FFRDC QA's.pdf

Amendment 000002 5/16/2012

FFRDC Questions & Answers

1. Organizations participating in the bid to serve as the CMS FFRDC, either as the prime contractor or as subcontractors, must clearly assess Conflict of Interest issues related to their involvement in the FFRDC. On the one hand, the solicitation clearly states that CMS is motivated to select an organization which has “comprehensive knowledge of CMS needs.” Thus, an organization which comprehensively understands the mission and operations of CMS is likely to be an organization which has provided contractual support to CMS’ operating divisions across the full breadth of the agency. On the other hand, the FFRDC solicitation makes it clear that organizations participating in FFRDC-sponsored pre-solicitation activities will be precluded from bidding on commercial procurements which directly result from those activities. Can CMS provide additional guidance regarding how organizations that believe they can make valuable contributions to CMS under the FFRDC mechanism can also limit their risk of being excluded as an ongoing contractor to CMS’ operating divisions? Because the OCI issues in question appear to be “Unequal Access to Information” or “Biased Ground Rules” issues, will the Government find appropriate mitigation plans based on internal firewalls to be acceptable? (thus allowing Contractors to participate in the FFRDC activities and related procurements?)

Answer: The Organizational Conflicts of Interest requirements have been updated and included in amendment 1.

2. Will the three sample task order projects definitely be funded?

Answer: Task Order awards will be determined at time of award.

3. Can estimated levels of effort be provided for the three sample task orders?

Answer: The Contractor should propose an appropriate level of effort based on performing the tasks and completing the deliverables as outlined in the individual task orders.

4. The solicitation provides a maximum contract value of $1 billion over five years, but no minimum contract value. Given the potential size of the FFRDC contract, the contractor will have to maintain considerable staffing capacity to accommodate new task orders issued under the FFRDC. Can CMS guarantee a minimal level of effort that will be issued under the FFRDC, at least in the first year of the contract?

Answer: The FFRDC will be established through an Indefinite Delivery, Indefinite Quantity (IDIQ) contract and it has a guaranteed minimum as listed under clause B.5 of $25K.

5. Page 21, Section H.4(a). Is FAR 9.5 OCI mitigation strategy acceptable for purposes of mitigating any actual or potential OCI related to the work covered by this RFP?

Answer: Yes, see amended OCI language in the RFP (amendment 1).

6. Page 23, Section H.4(c)(2)(c)(2). Section H.4(c)(2)(c)(2) states that “for the purposes of identifying entities with conflicts of interest above, the entity is one that competed for Government or Commercial contracts other than FFRDC efforts.”

• Does this mean that, for purposes of this RFP, an “entity” is a company that competes for government or commercial contracts?

• Or, does this mean that, for purposes of this RFP, a “conflict of interest” exists if an entity is competing for government or commercial contracts?

Answer: Please refer to Amendment 1, the Organizational Conflicts of Interest requirements have been updated.

7. Page 24, Section H.4(d)(1)(a). Please confirm that in Section H.4(d)(1)(a), the required “description of all current business or contractual relationships or activities” should be limited to only currently active contracts with CMS, HHS and non-government entities supporting CMS or HHS prime contracts.

8. Page 25, Section H.4(d)(1)(e). Please confirm that the term “Medicare Contracts” means contracts with providers or suppliers furnishing health services (e.g., doctors, hospitals, insurance companies), for which payment may be made under the Medicare program and does not include other CMS or HHS contracts related to the Medicare program (e.g., advisory and assistance services).

Answer: Correct – Medicare contracts refer to contracts with providers or suppliers furnishing health services (e.g., doctors, hospitals, insurance companies), for which payment may be made under the Medicare program.

9. Page 91, Section L.19, Tab A. (a) Please confirm that the disclosure requirement in Section L.19, Tab A (a), is limited to only contracts currently held with CMS, HHS, and non-government entities supporting CMS or HHS prime contracts. If this is not the case, please clarify exactly what information should be provided to satisfy this requirement.

(b) Please confirm that “government health care agencies” as it relates to the requirements in this paragraph is limited to HHS and its components.

Answer: L.19 Tab a – requires offerors to disclose only contracts currently held with CMS, HHS, and non-government entities supporting CMS or HHS prime contracts. Government health care agencies, as they relate to L.19, refer to HS and its Operating Divisions.

10. Page 85, RFP Section L.16 Business Proposal Instructions - In light of the RFP language regarding indirect rate agreements, rate history, and approved accounting and estimating systems:

• Does CMS prefer to award to a newly established legal entity, to meet the OCI requirements of Section H.4, that will subcontract to existing entities with established indirect rate agreements, history, and approved accounting systems.

o If yes, please confirm that CMS will waive the requirement of RFP paragraph L.16.6(1) relative to the last three years indirect rate history for an offeror that is a newly formed separate legal entity?

• Or, does CMS prefer to award to an existing corporation with an established history of performing federal government cost type contracts?

Answer: Please refer to Amendment 1, section L.16 has been updated.

11. General: Is it correct to assume that 11x17 pages can be used in the proposal and that they will count as one page?

Answer: The page size shall be 8 ½ by 11.

12. L.14, Proposal Presentation and Delivery: Are there any special facility security requirements that offerors need to account for to ensure that their proposals can meet the delivery deadline?

Answer: 7111 Security Boulevard does not have a secured parking lot; however there is a security desk in the lobby. Once in the lobby the contractor can use the desk phone to call the Contract Specialist’s extension at 6-5703. The Contract Specialist will meet the offeror in the lobby to pick up proposals.

13. L.13.b.7, pg 82 and L.19, Conflict of Interest and Compliance Program Proposal, pg. 91: Is it correct to assume that the Conflict of Interest and Compliance Program Proposal (Tabs A,B,C) belong as number 7 in the Business Proposal? Or given that this is a large document, should it be compiled as its own volume following the Past Performance Volume?

Answer: The Conflict of Interest and Compliance Program Proposal shall be its own volume.

14. L.15.2.f, pg 85: Is it correct to assume that any resumes provided in addition to the Key

Personnel resumes are excluded from the page count?

Answer: Yes, resumes are excluded from the page count

15. Task Orders: Is it correct to assume that the resumes requested in the Task Orders can be provided in the Technical Capability Resume section (excluded from the page count), L.15.2.f,and cross referenced in the Task Order, L.15.3?

Answer: Yes. Resumes can be included in the Technical Capability Section and cross referenced.

16. Task Order 1: Please confirm that the Program Management Organization be established as a

CMS organization and operated by the FFRDC.

Answer: Yes, the PMO will be established as a CMS organization and operated by the FFRDC.

17. Task Order 1: Will there be any public deliverables from Florida QIO program?

Answer: FMQAI, the BFCCNCC, will be responsible for conveying the details of their participation in user input meetings to the QIO community.

18. Task Order 1, Task 2.6, page 5/14: Please clarify what the BFCC “Aim Lead” and the BFCC “Aim Team” are and how the PMO relates to them.

Answer: The BFCC Aim Lead is the CMS lead for the BFCC Aim. There are several other CMS staff (CORs, GTLs, SMEs) that make up the Aim Team. The PMO will work directly with the BFCC Aim

Lead. The PMO may work with other members of the Aim Team occasionally and as needed for specific tasks.

19. Task Order 1, Task 4.6: Please identify the current CMS contractor responsible for production of content for communication vehicles. Does the contractor serve a broader purpose than support to the BFCC program?

Answer: The QIO for Virginia, VHQC, is the CMS contractor assigned to the CRISP Driver of the 10th SOW that is responsible for 10th SOW communication. This contractor is responsible for all 10th SOW communication and messaging, not just the BFCC program. The PMO may be asked to assist CMS in coordinating the BFCC related content for overall 10th SOW messaging requests.

20. Task Order 1, Task 4.7: Please identify the current CMS contractor responsible for CMS Open Door and Town Hall meetings. Does the contractor serve a broader purpose than support to the BFCC program?

Answer: The FMQAI, BFCCNCC is responsible for hosting BFCC related Town Hall and Open Door Meetings.

21. Task Order 1, Task 7: Please explain what will trigger the transition.

Answer: CMS will notify the PMO when end of contract transition should commence.

22. Task Order 1: How does CMS anticipate this work will be coordinated with the 3-year cycle of QIO contracts?

Answer: The PMO work may overlap with multiple QIO SOWs and is not intended to align with the 3-year cycle of QIO contracts.

23. Task Order 1, page 6/17 of 14: There is a 7th task (End of Contract Transition), but there is no 6th task. Please confirm that this was numbered in error and that there is not a Task 6 that is missing.

Answer: Yes, this was a numbering error. There are a total of 6 Tasks.

24. Task Order 1: Please clarify the relationship between the National Coordinating Center and the Program Management Organization.

Answer: Although both the BFCCNCC and the PMO will work with CMS in support of the BFCC program, there are certain functions that the BFCCNCC cannot perform, specifically because it is a QIO. The BFCCNCC’s primary expertise is used to assist QIOs, while the PMO’s primary function and expertise is to be used to assist CMS in its management of the BFCC program. The PMO will advise CMS on several matters which would create a conflict of interest were the BFCCNCC to be involved. The PMO, will assist CMS in organizing, increasing efficiencies, effectiveness and standardization of the entire BFCC program, which may include recommendations pertaining to the BFCCNCC’s functions.

25. Task Order 1: Please clarify how the work in this SOW relates to the timing of the upcoming QIO SOW cycle.

Answer: The PMO work may overlap with multiple QIO SOWs and is not intended to align with the 3-year cycle of QIO contracts.

26. Task Order 3, Task 3 and Schedule of Deliverables: Please define the deliverable listed in Task 3 as “the comprehensive paper” (p.7) and clarify the timing of deliverables in Task Order 3. There appears to be a conflict between the deliverables requested throughout the Task Order 3 description and the Schedule of Deliverables (p. 9). Please clarify.

Answer: The description of Task Order 3 was incorrect – it has been updated to reflect the deliverable described in row 6 on page 9:

Task 3: Establish and begin ongoing work on the FPP and TTP

Provide ongoing support of the FPP and TTP in accordance with the agreed-upon first year work plan within 65 days after the award of the contract.

27. Task Order 3: Will the TTP conduct all data analytics and predictive modeling, or will the FFRDC contractor also play a role (other than advising the TTP on best practices)?

Answer: This could be developed or changed as the relationship matures. But in the initial stages, the FFRDC would not be expected to conduct data analytics and predictive modeling.

28. Task Order 3: With regard to secure data transfers, is it expected that payers will transfer data directly to the TTP?

Answer: This and other technical requirements will be developed by work groups including public and private partnership members over the summer of 2012. Tentatively, it is expected that whatever raw data is exchanged will only be exchanged between participating entities and the TTP. It is also possible that the partnership could adopt a distributed data model that would minimize the amount of underlying data that was actually transferred to the TTP, as opposed to setting up an actual global database within the TTP. Under such a system, the TTP might be able to rely on only indirect access to underlying payer data. Again, these details will be worked out by the partnership after it forms.

29. Task Order 3: Will “beneficiary fraud” be investigated as part of this effort?

Answer: A determination if this will be included may be made at a later time.

30. Task Order 3: Is CMS interested in obtaining input from providers on the functioning of the TTP

(e.g., as part of the 100 interviews to be conducted in the first 4 months of the project)?

Answer: Yes; however this is subject to reassessment.

31. Task Order 3: It is our assumption that all information gathered and analyzed by the TTP will be provided only to CMS. Is this correct?

Answer: Most likely, no. The final decision on the specifics of the information-sharing must be made not by CMS or the federal government, but as a result of collaborative decision-making by the public and private partners together, which is expected to take place over the summer of 2012. However, CMS will be recommending that all participating entities (including private sector and CMS) will provide or make available in some way some level of data to the TTP, and then the TTP will provide some level of results back to each participating entity.

32. Task Order 3, page 5: Will the TTP be the venue for the pilot studies? If not, where will these studies be conducted?

Answer: Yes; however, the Data Analysis and Review Committee of the new entity may make other decisions or make other arrangements.

33. Task Order 3: In accordance with your COI instructions, is it correct to assume that the TTP entity must be apart from, and not affiliated with the FFRDC contractor?

Answer: Probably yes. The FFRDC contractor will assist CMS in managing and leveraging its relationship with the TTP and the entire public-private fraud prevention partnership. Having CMS’s FFRDC affiliated with the TTP may give the appearance to our private partners that the government could be treated differently from the private partners – this could impact the TTP’s “honest broker” role. Any proposal by a candidate for FFRDC who is affiliated with the TTP at a minimum would need to explain how this situation would be ameliorated. Conversely, depending on whether the TTP or the FFRDC comes into being first, any candidate for TTP with an affiliation to the CMS FFRDC would presumably need to make a similar explanation.

34. Draft Sponsoring Agreement paragraph V. C. 5., page 8: This item says that the FFRDC PMO

“Oversees implementation and execution of the Health Management Plan to ensure compliance.” There is no other reference to the Health Management Plan in the solicitation.

Please explain the plan in more detail.

Answer: This should be the Health FFRDC Management Plan, which is the governance document that CMS will use to manage the Health FFRDC.

35. Draft Sponsoring Agreement paragraphs VI. B. and VIII. A. 1., pages 10 and 11: Both paragraphs refer to FFRDC “core competencies” that are summarized or defined in Section III.

The agreement says the FFRDC may only perform work in those competencies. Section III lists “seven core task areas.” We assume that the core task areas are the same as the core competencies.

Answer: That is correct—the core competencies are the same as the core task areas.

36. Attachment J-4, FFRDC Services for Beneficiary and Family Centered Care (BFCC) Program, Project Management Organization (PMO) SOW There is no Task 6 in the body of the SOW – there is a Task 5 and a Task 7. In the Schedule of Deliverables there is a Task 6 deliverable that appears to match the product description for Task 5.

Question: Would the government please clarify the tasks and associated deliverables?

Answer: Yes, this was a numbering error. There are a total of 6 Tasks. The Task 6 deliverable is associated with Task 5 in the SOW.

37. 2. Section L.14 Proposal Presentation and Delivery The RFP requires “Offerors must submit one

(1) original and fifteen (15) hard copies and (2) electronic copies on Compact Discs (CD) for both the technical and business proposals.” Because of all the required elements of the business proposal, those volumes will be very large.

Question: Would the Government consider accepting 3 hard copies of the Business Volume?

Answer: Section L.14 has been updated. Offerors are required to submit One (1) original, fifteen

(15) hard copies and (2) electronic copies on Compact Discs (CD) for Volume I of the business proposals and one (1) original, two (2) hard copies and (2) electronic copies on Compact Discs for Volume II of the business proposal.

38. Page 9 Section G.1.(c).(2).a) “The estimated direct labor dollars (broken out by hours and rates for each month of effort)…”

Page 86 Section L.16.5 “The cost estimate shall describe an estimated total annual total dollar amount…”

Please clarify whether the hours and rate information for the Task Order Proposals must be provided by month or by year. Attachments J-2 and J-3 do not include 12 monthly periods for each year. If detail by month is required, may the Offeror modify Attachments J-2 and J-3 to accommodate 12 months of pricing detail for each year?

Answer: Attachments J-2 & J-3 are templates only and may be modified as needed to accommodate the elements in the technical solution and the offerors accounting system.

39. Page 13 Section IX SKILLMIX The FFRDC operator shall propose a skill mix consistent with previous levels of expertise and experience in support of the VDC/EDC Program. The skill mix shall consist of Senior, Principal, and Lead Information Systems Engineers; Communication Specialists; and Cost Analysts.

Please provide the current labor mix and effort for this task order. Please identify incumbent contractors that currently support the VDC/EDC Program activities expected to be performed on this task.

Answer: The language for Attachment J-5, Page 13, Section IX has been changed to:

The FFRDC operator shall propose a skill mix in support of the requirements presented in this SOW. CMS anticipates a skill mix similar to the support that is currently being provided which consists of Senior, Principal, and Lead Information Systems Engineers; Communication Specialists; and Cost Analysts.

40. Detail Tabs (Base Year, Option Year 1,etc.) The formulas in Row 20 currently calculate Overhead as a percentage of the Fringe dollars as calculated in Row 18.

May the formulas in Attachments J-2 and J-3 be modified, as appropriate, in order to accommodate the Offeror’s overhead rate application structure?

Answer: Yes

41. Clause B.3 (page 2) Type of Contract states “… Specific tasks and/or work to be performed, will be detailed in, and solicited by, individual task orders …”. This is contrary to the federal standard for other FFRDCs which has been to establish level of effort (LOE) contracts so that the operator can dedicate staff to the Center’s purpose and establish a firewall between the Center’s personnel and the rest of the contractor’s work to mitigate for any potential organizational conflict of interest.

Would CMS please consider this LOE approach since it provides the most effective mitigation approach and it is clear from other statements in the RFP that CMS is seeking CMS experienced contractors?

Answer: This award will be for an Indefinitely Delivery Indefinite Quantity contract with task order awards. CMS has the authority to award most types of fixed price and cost reimbursement task orders.

42. Clause H.4.c.2.(c)(1) (page 23) Identification of Conflict states “the entity is one that- (1) Prepared work or is under contract to prepare work that would be reviewed under the FFRDC contract”.

How would a contractor know if CMS personnel or the FFRDC will review their work when the contractor is bidding on the contracted work?

43. Clause H.4.c.2.(c)(2) (page 23) Identification of Conflict states that an entity will be identified as having a conflict of interest if they “Competes for Government or Commercial contracts other than FFRDC efforts”.

Please confirm that if an offeror or a proposed subcontractor submits an acceptable mitigation plan, their non-FFRDC operating units will be permitted to compete for contracts other than FFRDC efforts.

44. Clause H.4.c.2.(d)(2) (page 23) Identification of Conflict states that the Contracting Officer may determine that an Offeror has the potential for a conflict of interest based on holding “other contracts and grants with Federal Government”. This language literally could preclude all contractors with CMS program experience.

Would it be possible to provide clarification on the range of workscope of Federal contracts and grants or applicable agencies that would be deemed to conflict with the proposed work of the

FFRDC?

45. Clause H.4.d.1.(b) (page 24) Conflict of Interest Evaluation states the COI Certificate must provide “A description of the methods the Offeror or Contractor will apply to ensure any situations listed in the Certificate do not take place.”

Does this mean that CMS will not even consider mitigation plans to address potential or perceived conflicts?

46. Clause H.4.d.1.(e) (page 25) Conflict of Interest Evaluation requires confirmation that the “Contractor, nor its parent company, subsidiaries or other affiliated entities have no other Medicare contracts”.

Is this an absolute prohibition or can an offeror have Medicare contracts that are mitigated by separated business units or some other acceptable form of mitigation?

47. H.4.d.(h)(4) (page 25-6) Conflict of Interest Evaluation requires disclosure of financial interests in insurers, providers or suppliers of health services of Offeror’s officers, directors, and managers family members.

Does CMS view family members whose livelihood is derived from working in the medical or health care or insurance professions to create actual or perceived conflicts of interest?

48. Clause H.4.e. (page 26) Conflict of Interest Resolution. This section does not include an option of approving an acceptable mitigation strategy.

We respectfully request CMS add this resolution option so qualified contractors can bid on the

FFRDC.

49. Clause H.4.e. (page 26) Conflict of Interest Resolution. This section does not include an option of approving an acceptable mitigation strategy.

Is CMS stating that it intends to modify or terminate the winning Offeror’s existing work with the agency to avoid any perception of conflict?

50. Provision L.19 (page 91) “Conflict of Interest and Compliance Program Proposal Instructions,” TAB A requires disclosure of “all contracts” … Any contractor that is large enough to handle a $1billion FFRDC contract, will have a large portfolio of health related work. Is the Government sure it wants to receive the extensive amount of information (items (a) through (g) for thousands of projects for the Offeror, its parent company, its subsidiaries, and other affiliated entities? Assuming multiple bidders, the request for disclosures as written, including 15 copies each, will translate into a large volume of paper. If an Offeror’s COI Plan establishes workable firewalls to other business units, subsidiaries, etc. all of their contract information is irrelevant.

We respectfully suggest that the Government consider limiting the request to the proposed FFRDC autonomous organization or separate operating unit of the parent, based on the COI Plan called for in Tab B, and let the full detail be available for the audit, if necessary.

51. Provision L. 19 (page 91) TAB A “Conflict of Interest and Compliance Program Proposal Instructions,” state that the offeror must disclose all contracts, both government (local, state and federal ) and non-government currently held with CMS, other government health care agencies, or with non-government entities, as a Prime and/or Subcontractor, for itself, its parent company, subsidiaries or other affiliated entities.”

a). Please confirm that this disclosure detail is limited to the prime since the prime is responsible for subcontractors COI [H.4c.2.(d)(4)].

b). Please also confirm that you meant contracts held with non-government health care entities.

52. Provision L. 19 (page 91) TAB A “Conflict of Interest and Compliance Program Proposal

Instructions,” state that the offeror must disclose all contracts, both government (local, state and federal) and non-government currently held with CMS, other government health care agencies, or with non-government entities …” Many contracts with non-government entities, especially industry, contain non-disclosure terms preventing the contractor from naming the firm or the subject matter of the work. This is done to protect intellectual property and comply with SEC rules. Identifying a POC for those contracts would be a breach of contract.

Please confirm that in these cases we can refer to the firm in generic terms and not identify them by naming an individual POC.

53. Provision L. 19 (page 92) TAB A “Conflict of Interest and Compliance Program Proposal Instructions require all proposed subcontractors to disclose all their contracts to the Prime “at the same level of detail ...” This information is competitively sensitive information that offerors should not be forced to give to other offerors who compete with them, and some of the data cannot be disclosed to third parties due to existing non-disclosure agreements.

Since H.4 makes the Prime responsible for the OCI of their subcontractors, please provide the Primes with the authority and flexibility to manage that responsibility in a way that can accommodate the disclosure limitations subcontractors face. This can be done by revising the last sentence under TAB A to read:

All proposed subcontractors must disclose actual, potential, and apparent organizational conflicts of interest to the Prime contractor and their planned mitigation strategy.

54. Provision L.19. “Conflict of Interest and Compliance Program Proposal Instructions,” paragraph

(g) states, “If an actual, potential or apparent OCI is identified, then the Offeror will not be eligible for award.”

It is unreasonable to automatically declare an offeror ineligible on the basis of potential or apparent conflicts.

We request this language be modified to read: “If an actual, potential or apparent OCI is identified and cannot be mitigated, then the Offeror will not be eligible for award.”

55. Statement of Work, Sections 1 and 2 We recognize that the Scope has been intentionally written in very general terms to maintain flexibility. Given the extraordinary costs in preparing a proposal and the extensive conflict of interest rules, in order for contractors to determine the appropriateness of bidding on the FFRDC, could CMS please clarify if the Government envisions using the FFRDC to conduct work that is currently performed by individual contracts openly competed (including IDIQ contracts like MRAD, XRAD, MIDS, etc.) or will that type of contract work continue to be available outside the FFRDC?

Answer: No, CMS does not anticipate using the Health FFRDC to conduct work currently performed under openly-competed contracts.

56. Statement of Work, Section X, (page 15) Period of Performance states “The FFRDC operator shall work primarily in the Baltimore metropolitan area to include the FFRDC operator’s facilities, as well as other HHS facilities.”

a). Please clarify if the selected contractor is required to have a facility in Baltimore?

Answer: It is not a requirement of the contract.

b). Can the FFRDC operator utilize staff from their other locations and have a limited staff housed in Baltimore?

Answer: Yes.

57. Sponsoring Agreement, VIII.A.5 Limitations states “From inception, its accumulations from fee and other income constitute its retained earnings (reserves), which will be used in part to fulfill working capital requirements and to further the research and development purposes of the Health FFRDC.”

In normal Government contracts, the Government recognizes that it is in the Government’s best interest to provide a fee to the performing contractor of up to 10% for service contracts. The draft Agreement language however does not allow for any fee to the operator. FAR 35 requires a plan for the use of fee but not prohibit the contractor from earning fee.

In the interest of incentivizing good performance, will the Government reconsider providing for the normal FAR authorized fee provisions?

Answer: See FAR Part 35.017-1(c)(3) and FAR Part 35.017-1(d)(2).

58. L.19 Organizational Conflict of Interest In trying to understand the criteria for determining whether a contract has a OCI, we request further clarification of the FFRDC’s scope and the meaning of “health care” as used with respect to OCI. The Statement of Work describes the purpose as supporting CMS in its administration of Medicare, Medicaid, and Children’s Health Insurance Programs. But the term “health care” could be interpreted as covering any number of additional programs, such as a contractors’ s work in health registries, smoking cessation programs, electronic health records standardization, international development health programs, drug discovery, clinical trials, etc.

Would CMS please clarify that for the purposes of determining OCI, the disclosures and determinations of organizational conflicts of interest is limited to “health care directly related to CMS’s Medicare, Medicaid, and Children’s Health Insurance Programs”. Would CMS consider revising L.19 Tab A to state, “The Offerors must disclose all health care contracts, both government and non-government directly related to CMS’s Medicare, Medicaid, and Children’s Health Insurance Programs held with CMS, other government health care agencies…”