medicare and a separate MUE for Medicaid.

59. Question: RFP Section L.11.E, Proposal Organization, p.56

RFP states that "The offeror shall certify that each CD has been checked using the latest version of virus detection software and is virus free. The certification shall identify the virus detection software and version used."

Question: CMS has provided a specific certification as an attachment for this purpose in previous RFP's. Does CMS intend to provide such a certification, and if not, where should the offeror include this language in its submission?

Answer: CMS has included the certification letter as an attachment.

SECTION M

60. Question: RFP Section M.2.f, Source Selection, p. 65

RFP states: “Award of the single IDIQ with the accompanying task orders under this solicitation shall be made to the contractor whose proposal is determined to provide the best value to the Government. “

Question: Please confirm that this is a single award FFP contract, as specified in the RFP transmittal letter and RFP Section B.2 Type of Contract?

Answer: Yes, CMS intends to award one single Firm Fixed price contract. The RFP has been corrected to remove reference to IDIQ contracts.

COST TEMPLATE

61. Question: RFP Attachment J.2 Cost Template

Question: E-1 has tasks numbered 1-14 on the tab for each CLIN. The schedule of services in RFP B.3, pages 5-10, has what appear to be Tasks or "subclins" such as 0001aa "Project Plan." Attachment J.1, the SOW, identifies Tasks 1-14 for Medicare and 15-34 for Medicaid. Please clarify which scheme should be used in breaking down pricing per CLIN, specifically whether the offeror should use the Task 1-34 scheme or the 5 character structure, e.g. 0001aa, as identified in the RFP?

Answer: Please submit the proposed costs in accordance with the excel charts (E.1) that were provided which are a breakout of the Statement of Work tasks. CMS would also like each offeror to complete section B.3 on how they believe the SLIN should be priced. The total amount of the SLINs would equate to the amount proposed for the task. For example of the offeror believes that the project plan and the transition plan are worth the same they would make both of those plans the same amount or if they felt the project plan was worth more they would price the project plan higher.