J-02 Deliverable Schedule JL_02032012.xlsx

XLSX spreadsheet 45 KB Posted Feb 10, 2012

Attached to: Award: A/B MAC Jurisdiction L - RFP-CMS-2012-0003 Federal contract opportunity
Solicitation number: RFP-CMS-2012-0003
Issued by: Department of Health and Human Services Centers for Medicare and Medicaid Services

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J-02 Deliverable Schedule JL_02032012

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Other files attached to Award: A/B MAC Jurisdiction L - RFP-CMS-2012-0003, newest first.
File	Type	Posted
AB MAC CLIN 0003 Cost Proposal Template Option Year1.xlsx	XLSX spreadsheet	Feb 10, 2012
RFP Amd 1 02-10-2012 Final.docx	DOCX document	Feb 10, 2012
JL AB MAC Offeror's RFP Questions and Answers.FINAL.xlsx	XLSX spreadsheet	Feb 10, 2012
JL SF30 Amd1signed.pdf	PDF	Feb 10, 2012
J-03 Small Business Subcontracting Plan.doc	DOC document	Feb 10, 2012
RFP Amd 1 02-10-2012 Redlined.docx	DOCX document	Feb 10, 2012
J-08 Past Performance Questionnaire.docx	DOCX document	Feb 10, 2012
J-01 Statement of Work_JL_FINAL_FEB-03-2012.docx	DOCX document	Feb 10, 2012
AB MAC CLIN 0002 Cost Proposal Template Base Year.xlsx	XLSX spreadsheet	Feb 10, 2012
JL RFP Attachments 01_05_12.zip	ZIP file	Jan 5, 2012

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Deliverable Schedule

Deliverable Schedule- RFP-CMS-2012-0003 Attachment J-02
RFP/SOW WPS #	Related SOW Requirement Name	Deliverable Name	Deliverable Description	Deliver to	Deliverable Due Date	Frequency	CMS Business Owner Functional Area
C.5.1.1	Jurisdiction Implementation Project Plan	Jurisdiction Implementation Project Plan	A detailed description of all activities required to transfer all Medicare operations from each carrier and intermediary in the contractor’s jurisdiction.	Contracting Officer's Representative and/or Designees	Baseline due within 30 calendar days after contract award	Once	Center for Medicare (CM) / Medicare Contractor Management Group (MCMG) / Division of Medicare Administrative Contractor (MAC) Program Management (DMPM)
C.5.1.2	Segment Implementation Project Plans	Segment Implementation Project Plan	An expanded part of the Jurisdiction Implementation Project Plan that specifies in more detail the transfer of that segment’s workload.

NOTE: for the Part B CICS that are merging, the plan shall contain the following additional information: Provides a narrative summary of your approach to the merge.

Provides a narrative summary of the set up of your existing CICS regions and any unique non-base processing that would be impacted by the merge. Addresses the following

• Are system reference files from all regions standardized (ex: edits/audits/procedure code file/messages) or are they different from region to region?

• Do you have non-base processes that take files from one location and copy them to another?

• Are there other unique processing that would impact the effort associated with the merge?	Contracting Officer's Representative and/or Designees	Draft due at segment kickoff meeting. Baseline due within 30 calendar days of segment kickoff meeting	Twice	CMM / MCMG / DMPM
	C.5.1.3	Risk Management Plan	Risk Management Plan	Identifies the jurisdiction wide as well as segment specific risks, mitigation strategies, and maintenance process for the risks associated with the contractor’s segment workload transition	Contracting Officer's Representative and/or Designees	Due within 30 calendar days after jurisdiction kickoff meeting.	Once	CMM / MCMG / DMPM
	C.5.1.4	Segment Cutover Plan	Segment Cutover Plan	An expanded part of the Segment Implementation Project Plan that contain the day by day activities and procedures, some of which may be detailed to the hour, that the contractor will follow during the cutover period to ensure a successful cutover for a particular segment.	Contracting Officer's Representative and/or Designees	Initial within 45 calendar days prior to the segment cutover date contained in the Segment Implementation Project Plan	Once	CMM / MCMG / DMPM
	C.5.1.5	Segment Test Plan	Segment Test Plan	A consolidated plan to identify the approach to testing, types of tests, schedule, and progress for all segment implementations.
	Contracting Officer's Representative and/or Designees	Initial within 30 calendar days after first segment kickoff meeting, Updates are due within 30 calendar days following all remaining segment kickoff meetings.	Once	CMM / MCMG / DMPM
	C.5.1.6	Lessons Learned Documentation	Lessons-Learned Document Regarding Implementation Activities	Identifies the lessons learned during the implementation of each segment.	Contracting Officer's Representative and/or Designees	Within 40 calendar days after segment cutover	Once	CMM / MCMG / DMPM
	C.5.1.7	Accounts Receivable Reconciliation	Accounts Receivable Transmittal Document	Describes the total amounts and counts of the accounts receivables of the outgoing contractor.	Contracting Officer's Representative and/or Designees	Due within 10 calendar days after the date of transfer	Once	CMM / MCMG / DMPM and OFM/DFRP
	C.5.1.9	Implementation Stakeholder Communication	Communications Plan	Identifies the processes and procedures the contractor will follow to ensure that all transition stakeholders are informed of the transition and its progress.	Contracting Officer's Representative and/or Designees	Initial within 30 calendar days after first segment kickoff meeting, Updates are due within 30 calendar days following all remaining segment kickoff meetings.	Once	CMM / MCMG / DMPM
	C.5.2.1	Workload Closeout Project Plan (Option that may be exercised at the End of the Contract)	Workload Closeout Project Plan	Describes the outgoing contractor’s plan for the transfer of Medicare functions and the closeout of operations at contract end.	Contracting Officer's Representative and/or Designees	Initial within 30 calendar days of replacement contractor kickoff meeting	Once	CMM / MCMG / DMPM
	C.5.2.1	Closeout Project Plan (Option that may be exercised at the End of the Contract)	Jurisdiction Workload Closeout Report	Identifies workload indicators for a jurisdiction to allow CMS to determine if the outgoing Contractor is processing claims in accordance with the SOW.	Contracting Officer's Representative and/or Designees	Within 3 business days of biweekly period end	Biweekly	CMM / MCMG / DMPM
	C.5.2.3	Workload Closeout Risk Management Plan	Workload Closeout Risk Management Plan	Includes a periodic assessment of new risks and mitigation and contingency planning where appropriate.	Contracting Officer's Representative and/or Designees	Initial Due within 30 calendar days of replacement contractor kickoff meeting	Once	CMM / MCMG / DMPM
	C.5.2.4	Accounts Receivable Reconciliation (Option that may be exercised at the End of the Contract)	Accounts Receivable Transmittal Document	Describes the total amounts and counts of the accounts receivables of the outgoing contractor.	Contracting Officer's Representative and/or Designees	Due within 10 calendar days after the date of transfer	Once	CMM / MCMG / DMPM and OFM/DFRP
	C.5.2.5	Cost Accounting/Audit (Option that may be exercised at the End of the Contract)	Financial Audit Supporting Documentation	Describes the details to support the post-cutover financial activities of the outgoing contractor.	Contracting Officer's Representative and/or Designees	Within 30 calendar days after closeout end	Once	CMM / MCMG / DMPM
	C.5.2.5	Cost Accounting/Audit (Option that may be exercised at the End of the Contract)	Administrative Supporting Documentation	Describes the details to support the post-cutover administrative activities of the outgoing contractor.	Contracting Officer's Representative and/or Designees	Within 30 calendar days after closeout end	Once	CMM / MCMG / DMPM
	C.5.4.3	Security	Information Technology Systems Contingency Plan Report	Information Technology (IT) Systems Contingency Plan (See BPSSM Table 3.1 Planning Table, for 3.4)	Contracting Officer's Representative and/or Designees and CMS Business Owner	Initial within 90 days prior to the first segment cutover date and annually thereafter	Annually	OIS
	C.5.4.3	Security	IT Security Tests And Reports	Contractor conducted or any other independent IT evaluation	Contracting Officer's Representative and/or Designees	10 business days after conducted	As required	OIS
	C.5.4.3	Security	Risk Assessment Report	Risk Assessment (See BPSSM Table 3.1 Planning Table, for 3.2)	Contracting Officer's Representative and/or Designees	Initial within 90 days prior to making AB payments under the contract and annually thereafter	Annually	OIS
	C.5.4.3	Security	Statement of Security Compliance	Annual certification (See BPSSM Table 3.1 Planning Table, for 3.3)	Contracting Officer's Representative and/or Designees	In accordance with BPSSM	Annually	OIS
	C.5.4.3	Security	Systems Security Plan	Systems Security Plan (SSP) (See BPSSM Table 3.1 Planning Table, for 3.1)	Contracting Officer's Representative and/or Designees	Initial within 90 days prior to making AB payments under the contract and annually thereafter	Annually	OIS
	C.5.4.3	Security	Systems Security Profile Documentation	Systems Security Profile (See BPSSM Table 3.1 Planning Table, for 3.7)	Contracting Officer's Representative and/or Designees	Consistent with frequency	As required	OIS
	C.5.4.3.2	Administer Security Program	Corrective Action Management Process Report	Report progress in correcting deficiencies or findings identified by audits, reviews, etc. in accordance with guidance provided by the BPSSM and other CMS guidance.	Contracting Officer's Representative and/or Designees	In accordance with BPSSM or as requested by CMS (Corrective Action Plans for findings identified in Section 912 Evaluations must be remedied prior to making payments).	Monthly	OIS
	C.5.4.3.4	Correct Deficiencies	Incident Reporting and Responses Report	Incident Reporting and Response (See BPSSM Table 3.1 Planning Table, for 3.6)	Contracting Officer's Representative and/or Designees	Within 15 calendar days of month end or as required by CMS. Incidents involving individually identifiable information must be reported within one hour	Monthly and As required	OIS
	C.5.4.3.5	Security Review and Verification	FISMA Assessment	Contractor will examine and analyze implemented security safeguards to provide evidence of compliance with applicable laws, regulations, and requirements.	Contracting Officer's Representative and/or Designees	As part of the May 1st POA&M submission	Annually	CM/MCMG/DSSOO
	C.5.4.3.5	Security Review and Verification

	FISMA Compliance	Any FISMA Compliance evidence to CMS (See H.26- FEDERAL INFORMATION SECURITY MANAGEMENT ACT (FISMA)) on completed and current CMS contracts	Contracting Officer's Representative and/or Designees	As requested by CMS	As requested	CM/MCMG/DMSSOO
	C.5.4.4.1	Quality Control Program	Quality Control Plan (QCP)	Specifies the procedures and resources applied to ensure services meet contract performance requirements.	Contracting Officer's Representative and/or Designees and CMS Business Owner	No later than 45 calendar days after contract award; then annually at contractor renewal, thereafter, as significant changes occur.	Annually at contractor renewal or when there is a significant change to the operation or plan.	CMM/MCMG
	C.5.4.5	Public Relations	Public Relations Plan	Describes the contractor’s plans for managing the programs public relations.	Contracting Officer's Representative and/or Designees	Initial within 30 calendar days of contract award, thereafter within 7 calendar days of annual period end	One month after contract award then Annually thereafter	CMM/MCMG
	C.5.4.5.3.3	Review Written Responses for Reading Level (Fogging) Accuracy and Timeliness	Readability Attestation for Beneficiary Appeals Correspondence	Contractors are required to attest that they are issuing correspondence that satisfies the readability requirements outlined in the Federal Register. This attestation should include how contractors ensure that this requirement is being met (e.g., software programs, quality reviews, etc.). Additional information regarding the readability requirements is in IOM 100-04, Chapter 29, Section 290.3.2 -- Reading Levels.	Contracting Officer's Representative and/or Designees and CMS Business Owner	Within 30 days after cutover	Annual	CPC/MEAG/DAO
	C.5.4.6.1	Responses to Congressional Inquiries	Responses to Congressional Inquiries Report	Describes a summary of the congressional inquiry responses	Contracting Officer's Representative and/or Designees	Within 7 calendar days of month end	Monthly	OBIS/CMS
	C.5.4.8.3	Successful Implementation of Change Requests	Change Request Implementation Problem Log	Describes any problems and the resolution status associated with the implementation of change requests.	Contracting Officer's Representative and/or Designees	Within 15 calendar days of month end. Note: This is only the MAC's responsibility following cutover. Prior to cutover it is the OGC's responsibility.	Monthly	CMM/MCMG/ DCM; CMM/Provider Billing Group (PBG)/Division of Supplier Processing (DSCP)
	C.5.4.9	Business Continuity Planning and Disaster Recovery	Comprehensive Continuity of Operations (COOP) Plan	Describes the Contractor’s policies and procedures to ensure that essential business functions continue during a disaster. The COOP plan elements include protection of physical infrastructure, IT disaster recovery, business continuity (with or without system availability), and other topics	Contracting Officer's Representative and/or Designees	Initial is due 60 calendar days prior to cutover, thereafter annually as requested	Once, then Annually	CMM/OIS/SSG
	C.5.4.10.2	Self Assessment Process for Internal Controls	Certification Package for Internal Controls (CPIC) Report	Attestation and documentation of the adequacy of the internal controls.	Contracting Officer's Representative and/or Designees. CPIC should also be delivered to CMS internalcontrols@cms.hhs.gov.	Initial is due within 15 business days after June 30. Update is due 5 business days after September 30.	Annually	OFM/ Accounting Management Group (AMG)/ Division of Financial Reporting, Policy & Oversight (DFRPO)
	C.5.4.10.3	Correcting Internal Control Deficiencies – CAP process	Corrective Action Plan (CAP)	Describes a plan of action to correct weaknesses, findings, gaps, or other deficiencies.	Contracting Officer's Representative and/or Designees. CAP reports should also be delivered to CMS CAPS@cms.hhs.gov.	Initial CAP reports are due within 45 calendar days of receiving a final audit report or after discovery of a material weakness; thereafter 30 calendar days form quarter end	Within 45 calendar days after discovery of material weakness, and quarterly	OIS and OFM/AMG/DFRPO
	C.5.4.10.4	Statement on Standards for Attestation Engagements 16 (SSAE 16)	Final Statement on Standards for Attestation Engagements 16 (SSAE 16) Report	Describes the Final SSAE 16 Report which includes a matrix at Section I, reporting all SSAE 16 findings. Working papers and supporting documentation must be made available upon request to any party designated by CMS.	Contracting Officer's Representative and/or Designees	Draft Report due by June 15 of each fiscal year. Final Report due by July 1 of each fiscal year.	Annually	OFM/AMG/DFRPO
	C.5.4.10.4	Statement on Standards for Attestation Engagements 16 (SSAE 16)	Final CAP Follow-up Report	Describes the Final CAP Follow-up Report which includes a matrix to report the status of all prior CAPs. Working papers and supporting documentation must be made available upon request to any party designated by CMS.	Contracting Officer's Representative and/or Designees	Draft Report due by June 15 of each fiscal year. Final Report due by July 1 of each fiscal year.	Annually	OFM/AMG/DFRPO
	C.5.4.11	Compliance Program	Compliance Documents	Position Description for the Compliance Officer and other members of the Compliance Department	Contracting Officer's Representative and/or Designees	Initial 30 calendar days after contract award and annually thereafter	Annually	OAGM
	C.5.4.11	Compliance Program	Compliance Documents	Code of Conduct	Contracting Officer's Representative and/or Designees	Initial 30 calendar days after contract award and annually thereafter	Annually	OAGM
	C.5.4.11	Compliance Program	Compliance Documents	Written compliance policies and procedures	Contracting Officer's Representative and/or Designees	Initial 30 calendar days after contract award and annually thereafter	Annually	OAGM
	C.5.4.11	Compliance Program	Compliance Documents	Compliance training materials used or developed in the last year	Contracting Officer's Representative and/or Designees	Initial 30 calendar days after contract award and annually thereafter	Annually	OAGM
	C.5.4.11	Compliance Program	Compliance Documents	Names and positions of the Board of Directors and/or Compliance Committee members charged with oversight of the compliance program	Contracting Officer's Representative and/or Designees	Initial 30 calendar days after contract award and annually thereafter	Annually	OAGM
	C.5.4.11	Compliance Program	Compliance Documents	Charters for the Board and/or Executive Compliance Committees	Contracting Officer's Representative and/or Designees	Initial 30 calendar days after contract award and annually thereafter	Annually	OAGM
	C.5.4.11	Compliance Program	Compliance Documents	Conflict of interest questionnaire(s) that are completed by employees, managers, officers and Board members	Contracting Officer's Representative and/or Designees	Initial 30 calendar days after contract award and annually thereafter	Annually	OAGM
	C.5.4.11	Compliance Program	Compliance Documents	Risk assessment protocol(s) developed by the Compliance Department	Contracting Officer's Representative and/or Designees	Initial 30 calendar days after contract award and annually thereafter	Annually	OAGM
	C.5.4.11	Compliance Program	Compliance Documents	Internal audit plan	Contracting Officer's Representative and/or Designees	Initial 30 calendar days after contract award and annually thereafter	Annually	OAGM
	C.5.4.11	Compliance Program	Compliance Documents	Any reportable events to CMS (See H.18- Reportable Events) on completed and current CMS contracts	Contracting Officer's Representative and/or Designees	Initial 30 calendar days after contract award and annually thereafter	Annually	OAGM
	C.5.7.1	Provider Outreach and Education	Error Rate Reduction Through Education Report	Report detailing the Contractor's efforts to reduce its their error rate through the use of provider outreach and education. At the request of the business component, this information shall be submitted electronically to ProviderServices@cms.hhs.gov. These deliverables must also be delivered concurrently to the Contracting Officer's Representative in accordance with CMS technical direction regarding the contract deliverable process.	Contracting Officer's Representative and/or Designees, and mailbox ProviderServices@cms.hhs.gov.	If requested by CMS, quarterly or monthly within 5 business days after the enc of the quarter or the month, depending on the contractor's CERT score.	As required.	CMM/PCG/DCPC
	C.5.7.1.7	Provider Service Plan	Provider Service Plan (PSP)	Describes the outreach and education activities the contractor will accomplish throughout the year	Contracting Officer's Representative and/or Designees and mailbox ProviderServices@cms.hhs.gov	By the last day of the first month of the contract year.	Annually	CMM/PCG/DCPC
	C.5.7.1.8	Education Activity Report	Education Activity Report (EAR)	Summarizes and recounts the completed Provider Outreach and Education activities in the previous 5 1/2 to 6-month period.	Contracting Officer's Representative and/or Designees and mailbox ProviderServices@cms.hhs.gov	First report due on the 30th day after the first 6 months of the contract year; second report due 30 days after the last day of the contract year.	Semiannually	CMM/PCG/DCPC
	C.5.7.2	Provider Contact Center	Primary provider inquiry contact	Contact information for primary Provider Contact Center (PCC) contact at contractor.	Contracting Officer's Representative and/or Designees and PCSP Contractor Information Database (PCID)	End of first month of contract year	Annually and as primary provider inquiry contact changes	CMM/PCG/DCPC
	C.5.7.2	Provider Contact Center	Planned PCC closures	Schedule of planned closures for PCC, including Federal holiday closures	Contracting Officer's Representative and/or Designees and PCSP Contractor Information Database (PCID)	End of first month of contract year	Annually	CMM/PCG/DCPC
	C.5.7.2	Provider Contact Center	Ad Hoc PCC Closure Requests	Requests to close PCC at times different from planned closures	Contracting Officer's Representative and/or Designees and mailbox ServiceReports@cms.hhs.gov	As needed, at least 3 weeks before requested closure date	As requested	CMM/PCG/DCPC
	C.5.7.2	Provider Contact Center	Customer service operations surveys	Surveys of contractor’s customer service operations, such as PCC technology, staffing, training needs.	Contracting Officer's Representative and/or Designees and mailbox ProviderServices@cms.hhs.gov	Upon request	As requested	CMM/PCG/DCPC
	C.5.7.2.1	Telephone Inquiries	Remote monitoring instructions	Instructions for CMS to remotely monitor live provider inquiry calls	Contracting Officer's Representative and/or Designees and PCSP Contractor Information Database (PCID)	3 business days before instructions are active	Annually, and as instructions change	CMM/PCG/DCPC
	C.5.7.2.1	Telephone Inquiries	Disaster recovery plans	Plan describing how the Medicare provider telecommunications operations will be maintained or continued in event of natural or manmade disaster	Contracting Officer's Representative and/or Designees and mailbox ServiceReports@cms.hhs.gov	End of third month of contract year	Annually	CMM/PCG/DCPC
	C.5.7.2.1	Telephone Inquiries	Interruption of Call Center Service Report	Report about interruption of telecommunications service, both Verizon related and in-house	Contracting Officer's Representative and/or Designees and mailbox ServiceReports@cms.hhs.gov	End of month	Monthly	CMM/PCG/DCPC
	C.5.7.2.4	Inquiry Tracking System	Contractor Inquiry Tracking Report	Report of all provider inquiries using standard inquiry categories.	Contracting Officer's Representative and/or Designees and PCSP Contractor Information Database (PCID)	Within 15 calendar days after the end of each month	Monthly	CMM/PCG/
	C.5.7.3.2	Web Technology	Website Attestation statement -- website guidelines	Statement by contractor attesting that CMS contractor website guidelines have been followed in accordance with IOM Pub. 100-9, Chapter 6, Section 50.	Contracting Officer's Representative and/or Designees and mailbox ProviderServices@cms.hhs.gov	Within 30 calendar days after cutover; thereafter, by the end of the sixth month of the contract year.	Annually	CMM/PCG/DCPC
	C.5.7.3.2	Web Technology	Website Attestation statement-- Current Procedural Terminology (CPT) usage	Statement by contractor attesting contractor compliance with IOM Pub 100-4, Chapter 23, Section 20.7	Contracting Officer's Representative and/or Designees and mailbox ProviderServices@cms.hhs.gov	Within 30 calendar days after cutover; thereafter, by the end of the sixth month of the contract year.End of sixth month of contractor year	Annually	CMM/PCG/DCPC
	C.5.7.4	Provider Customer Service Program Staff Training	PCC training schedules	A training schedule, including dates, times, topics, subtopics, and contact information about PCC closure for training	Contracting Officer's Representative and/or Designees and PCSP Contractor Information Database (PCID)	Closure dates due 15th of month prior to training closure. Training topics, subtopics, categories and subcategories due 15th of month after training closure.	Monthly	CMM/PCG/DCPC
	C.5.7.4	Provider Customer Service Program Staff Training	Requests for PCC closure greater than 4 hours	A request to close PCC for more than 4 hours in a day for training	Contracting Officer's Representative and/or Designees and mailbox ProviderServices@cms.hhs.gov	1 month prior to requested training date	As requested	CMM/PCG/DCPC
	C.5.7.4	Provider Customer Service Program Staff Training	Provider complaints about PCC closure	Report about provider complaints and their resolution related to PCC closures	Contracting Officer's Representative and/or Designees and mailbox ProviderServices@cms.hhs.gov	Upon contractor receipt of complaintsrequest	As requested	CMM/PCG/DCPC
	C.5.8.2.5	Payment of Claims Outside Common Working File	Workload Report for Payment of Claims Outside Common Working File	Workload Report for Payment of Claims Outside Common Working File	Contracting Officer's Representative and/or Designees	Within 20 calendar days of the month end.	Monthly	CMM/MCMG
	C.5.8.4.4	The Do Not Forward Initiative	Do-Not-Forward (DNF) Initiative Report	Describes the Medicare checks and payments for professional claims returned or held to the contractor thru the DNF initiative.	Contracting Officer's Representative and/or Designees	Within 15 calendar days of quarter end	Quarterly	CMM/PBG
	C.5.11.2	Banking Relations	Copy of Tripartite Agreement	Describes the agreement between CMS, the contractor and its bank.	Contracting Officer's Representative and/or Designees	Upon initiation	Once	OFM / Financial Services Group (FSG)/ Division of Financial Strategies and Evaluation (DFSE)
	C.5.11.2.3	Account Reconciliation (Contractor Monthly Bank Reconciliation Worksheet - CMBRW)	CMBRW	Bank reconciliation	Contracting Officer's Representative, CMS Business Owner, and mailbox higlasbankrecon@cms.hhs.gov	On or before the 15th of the month	Monthly	OFM/AMG/DFRPO
	C.5.11.2.3.1	Cash Collection Worksheet	Cash Collection Worksheet	Reconciles the cash balance	Contracting Officer's Representative, CMS Business Owner, and mailbox	On the 15th of the month	Monthly	OFM/AMG/DFRPO
	C.5.11.2.3.2	Estimated Allowance for Uncollectible Accounts	Allowance Matrix	Calculates the allowance percentage of receivable	Contracting Officer's Representative, CMS Business Owner, and mailbox	HIGLAS Contractors: 4 5 days after quarter end Non-HIGLAS: April 21 and as stated by Year End JSM	HIGLAS Contractors: Monthly Non-HIGLAS Contractors: March and September	OFM/AMG/DFRPO
	C.5.11.2.4	Letter-of-Credit Limitation	Letter of Credit Limitation Change Request	Written requests for changes to the monthly letter-of-credit limitation.	Contracting Officer's Representative and/or Designees	Consistent with frequency	As required	OFM / Financial Services Group (FSG)/ Division of Financial Strategies and Evaluation (DFSE)
	C.5.11.3.2.5	Audit Plan	Audit Plan	The audit plan identifies each cost report selected for an audit (in-house or field.) The audit plan lists each provider’s name, provider #, cost reporting period, issues selected for audit, and an explanation as to why the provider was chosen for an audit.	Contracting Officer's Representative and/or Designees	Initial within 30 calendar days after the cutover date; thereafter within 30 calendar days prior to the annual period end	Annually	OFM/FSG
	C.5.11.4.2	Applications for Extended Repayment Schedule	Extended Repayment Plan (ERS) Extension Requests	Usually in Excel format, this report identifies providers who have requested an ERS and identifies those requests that have been approved and denied.	Contracting Officer's Representative and/or Designees	Within 15 calendar days of quarter end	Quarterly	OFM / FSG / Division of Medicare Overpayments (DMO)
	C.5.11.7.1	Unsolicited/Voluntary Refunds	Unsolicited/Voluntary Refund Check Summary Report	Describes a summary of the unsolicited/voluntary refund checks.	Contracting Officer's Representative and/or Designees	Upon Request	Upon Request	OFM / Program Integrity Group (PIG)
	C.5.11.8.1	Administrative Freeze Payments	Provider Overpayment Referral Checklist	Describes summary of overpayment information for a Provider in bankruptcy.	Contracting Officer's Representative and/or Designees	Consistent with frequency	As required	OFM / AMG / DFO
	C.5.11.8.2	Closed Bankruptcy Case	Quarterly Bankruptcy Tracking Report	Describes the status of the discharge of bankruptcy proceedings. Builds on the information contained in the summary of detailed underpayment and overpayment information for a Provider in bankruptcy.	Contracting Officer's Representative and/or Designees	Quarterly	As required	OFM / AMG / DFO
	C.5.11.9	Financial Reporting and Accounting	Statement of Financial Position and Status Accounts Receivable	Forms CMS 750/751 Describes the accounts receivable activity for Fiscal year-to-date	Contracting Officer's Representative and/or Designees	Within 21 days of the quarter end	Quarterly	OFM / AMG / DFRP
	C.5.11.9.1	Accounts Receivable Trend Analyses	Accounts Receivable Trend Analysis Reports	Describes the results of accounts receivable trend analyses.	Contracting Officer's Representative and/or Designees	On or before February 8, May 8, August 8, and November 1. (The third and fourth quarter due dates may change due to the accelerated time periods. Medicare contractors will be notified of these changes by a Joint Signature Memorandum (JSM)Technical Direction Letter (TDL).	Quarterly	OFM / AMG / DFRP
	C.5.11.10	Medicare Credit Balance Report Activities	Credit Balance Summary Report	Describes a summary of the credit balances.	Contracting Officer's Representative and/or Designees, and mailbox CMS_SCBR@cms.hhs.gov	Within 90 calendar days after the close of the quarterly period	Quarterly	OFM / AMG / DFO
	C.5.12.1	Development of Medical Review Strategy	Medical Review Strategy Report (MRS)	Describes the operational plan for how the contractor will evaluate data and address program vulnerabilities throughout the year.
Effective 4/1/2008 the MR system located at CMS's Local Coverage Systems Portal Website is the primary collection tool for the MRS (refer to CR 5760).	Contracting Officer's Representative and/or Designees	The Initial strategy is due after contract award no less than 30 calendar days prior to first claims cutover date even if there are multiple cutover dates. Thereafter the strategy is due no less than 45 calendar days prior to start of each option year. (See also PIM 100-08 Chapter 1.2.3 where there are major changes).	Annually	OFM/ Program Integrity Group (PIG)/ Division of Medical Review and Education (DMRE)
	C.5.12.1	Development of Medical Review Strategy	Strategy Analysis Report (SAR)	A once annual update to the MR Strategy Report that describes progress towards goals as defined in the strategy and any changes that need to be made to the strategy.
Effective 4/1/2008 the MR system located at CMS's Local Coverage System Portal Website is the primary collection tool for the SAR (refer to CR 5760).	CMS Local Coverage Systems Portal Website via the MR.	The SAR is due within 14 calendar days after final cutover date and 7.5 months after option year starts.
Where the initial SAR and Option year strategy would be due within 30 calendar days of each other the contractor shall inform the Contracting Officer's Representative of this occurrence, to address on a case by case basis	Annually	OFM/PIG/DMRE
	C.5.13.2	Support of Comprehensive Error Rate Testing	Error Rate Reduction Plan Report	Describes the error rate reduction plan and is updated once per year.
The error rate reduction plan (ERRP) database is the primary collection tool for the error rate reduction plans.	Contracting Officer's Representative and/or Designees	Initial within 60 calendar days of contract award; a new plan is required each year following the release of the November error rate report; an update to the ERRP Report is required 30 days following the release of the May report	Semi-annually (twice per year)	OFM / PCG/Division of Error Rate Measurement (DERM)
	C.5.14.2	Electronic Correspondence Referral System Status Inquiries	Number of ECRS request submitted to the COBC	Provides the number of MSP prepay ECRS Requests by category (Inquiries and CWF Assistance Requests) sent to the COBC each month.	Contracting Officer's Representative and/or Designees	Last business day of the month	Monthly	OFM/FSG/ Division of Medicare Benefit Coordination (DMBC)
	C.5.14.3	Identification and Adjudication of Medicare Secondary Payer Claims and Application of Benefits and Processing Formula	Number of MSP claims processed	Provides the number of MSP claims processed during the given month including the number of claims processed, rejected, adjusted and denied.	Contracting Officer's Representative and/or Designees	Last business day of the month	Monthly	OFM/FSG/ Division of Medicare Benefit Coordination (DMBC)
	C.5.14.3.3	Medicare Secondary Payer Claims Inquiries	The number of inquiries and documentation received and responded to.	The number of inquiries and documentation the Contractor responded to from insurers and other interested parties (e.g., attorneys and/or beneficiaries, etc.) on MSP billing requirements to assist with resolving claims inquiries accurately, timely, and responsively.	Contracting Officer's Representative and/or Designees	Last business day of the month	Monthly	OFM/FSG/ Division of Medicare Benefit Coordination (DMBC)
	C.5.14.4	Transfer of Documentation and Phone Calls to the Coordination of Benefits Contractor	Number of phone calls and documentation transferred to the COBC	Number of phone calls and documentation transferred to the COBC	Contracting Officer's Representative and/or Designees	Last business day of the month	Monthly	OFM/FSG/ Division of Medicare Benefit Coordination (DMBC)
	C.5.14.5	Medicare Secondary Payer Hospital Audits	Hospital Audit Report	Describes the results of hospital audits and reviews for Medicare Secondary Payer hospitals.	Contracting Officer's Representative and/or Designees	Within 30 calendar days from final audit completion	Annually	OFM/FSG/ Division of Medicare Benefit Coordination (DMBC)
	C.5.14.6.1	Duplicate Primary Payments	Unsolicited/Voluntary MSP Posted Checks Status Report (identifying associated vs. not associated with a known debt) vs. NO ECRS needed but NO A/R has been established yet)	Provides a listing of all Posted Provider, Physician, or Other Supplier MSP Unsolicited/Voluntary Refund Checks (identifying each entry as (1) associated to a known debt vs. (2) NOT associated to a known debt and ECRS entry required) vs. NO ECRS needed but NO A/R has been established yet) received by the MAC Contractor.	Contracting Officer's Representative and/or Designees	Last business day of the month	Monthly	OFM/FSG/Division of Medicare Debt Management (DMDM)
	C.5.14.6.2	Inquiries Specific to General MSP, MSP DPP, MSP DCIA, and/or Debt Collection Efforts for Providers, Physicians, and other Suppliers	MSP Pending Correspondence Report	Provides a listing of all pending MSP correspondence.	Contracting Officer's Representative and/or Designees	Last business day of the month	Monthly	OFM/FSG/DMDM
	C.5.14.6.5	Misrouted Medicare Secondary Payer Recovery Checks	Medicare Secondary Payer (MSP) Misrouted Recovery Checks (and Associated Correspondence)	Provides a listing of all misrouted checks and correspondence that was transferred to the Medicare Secondary Payer Recovery Contractor	Contracting Officer's Representative and/or Designees	Last business day of the month	Monthly	OFM/FSG/DMDM
	C.5.14.6.6	Misrouted Medicare Secondary Payer Post Payment Recovery Correspondence	Medicare Secondary Payer (MSP) Misrouted Recovery Correspondence	Provides a listing of all misrouted correspondence that was transferred to the Medicare Secondary Payer Recovery Contractor	Contracting Officer's Representative and/or Designees	Last business day of the month	Monthly	OFM/FSG/DMDM
	C.5.15.2	Review of Comprehensive Outpatient Rehabilitation Facility Billing Records	Aberrant Billing Practices Notification	Immediate written notification whenever aberrant billing practices are discovered	Contracting Officer's Representative and/or Designees	Consistent with Frequency	As required	CMSO/SCG/DCCP
	C.5.15.3	Review of Inpatient Rehabilitation Facilities and Critical Access Hospitals’ Rehabilitation Distinct Part Units (DPU)	Written Report of the Applicable Calculated Compliance Percentage	Written report of the applicable calculated compliance percentage attained by the IRF or a provider attempting to be classified as an IRF. The contractor must determine each IRFs applicable compliance percentage prior to the start of each IRF's next cost reporting period and include the most current information for all IRFs within the contractor's jurisdiction in the written report.	Contracting Officer's Representative, CMS Business Owner, and the RO responsible for the geographic area where the IRF is located, and, if appropriate, to the appropriate ROs involved with the administration of the MAC contract.	On or before the 15th of each month.	Monthly	CMM/ Chronic Care Policy Group (CCPG)/ Division of Institutional Post Acute Care (DIPC)
	C.5.18.1	Education Materials	Rural Health Clinic (RHC) Education Materials	The Contractor is encouraged to use CMS-created national education materials when training RHCs.	Contracting Officer's Representative and/or Designees	Six weeks prior to the intended use of the education materials	As required	CMM / MCMG/ DMPM
	C.5.19.1	Education Materials	Federally Qualified Health Center Education Materials	The Contractor is encouraged to use CMS-created national education materials when training FQHCs.	Contracting Officer's Representative and/or Designees	Six weeks prior to the intended use of the education materials	As required	CMM / MCMG/ DMPM
	C.5.23.1	Post-Award Meeting	Post-Award Meeting Minutes	Describes the results of the Post-Award meeting conducted.	Contracting Officer's Representative and/or Designees	Within 3 business days of the Post-Award meeting	Once	CMM/MCMG
	C.5.23.2	Project Management Plan	Project Management Plan	Describes the plan for overall management of the program.	Contracting Officer's Representative and/or Designees	Initial within 30 business days after contract award, updates within 15 calendar days after quarter end	Quarterly	CMM/MCMG
	C.5.23.4	Monthly Status Report and Meeting	Monthly Status Report (MSR)	Describes the monthly status of the program through a report. This deliverable is comprised of both the narrative MSR Word document and the Monthly A/B MAC Supplied Data Excel document. Please include in the file name the jurisdiction number, the MAC Name, and the month for which you are reporting.	Contracting Officer's Representative and/or Designees	Within 20 calendar days after month end.	Monthly	CMM/MCMG
	C.5.23.6	Voucher/Financial Management System	Monthly Cost Report	Submit a monthly cost report to the CMS ART System in accordance with the work breakdown structure (WBS) schedule instructions. In addition, submit a statement to the Contracting Officer's Representative via the deliverable mailbox indicating that this action has been completed.	Contracting Officer's Representative and/or Designees	Monthly cost reports are due into CMS ART no later than 30 calendar days after the end of the reporting month	Monthly	CMM/MCMG
	C.5.23.6	Voucher/Financial Management System	Final Estimated Cost Proposal	The contractor shall submit the final estimated cost proposal into CMS ART once contract estimated costs have been negotiated, and a subsequent modification has been executed by the CO. In the case of a change order, change order funding shall be entered into CMS ART once the change order has been executed. Once the change order has been definitized, the contractor shall submit the final estimated cost proposal into CMS ART. In addition, the contractor shall submit a statement to the Contracting Officer's Representative via the deliverable mailbox indicating that this action has been completed.	Contracting Officer's Representative and/or Designees	The final estimated cost proposal shall be entered into CMS ART no later than 5 business days after the contract modification has been executed. In the case of a change order, change order funding shall be entered into CMS ART no later than 5 business days after the execution of the change order. The final estimated cost proposal shall also be entered into CMS ART no later than 5 business days after the change order has been definitized.	As required	CMM/MCMG
	C.6.1	Joint Operating Agreements	Initial Joint Operating Agreement (JOA)	The initial JOA defines roles and responsibilities of a mutually agreed upon methods to work with and support CMS’ mission—with each of the following parties: Administrative QICs (AdQIC), Appeals Support Contractors (ASC), Beneficiary Contact Centers (BCC), Enterprise Data Centers (EDCs), Medicare Secondary Payer Recovery Contractors (MSPRC), Program Safeguard Contractors (PSCs)/Zone Program Integrity Contractors (ZPICs) to inlclude Audit PSC/ZPIC, Qualified Independent Contractors (QIC), Quality Improvement Organizations (QIO), Recovery Auditors, and the Single Testing Contractor (STC).	Contracting Officer's Representative and/or Designees	30 calendar days prior to cutover	Once	Office of Acquisitions and Grants Management (OAGM)
	C.6.1	Joint Operating Agreements	Updated Joint Operating Agreement	The updated JOA defines any updates to the roles and responsibilities of a mutually agreed upon methods to work with and support CMS’ mission—with each of the following parties: AdQICs, ASCs, BCCs, MSPRCs, PSCs)/ZPICs, QICs, QIOs, and the RACs.	Contracting Officer's Representative and/or Designees	Consistent with frequency updates: By January 15th, April 15th, July 15th, and October 15th.	First Year Quarterly; Subsequent Years Semiannually	OAGM
	C.6.1.1.1	Referrals to Quality Improvement Organization	Quality Improvement Organization Referrals	Describes the referrals to the QIO for medical necessity determinations.	Contracting Officer's Representative and/or Designees	Consistent with frequency	Every 6 months due January 1 & July 1	Office of Clinical Standards and Quality (OCSQ)
	C.6.2.1	State Agencies Responsible for Licensing Institutional Providers (e.g., Survey and Certification, Licensing Authorities)	Health Insurance Benefits Agreement, Provider-Based Determination, or Other Institutional Provider Information	The Health Insurance Benefits Agreement, Provider-Based Determination, or Other Institutional Provider Information is provided in the format requested to state agencies with a copy to CMS.	Contracting Officer's Representative and/or Designees	Consistent with frequency	As required	CMSO/SCG/DACS
	RFP/SOW section H.3	Conflict of Interest	Annual Conflict of Interest Audit	Conflict of Interest Certificate	Contracting Officer (CO)	Annually, on the anniversary date that the contract became fully operational	Annually	OAGM
	RFP L.16.a	Volume IIA Business Proposal Cost Template Instructions	Final Proposal Revision Business Proposal Reporting	Upon award, Attachments J-11 (CLIN 0001 Implementation) and J-12 (CLIN 0002 Base) are required to be submitted in their entirety into the CMS ART System by the awardee.	Contracting Officer's Representative and/or Designees	Business proposal is due into the CMS ART System no later than five (5) days after contract award.	One time	CMM/MCMG

&"Arial Narrow,Regular"RFP-CMS-2012-0003 &"Arial Narrow,Regular"Attachment J-02 Updated 02/03/2011

&"Arial Narrow,Regular"RFP-CMS-2012-0003 &"Arial Narrow,Regular"Attachment J-02 Updated 4/15/2011

&"Arial Narrow,Regular"RFP-CMS-2011-00xx &"Arial Narrow,Regular"Attachment J-02 Updated 4/15/2011

&"Arial Narrow,Regular"RFP-CMS-2010-0052 &"Arial Narrow,Regular"Attachment J-02 Updated 5/19/10

&"Arial Narrow,Regular"RFP-CMS-2010-0050 &"Arial Narrow,Regular"Attachment J-02 Updated 5/19/10

&"Arial Narrow,Regular"RFP-CMS-2011-0026

&"Arial Narrow,Regular"RFP-CMS-2012-0003 &"Arial Narrow,Regular"Attachment J-02 Updated 4/15/2011

&"Arial Narrow,Regular"RFP-CMS-2012-0003 &"Arial Narrow,Regular"Attachment J-02 Updated 02/03/2011

&"Arial Narrow,Regular"Page &P of &N

&"Arial Narrow,Regular"Page &P of &N mailto:ServiceReports@cms.hhs.govmailto:ServiceReports@cms.hhs.govmailto:ServiceReports@cms.hhs.govmailto:ProviderServices@cms.hhs.govmailto:ServiceReports@cms.hhs.govmailto:ServiceReports@cms.hhs.govmailto:ServiceReports@cms.hhs.govmailto:ProviderServices@cms.hhs.govmailto:ProviderServices@cms.hhs.govmailto:ProviderServices@cms.hhs.govmailto:ProviderServices@cms.hhs.govmailto:ProviderServices@cms.hhs.govmailto:ProviderServices@cms.hhs.govmailto:CMS_SCBR@cms.hhs.govmailto:ProviderServices@cms.hhs.govmailto:ProviderServices@cms.hhs.gov

File details come from the government source that posted it. Updated Nov 14, 2017.