Amendment 000002.pdf

RFP-CMS-2011-0026 A/B MAC Jurisdiction E Amendment 000002

The purpose of this amendment is to incorporate the following changes into the solicitation and provide responses to solicitation questions. The solicitation is amended as follows:

I. PART IV – REPRESENTATIONS AND INSTRUCTIONS

A. SECTION L, INSTRUCTIONS, CONDITIONS AND NOTICES TO OFFERORS,

subsection L.13.b, Tab B: Past Performance Instructions is amended as follows:

b) Tab B: Past Performance Instructions (Past Performance Questionnaires, Attachment J-08, and a summary listing of PPQs are NOT included in the 60-page limit. All other information submitted by the Offeror on Past Performance WILL BE INCLUDED in the 60-page limit)

Offerors shall submit the information described below as part of its written technical proposal for both the Offeror (as prime) and proposed subcontractors.

Offerors may submit a Past Performance Questionnaire (PPQ), provided as Attachment J-08, from a maximum of three (3) contracts and/or subcontracts for only(completed and/or currently in progress) for the prime contractor and any subcontractors for the last three (3) years; provided, however, Offerors shall not submit a PPQ for any MAC contract, Medicare fiscal intermediary (FI) contract, or Medicare carrier contract (CMS will review relevant MAC, FI and carrier performance information maintained in its internal records and or with its personnel and will not consider any PPQ relating to Medicare, FI or Carrier contracts).

Offerors and proposed subcontractors shall limit the number of PPQs submitted to no more than three each. Please note that one PPQ, Attachment J-08, may be submitted for multiple MAC proposals as long as the PPQ is clearly identified for “MAC Jurisdiction E.” This PPQ will be kept on file and used for all current and future proposals as long as it falls within the respective past three years. This list will only include all contracts within the separate Business Units where the MAC contracts will be performed. Contracts listed may include those entered into with the Federal Government, agencies of state and local governments and commercial customers.

The PPQ (Attachment J-08) must be submitted directly by the references. Attachment J-08 includes a sample cover letter, instructions for questionnaire response and the questionnaire.

Offerors shall ask references to submit their responses directly to CMS no later than one (1) week after the proposal due date.

Offerors should include in their technical proposal, under Tab B, a summary listing of each entity that was asked by the Offeror and/or subcontractor to complete a Past Performance Questionnaire (PPQ). Offerors should not provide copies of letters and blank PPQs mailed to persons for completion. This summary is NOT included in the page limit. This summary should include:

• Contract Number and Type the PPQ is being completed for

• Contact Person completing PPQ

• Contact Person’s Phone Number

• Company Name and Address of Contact Person

CMS may review the Federal Government’s Past Performance Information Retrieval System (PPIRS) and/or the Contractor Performance Assessment Reporting System (CPARS) for existing performance evaluations. If your designated reference(s) have previously submitted an evaluation in PPIRS and/or CPARS they do not need to resubmit using the PPQ attachment. CMS will locate the evaluation in the appropriate performance system.

Offerors having no organizational past performance record may provide references for proposed personnel. The Offeror may describe any quality awards or certifications received in the past three (3) years that indicate the Offeror possesses a high-quality process for developing and producing the services required. Also, describe when the award or certification was bestowed. A joint venture having no past performance history itself may provide references based on the constituent companies.

In addition to Attachment J-08, PPIRS, and/or CPARS, CMS may consider information from a range of CMS internal and external sources to complete its past performance evaluation;

including but not limited to the following:

a. 912 Evaluations

b. CFO Audits

c. Medicare Contractor Provider Satisfaction Survey (MCPSS) Results

d. Quality Assurance and Surveillance Plans

e. Reports of Contractor Performance

f. Statements on Auditing Standards Number 70 (SAS70), now being replaced with the Statement on Standards for Attestation Engagements (SSAE) No. 16, Reporting on Controls at a Service Organization

g. Award Fee Determination

h. Previous MAC Implementations

When making the contract award determination, an Offeror’s past performance rating will take into consideration information available up to the date of proposal submission (or final proposal submissions if discussions are conducted). However, the Government is not prevented from considering any other relevant past performance information that may become available.

B. SECTION M – EVALUATION FACTORS FOR AWARD is amended as follows:

1. SECTION M.1, GENERAL PROCEDURES, is deleted in its entirety and replaced as follows:

The Technical Evaluation Panel (TEP) will evaluate and rate each technical proposal (including the written technical proposal and Oral Presentation, inclusive of the oral presentation slides) by applying the weighted Technical Evaluation Factors set forth below. The written technical proposal and the Oral Presentation shall provide all information necessary to properly evaluate the proposals in accordance with the evaluation factors.

The Government will include the Offeror’s oral presentation (as described in section L.18) in its technical evaluation. Oral presentations will be required of all Offerors.

Offerors will be provided specific instructions and schedule information for preparation and delivery of oral presentations. In accordance with FAR 15.306, Exchanges with Offerors after receipt of proposals, the Government may find it necessary to conduct clarifications.

The following evaluation factors will be applied to the technical evaluation of each proposal. The Government will evaluate the factors listed below based on the Offeror’s written technical proposal and oral presentation. The three factors are weighted as follows:

1. Past Performance – 40%

In accordance with FAR 9.104-1, General standards, the Offeror must have a satisfactory performance record in order to be considered for award. See also FAR 9.104-3(b), Satisfactory Performance Record, and FAR 42.15, Contractor Performance Information. Past performance information will be used to assess responsibility and to evaluate technical merit in accordance with FAR 15.305 and any requirements of this solicitation.

The evaluation of past performance will be based on the Offeror’s demonstrated ability, (considering its performance of the requirements of other contracts of a similar nature, scope, and complexity as the MAC contract) to successfully meet the requirements of the SOW in this solicitation.

2. Technical Understanding – 40%

The evaluation of technical understanding will be based on the Offeror’s proposed approach, included in TAB C (inclusive of all sub-tabs) of the written technical proposal and oral presentation.

3. Implementation – 20%

The evaluation of implementation will be based on the Offeror’s proposed approach, included in Tab D of the written technical proposal and oral presentation.

All three of the evaluation factors will be assigned a rating after consideration of all identified findings. After rating the factors, CMS will consider the factor ratings and findings in determining which proposal represents the best value to the Government.

In performing its review of each evaluation factor (Past Performance, Technical Understanding and Implementation), CMS will consider all of its findings in relation to one or more of the following four aspects. These aspects are not factors or subfactors.

They are elements for CMS’ consideration in evaluating the three factors, Past Performance, Technical Understanding and Implementation; the four aspects are:

a. Customer Service - CMS may consider the Offeror’s ability to maintain a high level of service and satisfaction to Medicare FFS providers/suppliers, and the Offeror’s ability to effectively respond to provider/supplier inquiries and complex beneficiary inquiries about the Medicare program. CMS may consider the Offeror’s ability to maintain effective provider/supplier education that achieves accurate billing with prompt and correct provider/supplier payment, and the Offeror’s ability to facilitate Medicare beneficiary healthcare through well-informed FFS providers/suppliers.

CMS may also consider the Offeror’s ability to work collaboratively with CMS and its Business partners to foster integration of Medicare operations. Business partners include, but are not limited to: other Government entities (including, but not limited to, Congress), and other CMS contractors responsible for FFS benefit administration support activities (i.e., Qualified Independent Contractor (QIC), Zone Provider Integrity Contractor (ZPIC), Enterprise Data Center (EDC), and other contractors identified in the MAC SOW).

b. Financial Management – CMS may consider the Offeror’s ability to promote the fiscal integrity of Medicare FFS benefit administration and be an accountable steward of trust fund dollars. CMS may also evaluate the Offeror’s ability to process adjustments timely, accurately, and reliably.

c. Operational Excellence – CMS may consider the Offeror’s ability to promote corporate integrity, establish an effective organization alignment, establish internal controls, and establish and manage its employees and infrastructure; and consistently implement information technology systems in order to maintain the confidentiality, integrity, and availability of Medicare system operations. CMS may consider the Offeror’s adherence to the contract schedule, including, but not limited to, transition/implementation activities and contract administration activities; the Offeror’s compliance with contract requirements and standards (e.g. the Offeror’s ability to pay claims timely, accurately, and reliably); and the Offeror’s ability to control the administrative costs of the contract.

d. Innovations and Technology – CMS may consider the Offeror’s ability to foster efficiencies in the administration of the Medicare FFS program, and the Offeror’s ability to use innovations and creative technological solutions to improve Medicare FFS program operations. CMS may also consider the Offeror’s ability to develop and continually refine business processes to foster excellence and quality in the administration of the Medicare FFS Program.

2. SECTION M.3, CAPABILITIES DETERMINATION FOR AWARD is deleted in its entirety

Attachments A/B MAC Jurisdiction E RFP-CMS-2011-0026, Redline A/B MAC Jurisdiction E RFP-CMS-2011-0026, Final

All other terms and conditions of this solicitation remain unchanged.