JL AB MAC Offeror's RFP Questions and Answers.FINAL.xlsx
XLSX spreadsheet 30 KB Posted
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- Award: A/B MAC Jurisdiction L - RFP-CMS-2012-0003 Federal contract opportunity
- Solicitation number
- RFP-CMS-2012-0003
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JL AB MAC Offeror's RFP Questions and Answers.FINAL
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| RFP Amd 1 02-10-2012 Final.docx | DOCX document | |
| J-02 Deliverable Schedule JL_02032012.xlsx | XLSX spreadsheet | |
| JL SF30 Amd1signed.pdf | ||
| J-03 Small Business Subcontracting Plan.doc | DOC document | |
| RFP Amd 1 02-10-2012 Redlined.docx | DOCX document | |
| AB MAC CLIN 0003 Cost Proposal Template Option Year1.xlsx | XLSX spreadsheet | |
| J-08 Past Performance Questionnaire.docx | DOCX document | |
| J-01 Statement of Work_JL_FINAL_FEB-03-2012.docx | DOCX document | |
| AB MAC CLIN 0002 Cost Proposal Template Base Year.xlsx | XLSX spreadsheet | |
| JL RFP Attachments 01_05_12.zip | ZIP file |
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Section J
| ID | Section | Question | Answer/Action |
| J1 | Section C.5.5 - Provider Enrollment | This section states that “Using the government-furnished PECOS and corresponding instructions the Contractor will input provider enrollment information into PECOS and verify the enrollment data unless otherwise prescribed in IOM Pub.100-08.” Regarding the verification of enrollment data, please confirm that the CMS Provider Screening Contractor will be performing the verification processes associated with PECOS information (i.e. Automated Provider Screening) and the National Site Visit Contractor will be completing required site visits. | CMS confirms that the Automated Provider Screening (APS) contractor and the National Site Visit Contractor (NSVC) are to be implemented January 2012. During the spring of 2012, CMS has recently instructed MACs to continue current processes in order to ensure the verification of enrollment data before a complete transition is made to the APS contractor and the NSVC. |
| J2 | Section C.5.10.1.3.1 - Confirmation of Receipt of Redetermination Requests | Confirmation notices are to be available to the provider/supplier within 10 calendar days of the receipt of the redetermination request by the Contractor. Please confirm that beneficiary redetermination requests are excluded from this confirmation process. | CMS confirms MACs are not required to send confirmation notices, but must provide some mechanism, like an IVR, so that providers and suppliers can verify receipt of requests for redetermination. Beneficiary redetermination requests are excluded. |
| J3 | Section C.5.11.3 - Cost Reporting and Reimbursement Payment Policy | The last paragraph of the Background indicates that “all the requirements in C.5.11.3 apply to all freestanding Hospices and Home Health Agencies.” Currently, the J15 MAC is responsible for servicing the Home Health Agencies and Hospices in the JL region. As such, please confirm that the SOW requirement under Section C.5.11.3 does not apply to the JL MAC. | CMS confirms the Jurisdiction L ("JL") Medicare Administrative Contractor (MAC) is not responsible for servicing Home Health Agencies or Hospices located within the JL region. Section C.5.11.3 provides background information in the event an A/B MAC's defined Jurisdiction includes workload from one of the four Home Health & Hospice regions. |
| J4 | C.5.11.4 - Non-Medicare Secondary Payer Overpayment | The JL RFP requirement states that for HIGLAS workloads, second demands are issued on day 36. As a result of TDL 11409 (dated July 25, 2011), contractors were to discontinue sending the second demand letter. HIGLAS was programmed to cease generating second demand letters effective October 29, 2011. Please confirm that this SOW requirement will be updated to reflect this TDL change. | CMS confirms the Jurisdiction L (“JL”) Statement of Work (“SOW”) requirement has been amended to reflect Technical Direction Letter TDL-12089-11-30-11. See amended and red-lined JL SOW. |
| J5 | C.5.11.4.3 - Limitation on Recoupment (935) for Providers, Physicians and other Suppliers overpayments | The JL RFP requirement states that the Recovery Auditor will send out the first demand for a recovery overpayment that is subject to 935. As of January 3, 2012, in accordance with Change Request 7436 (Recovery Audit Program MAC –issued Demand Letters) dated July 29, 2011, the MACs are now responsible for sending Recovery Auditor demands on their behalf. Please confirm that this SOW requirement will be updated to reflect this CR change. | CMS confirms the Jurisdiction L (“JL”) Statement of Work (“SOW”) requirement has been amended to reflect Change Request 7436. See amended and red-lined JL SOW. |
| J6 | Section C.6.1 - Successful Collaboration with Entities Requiring Joint Operating Agreements | Sections C.6.1 and C.6.1.9 address Joint Operating Agreement requirements for the Enterprise Data Center (EDC) and the MSP Recovery Contractor (MSPRC). However, historically, these business partners have not had a similar JOA requirement in their SOWs. Please confirm that JOAs and quarterly reviews in the first year and semi-annual reviews in subsequent years will be required with these entities under the JL MAC. | CMS confirms that a Joint Operating Agreement ("JOA") is required as well as the quarterly review (first year) and semi-annual reviews (in subsequent years) between the Medicare Secondary Payer Recovery Contractor ("MSPRC") and the Jurisdiction L ("JL") Medicare Administrative Contractor ("MAC"). CMS also confirms that a JOA between the Enterprise Data Center ("EDC") and the JL MAC is required. |
| J7 | Section C.5.11.2.3.2 - Estimated Allowance for Uncollectible Accounts |
Question/Comment
| The Allowance Matrix deliverable has a due date of “4 days after quarter end” for HIGLAS Contractors. Currently, HIGLAS workloads, CMS has established the due date for this deliverable to coincide with the due date of the HIGLAS CFO reports, i.e., 5 days after quarter end. Please confirm that the due date for this deliverable under JL will coincide with the due date of the HIGLAS CFO reports, i.e., 5 days after quarter end. | CMS confirms that certifications are due on the 5th day. HIGLAS Contractors are expected to e-mail certification packages and Estimated Allowance for Uncollectible Accounts Matrix on the 5th day. See amended deliverable schedule. | |||
| J8 | Section C.5.11.9 - Financial Reporting and Accounting | The deliverable for Financial Reporting and Accounting is listed as Statement of Financial Position and Status Accounts Receivable (Forms CMS 750/751). These reports relate to non-HIGLAS workloads. Since all JL workloads are in HIGLAS, please confirm that this deliverable will be updated to reflect the required HIGLAS report submissions. | CMS amended the deliverable schedule to confirm that the 750/751 is not a required deliverable for JL; the JL MAC will provide the appropriate HIGLAS reports. | |
| J9 | C.5.11.9.1 - Accounts Receivable Trend Analyses | The Accounts Receivable Trend Analysis Reports deliverable is listed with due dates of February 8, May 8, August 8, and November 1. These due dates relate to non-HIGLAS workloads. Since all JL workloads are in HIGLAS, please confirm that this deliverable will be updated with the due dates for HIGLAS workloads. | CMS confirms that the dates are the same for HIGLAS and non-HIGLAS workloads. However, the third/fourth quarter due dates may change due to the accelerated time periods. Medicare contractors will be notified of these changes by a Technical Direction Letter (TDL). |
| J10 | C.5.14.6.1 - Unsolicited/Voluntary MSP Posted Checks Status Report | Deliverable C.5.14.6.1 – 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) is requiring the contractor to provide a listing of posted checks as stated in the Deliverable Name and Deliverable Description. The wording “but No A/R has been established yet” implies that this report should also include pending voluntary checks that are not yet worked. Please confirm that this deliverable is to include posted checks only which will allow contractors to utilize a standard HIGLAS voluntary refund report to fulfill this deliverable. | CMS confirms that Deliverable C.5.14.6.1 - Unsolicited/ Voluntary MSP Posted Checks Status Report is for posted checks only. |
| J11 | C.5.14.6.2 - MSP Pending Correspondence Report | The SOW Requirement Name noted on the Deliverable Schedule (Inquiries Specific to General MSP, MSP DPP, MSP DCIA, and/or Debt Collection Efforts for Providers, Physicians, and other Suppliers) is more expansive than the actual RFP SOW Section name (Inquiries Specific to Debt Collection Efforts for Providers, Physicians and other Suppliers). The Deliverable Schedule refers to various types of MSP inquiries, but the RFP SOW Section name refers to MSP inquiries related to debt collection which is a more specific type of inquiry. Please confirm that this deliverable relates to debt collection inquiries only. | CMS confirms the SOW Requirement Name noted on the Deliverable Schedule (Inquiries Specific to General MSP, MSP DPP, MSP DCIA, and/or Debt Collection Efforts for Providers, Physicians, and other Suppliers) is more expansive than the actual RFP SOW Section name (Inquiries Specific to Debt Collection Efforts for Providers, Physicians and other Suppliers). This deliverable schedule requirement (Section C.5.14.6.2 of the Deliverable Schedule or Attachment J-02) is also known as the “MSP Pending Correspondence Report.” CMS requires MACs to report all pending MSP correspondence involving General MSP, MSP DPP, MSP DCIA, and/or Debt Collection Efforts for Providers, Physicians, and other Suppliers. Additionally, the MSP Correspondence Report shall list the applicable pending correspondence with the following level of details: (1) the subject matter of the MSP correspondence; (2) the date received; and (3) the date completed. |
| J12 | Section C.6.1 - Updated Joint Operating Agreement | The list of parties with whom the JL MAC is required to update JOAs in Attachment J-02 is not consistent with the list of required JOAs in Section C.6.1 of Attachment J-01, Successful Collaboration with Entities Requiring Joint Operating Agreements. Attachment J-02 lists all of the parties included in Attachment J-01, with the exception of the Enterprise Data Center (EDC) and the Single Testing Contractor (STC). Please clarify if an updated JOA deliverable is required for the JOAs between the JL MAC and the EDC and the STC. | CMS clarifies the Jurisdiction L ("JL") Medicare Administrative Contractor ("MAC") shall establish an initial Joint Operating Agreement ("JOA") with its Enterprise Data Center ("EDC") and the Single Testing Contractor ("STC"). Following the execution of the initial JOA, CMS does not expect the MAC to resubmit an updated/revised/refreshed JOA(s) as a periodic deliverable. However, CMS would expect the JL MAC to submit a revised JOA in the event that circumstances warrant a significant revision to the document, such as the award of the Virtual Data Center contract to a new data center services vendor for the JL MAC. |
| J13 | CMS Cover Letter | The CMS cover letter included in Attachment J-08 contains green highlighting for the CMS contact person for submission of the PPQ as well as for the CMS Contracting Officer. Please note that Attachment J-08 shows James Wilkerson as the contact person and Christina Honey as the Contracting Officer. The RFP for JL states the Contracting Officer for the JL procurement as Edward Farmer and the Contract Specialist as Jacob Reinert. Please confirm to whom the completed PPQs for this solicitation are to be sent. | CMS clarifies that the PPQ's should be sent to the JL Contracting Officer Edward B. Farmer, Jr."Chip" and the Contract Specialist, Jacob Reinert. |
| J14 | CLIN Template Tabs | It appears that several SOW sections are missing from the CLIN templates provided by CMS in the JL RFP. SOW Sections C.5.10.5 (Administrative Law Judge Hearings) and C.5.11.7 (Refunds) are missing from the “C.5.10” and “C.5.11” tabs respectively within SLIN AA (Part A PM) and SLIN AC (Part B PM). Please confirm that CMS will be issuing revised CLIN templates to include these missing sections. | CMS confirms the following: |
• C.5.4.9 Business Continuity Planning and Disaster Recovery - The WBS was eliminated between Round 1 and Round 2 procurements. Costs should be allocated across the other C.5.4 WBS codes as an ODC.
• C.5.10.5 Administrative Law Judge Hearings - The CLIN templates have been modified to allow offerors to propose ALJ hearing-related labor and costs (other than CMD activities) under C.5.10.5 in the Program Management SLINs (AA and AC) for the operational periods. Costs related to Physician Participation in ALJ Hearings has been moved within the SOW to C.5.12.1.6, and the CLIN templates have been modified to allow offerors to propose CMD labor and costs under the MIP SLINs (AB and AD) for this activity.
• C.5.11.7 Refunds - The WBS was eliminated between Round 1 and Round 2 procurements. Costs should be allocated across the other C.5.11 WBS codes as an ODC.
• C.5.11.10 Medicare Credit Balance Report Activities – The WBS was eliminated between Round 1 and Round 2 procurements. Costs should be allocated across the other C.5.11 WBS codes as an ODC.
The applicable Cost Templates have been updated.
J15 J.1 SOW, Page 65, 100, 123, 127 The following WBS items appear to be omitted from the Cost Templates provided by CMS. However, they are called out in the Statement of Work.
C.5.4.9 Business Continuity Planning and Disaster Recovery C.5.10.5 Administrative Law Judge Hearings C.5.11.7 Refunds C.5.11.10 Medicare Credit Balance Report Activities
Please advise as to whether the Offeror shall include the applicable cost for each of these SOW items and, if required, where to include them.
CMS confirms the following:
• C.5.4.9 Business Continuity Planning and Disaster Recovery - The WBS was eliminated between Round 1 and Round 2 procurements. Costs should be allocated across the other C.5.4 WBS codes as an ODC.
• C.5.10.5 Administrative Law Judge Hearings - The CLIN templates have been modified to allow offerors to propose ALJ hearing-related labor and costs (other than CMD activities) under C.5.10.5 in the Program Management SLINs (AA and AC) for the operational periods. Costs related to Physician Participation in ALJ Hearings has been moved within the SOW to C.5.12.1.6, and the CLIN templates have been modified to allow offerors to propose CMD labor and costs under the MIP SLINs (AB and AD) for this activity.
• C.5.11.7 Refunds - The WBS was eliminated between Round 1 and Round 2 procurements. Costs should be allocated across the other C.5.11 WBS codes as an ODC.
• C.5.11.10 Medicare Credit Balance Report Activities – The WBS was eliminated between Round 1 and Round 2 procurements. Costs should be allocated across the other C.5.11 WBS codes as an ODC.
The applicable Cost Templates have been updated.
| J16 | RFP Section J, Attachment J-05 Government Furnished Property | In some instances within Attachment J-05, there is a discrepancy between the "Related SOW Major Section Number" and the "Related Major Section Name". For example, in Attachment J-05, the section number C.5.23.6 is related to major section name "CMS ART". Section C.5.23.6 in the SOW is titled "Voucher/Financial Management System". In our response in the Business Proposal for TAB H - Equipment and Property, should we reference the "Related Major Section Name" as identified in Attachment J-05 or the section name identified in the SOW? Please clarify. | CMS clarifies that offerors shall reference the Government Furnished Property name and the "Related SOW Major Section Number" that the Government Furnished Property name applies to. |
| J17 | RFP Section J, Attachment J.28 Staffing Matrix and J.29 Service Center Matrix, Page 70 | There does not appear to be any direction whether the Staffing Matrix or Service Center Matrix attachments should be hard copy or electronic submittals. These have historically been submitted electronically. Please advise. | CMS clarifies that Offerors shall only provide electronic submittals of Attachments J-28 and J-29 with their CD-ROM submission. Offerors are not required to submit hard copies of Attachments J-28 and J-29. |
| J18 | C.5.4.1 - Key Personnel | The CLIN templates provided with the Jurisdiction L solicitation allow for Key Personnel hours and costs to be proposed for Program Management funds (SLINs AA and AC) but not for Medicare Integrity Program funds (SLINs AB and AD). Where does an offeror propose hours and costs for Key Personnel that will be engaged in MIP activities (e.g., the PSC Liaison, the Contractor Medical Director, and the Audit/Reimbursement Director, etc.)? | CMS is revising the CLIN templates. MAC offerors will no longer propose (and MAC contractors will no longer report) costs for Key Personnel under the WBS element C.5.4.1. Rather, MAC offerors will propose their direct Key Personnel hours and costs to the WBS element(s) that relate to the activities in which the Key Personnel will be engaged. Note that, based on the structure of an offeror’s approved accounting system, the costs of some/all Key Personnel may be included in the offeror’s indirect rates. Offerors shall explain where they have included their Key Personnel hours and costs in their Basis of Estimate (Attachment J-07) and Business Proposal Assumptions. |
&D A/B MAC Jurisdiction L
&9RFP-CMS-2012-0003 &9&A &9&P
Section L
| ID | Section | Question | Answer/Action |
| L1 | Proposal Assumptions |
Subsection f. - Mandatory Workloads (Clerical Error Reopening Workloads)
| Please clarify what portion of the Part A and Part B clerical error reopenings require manual intervention. | CMS does not provide the Part A and Part B rate of manual intervention for the clerical error reopenings workload. Rather, in Volume IIB of the Business Proposal, the offeror shall describe its approach and assumptions to handling the clerical error reopenings including its assumed rate of manual intervention required to process this workload category. Additionally, the Offeror shall identify its proposed level of effort and/or costs associated with manually processing clerical error reopenings either in the Basis of Estimate (Attachment J-07) or Tab F of the Business Proposal. If applicable, the Offeror shall submit and describe any proposed clerical error innovations within its Technical Proposal. | |
| L2 | Section L.10 – Proposal Assumptions |
Subsection f. - Mandatory Workloads (Non-Clerical Error Reopening Workloads)
| Please clarify what portion of the Part A and Part B non-clerical error reopenings require manual intervention. | CMS does not provide the Part A and Part B rate of manual intervention for the non-clerical error reopenings workload. Rather, in Volume IIB of the Business Proposal, the offeror shall describe its approach and assumptions to handling the non-clerical error reopenings including its assumed rate of manual intervention required to process this workload category. Additionally, the Offeror shall identify its proposed level of effort and/or costs associated with manually processing non-clerical error reopenings either in the Basis of Estimate (Attachment J-07) and/or Tab F of the Business Proposal. If applicable, the Offeror shall submit and describe any proposed non-clerical error innovations within its Technical Proposal. | |
| L3 | Section L.10 - Proposal Assumptions |
Subsection f. - Mandatory Workloads (Effectuations of Redetermination Decisions) We interpret the Part A and Part B Effectuations of Redeterminations workloads for JL to include the workload for RAC effectuation of redeterminations. Please confirm.
CMS confirms the Jurisdiction L Part A and Part B Effectuations of Redetermination workloads does include workload for RAC effectuation of redeterminations.
L4 Section L.10 - Proposal Assumptions Subsection f. - Mandatory Workloads (RAC Redeterminations Part A of A and Part B of A and Redeterminations on RAC Determinations) We interpret the Part A and Part B RAC Redeterminations workloads for JL to include the workload for the RAC pre-payment initiative. Please confirm. CMS clarifies the Jurisdiction L Part A and Part B RAC Redeterminations workloads do not include the RAC pre-payment initiative.
L5 Section L.10 - Proposal Assumptions Subsection f. - Mandatory Workloads (Effectuations of ALJ Decisions)
| We interpret the Part A and Part B Effectuations of ALJ Decisions workloads for JL to include the workload for RAC effectuation of redeterminations. Please confirm. | CMS confirms that the Jurisdiction L ("JL") Part A and Part B Effectuations of ALJ Decisions workload includes the workload for RAC Effectuation of Redeterminations. Upon review of current workloads, the Part A and B proposed workloads for JL will be updated. The new Part A and Part B Effectuations of ALJ Decisions workload assumptions are found in the updated Section L.10 of the Amended Solicitation. | |
| L6 | Section L.10 - Proposal Assumptions |
Subsection f. - Mandatory Workloads (Effectuations of QIC Decisions) We interpret the Part A and Part B Effectuations of QIC Decisions workloads for JL to include the workload for RAC effectuation of redeterminations. Please confirm. CMS confirms the Jurisdiction L Part A and Part B Effectuations of QIC Decisions workload includes the workload for RAC effectuation of redeterminations. Upon review of current workloads, CMS has updated the Base Year and Option Years 1-4 workload projections for Jurisdiction L's Part A Effectuations of QIC Decisions workload category. The new Part A Effectuations of QIC Decisions workload assumptions are found in the updated Section L.10 of the Amended Solicitation.
L7 Section L.10 - Proposal Assumptions Subsection f. - Mandatory Workloads (QIC Requests Supported) We interpret the Part A and Part B QIC Requests Supported workloads for JL to include the workload for RAC effectuation of redeterminations. Please confirm. CMS confirms the Jurisdiction L Part A and Part B QIC Requests Supported workloads include the workload for RAC effectuation of redeterminations.
L8 Section L.10 - Proposal Assumptions Subsection f. - Mandatory Workloads (Provider Reimbursement and Audit) Does CMS have an expectation as to what percent of the cost report audits should be conducted in-house versus in the field? CMS does not mandate a percentage of cost report audits to be conducted in-house or as field audits. The provider mix and the number of issues scoped for audit after completing the uniform desk review determines whether a cost report audit shall be performed in the field or in-house. Offerors shall document their specific approach to estimating audit-related costs in their Basis of Estimate forms (Attachment J-07) and in accordance with the Business Proposal submission requirements.
L9 Section L.10 - Proposal Assumptions Subsection f. - Mandatory Workloads (Provider Reimbursement and Audit)
| The Wage Index Reviews workload (167) provided in the JL RFP for the Base Year is extremely high. Generally, Wage Index Reviews are completed between the beginning of December through the beginning of February each year. According to the JL RFP, the Base Year starts on January 20, 2013 leaving little to no time to perform Wage Index Reviews by the CMS Wage Index Review deadline of the first week of February. Please confirm the Wage Index Review workload to be used for the Base Year. | CMS confirms that since the Jurisdiction L Part A cutover is scheduled for January 20, 2013, the incumbent contractor shall be responsible for forwarding the CMS notice to alert hospitals of the December 5th deadline for providing documentation to request revisions to the wage index data. Contractors have approximately 10 weeks to complete their reviews and transmit data to CMS’s Division of Acute Care. Notwithstanding, the incumbent contract's expiration date of February 27, 2013, when the Part A cutover occurs for Jurisdiction L, the new contractor shall assume all of the responsibilities, including the review and finalization of wage index data. The workload shall remain as stated in the JL RFP for the Base Year. | |
| L10 | Section L.10 – Proposal Assumptions |
Subsection f. - Mandatory Workloads (PM Provider Inquiries – Part A and Part B Workloads) Given the SOW requirement in SOW C.7.26 (Provider Call Center Single Toll Free Number), please confirm if the published JL workload figures for PM Provider Inquiries for Part A and Part B include those inquiries completed by the Provider Enrollment and EDI helpdesks? If so, please provide the mix of EDI, Provider Enrollment, and General Information inquiries included in the workload figures. CMS clarifies the published JL Part A and Part B PM Provider Inquiries include only General Inquiries.
L11 Section L.10 – Proposal Assumptions Subsection f. - Mandatory Workloads
| The note following the Mandatory Workload schedule at the end of Subsection f. states that CMS has provided revalidation workload estimates for JL’s Base Year and Option Years 1 through 4. This workload is for the newly adopted 5-year Special Revalidation Schedule developed in Autumn 2011. The total revalidation workload for Base Year and Option Years 1-4 in the Provider Enrollment Part A (6,018 applications) and Part B (277,722 applications) sections seems very high considering the supplied PM Customer Service Workload shows 3,284 Part A Providers and 154,290 Providers. Please confirm the revalidation workload. | CMS has amended the Part A Providers and Part B Providers Revalidation workload projections for Base Year and Option Years One through Four. Please see the amended RFP for new workload numbers for Part A and Part B Provider Enrollment Revalidations. | |
| L12 | Section L.12 – Written Technical Proposal Organization and |
Section L.13 - Volume I – Written Technical Proposal Instructions Subsection c. – TAB C: Technical Understanding Section L.12 (first paragraph) states that “Volume I must NOT contain reference to price/cost”. Section L.13, Tab C.3: Innovations, states that “the Offeror is NOT to provide the cost of implementing an innovation in the technical proposal”; however, Offerors are to describe the benefit of the innovation to the Government, i.e., “operational cost savings, improved customer service, and reductions to improper payments.” Please confirm that it is acceptable to specify the benefit of an operational cost savings under Tab C.3: Innovations of the Technical Proposal in terms of dollar savings. CMS clarifies that "cost savings" may be included in the Technical Proposal (Volume I), Tab C.2.2. The Offeror is also reminded of the instruction under L.13 for Tab C.2.2 which states:
Benefits to the Government may include operational cost savings, improved customer service, and reductions to improper payments. Where applicable, the Offeror shall crosswalk operational savings to the line items/functional areas of its cost proposal templates and/or its Attachment J-07 Basis of Estimate submission (e.g., specific level of effort savings reported for each affected WBS line). Where level of effort savings are proposed for innovations, the Offeror shall separately identify the hourly savings to each functional area (e.g., hours saved to WBS item C.5.7, hours saved to WBS item C.5.8, etc.), by labor category (e.g., reduction of 4,000 hours for Claims Adjudicator I), and by SLIN.
The Government does not consider an Offeror's explanation/quantification of the value of a proposed innovation (or an explanation of avoided cost) to represent cost/pricing data.
At a minimum, the Offeror shall identify any associated costs for an innovation in Tab F.1 of its Business Proposal. Further, at a minimum, any expected cost savings for an innovation shall be stated clearly in the Offerors Technical Proposal, Tab C.2.2. Where applicable, the Offeror shall also identify under column J of its Attachment J-07 submission proposed innovations highlighted in the Technical Proposal that have resulted in the proposed productivity for a labor category in accordance with the instructions provided in the Attachment J-07 template.
L13 Section L.13 - Volume I – Written Technical Proposal Instructions Subsection c. – TAB C: Technical Understanding Tab C.3: Innovations
| In Section L.13, Tab C.3: Innovations, it states that for each innovation, the Offeror shall provide a contingency plan for proposed innovations and/or process improvements in the event that there is a delay in the Offeror’s implementation. We interpret this to mean that a contingency plan would be required only for those innovations that are not yet part of current operations. Please confirm. | CMS confirms a contingency plan is only required for proposed new innovations/processes that are not part of the current operations. | |
| L14 | Section L.13 - Volume I – Written Technical Proposal Instructions |
Subsection c. – TAB C: Technical Understanding Tab C.4: Medical Review Strategy
| In Section L.13, Tab C.4: Medical Review Strategy, it states that this proposal section is included in the 60-page limit. Please confirm that this should state that Tab C.4 is included in the 90-page limit. | CMS has amended Section L.13, Tab C.4: Medical Review Strategy to state that this proposal section is included in the 90-page limit. Please see Amended Request for Proposal (RFP) | ||
| L15 | RFP Section L.8 Proposal Submission and Delivery; L.9(j) Binding and Labeling, Pages 88 and 94 | Section L.8 states: One (1) original and eight (8) copies of Volume IIA Business Proposal Cost Templates (this will also include the Basis of Estimate document, Attachment J-07) in hard copy and 2 CD-ROMs; L.9(j) states: (b) Volume IIA Business Proposal – hard copy (to include the Basis of Estimate). |
Please confirm that J-07 is only to be included electronically and not printed out for the hard copy.
| CMS clarifies that Offerors shall only provide an electronic submittal of Attachment J-07 with their CD-ROM submission. Offerors are not required to submit hard copies of Attachment J-07. | ||
| L16 | RFP Section L.8 Proposal Submission and Delivery; L.9(m), Pages 89 & 95 | Section L.8, p. 89— States that the Offeror is required to use “recycled paper”. |
Section L.9(m), p. 95—Requests use of “high-grade paper which can be recycled”.
Please clarify the type of paper to be used.
| Consistent with the FAR, CMS requires proposals to be printed and copied double-sided on recycled paper to the greatest extent practicable. | |||
| L17 | RFP Section L.9 (m) Page Size, Typing, Spacing and Page Numbering, Page 95 | Section L.9(m): States that the Business Proposal templates may be 11 inches x17 inches. Double-sided printing for paper of this size is problematic. Please confirm that the templates on 11x17 paper do not need to be printed double-sided. | Consistent with FAR 52.204-4, if it is not practical to print 11x17 double sided, the Offeror may print these documents single sided. |
| L18 | RFP Section L.10(f) Mandatory Workloads, Page 98 | If changes to the initial RFP-provided workloads are included with the answers to questions in the February 9th solicitation amendment, will there be an extension to the proposal submittal date due to the impact to both the Technical and Business Volumes? | At this time CMS does not anticipate granting a proposal due date exttension. |
| L19 | RFP Section L.10.(f) Mandatory Workloads, Page 98 | Please confirm that regardless of whether the Offeror has reason to believe that a certain RFP workload has been estimated either too high or too low, he must utilize the furnished workload or risk the possibility of the proposal being deemed unacceptable and removed from award consideration. | CMS Response: Section L.10(f) on page 98 states: |
For estimating purposes, the workloads in the tables below shall be used by all Offerors in preparing their technical and business proposals.
CMS would like to clarify that this instruction applies to all workloads that are labeled as "mandatory workload." As such, CMS advises that Offerors shall use the CMS-supplied mandatory workloads under sections L.10(f), L.10(h), and L.10(t). Offerors shall also use the CMS-supplied out-of-jurisdiction provider assumptions under section L.10(s).
In addition to these mandatory workload assumptions, CMS would like to clarify that the Medical Review workloads provided under L.10(g) are adjustable. As stated on page 109, the Offeror may adjust these workloads based on its proposed Medical Review strategy. However, if the Offeror chooses to adjust the Medical Review workloads supplied under section L.10(g), the Offeror shall provide its rationale and assumptions to support the change in workloads as part of its Medical Review Strategy (see also section L.13.c, TAB C.4: Medical Review Strategy for additional instructions).
L20 RFP Section L.10(f) Mandatory Workloads, Page 103
Page 103 identifies workload associated with Initial Applications and Change Applications submitted on “Paper” and via the “Web”. However, the Revalidation workload is presented as a total rather than split between applications submitted on “Paper” and “Web”. Will CMS provide the revalidation workload associated with “Paper” and “Web” applications or should the contractor assume the same allocation percentages identified for Initial Applications in the RFP?
| CMS clarifies that the same allocation percentages used for new applications should be used for revalidations. | |||
| L21 | RFP Section L.10(f) Mandatory Workloads, Page 103 | Page 103 indicates 1,313 Part A Revalidations will be processed annually during Option Years One through Four. This represents processing annual revalidation applications associated with 48.67% of the “Total Hospitals and Other Facilities” (2,698) identified on page 102. This workload does not appear consistent with the requirements of CR 7588, projected completion of the special revalidation project by 03/25/2015 or the CMS requirement to revalidate a provider’s enrollment data every five years. Please confirm the appropriateness of this workload. | CMS has amended the Part A Providers and Part B Providers Revalidation workload projections for Base Year and Option Years One through Four. Please see the amended RFP for new workload numbers for Part A and Part B Provider Enrollment Revalidations. |
| L22 | RFP Section L.10(s) Jurisdiction L Out-of-Jurisdiction Provider Facilities Table, Pages 118, 119 | Page 118 includes the “Jurisdiction L Out-of-Jurisdiction Provider Facilities Table”. The portion of the table included on page 119 identifies 33 Children’s Hospitals in Massachusetts. It appears the 33 providers are Skilled Nursing Facilities rather than Children’s Hospitals. Please confirm the type of provider associated with this workload. | For proposal purposes, offerors shall assume that the "Out-of-Jurisdiction Provider Facilities Table" found at L.10.s (page 118-119) is correct. That is, for proposal purposes, offerors shall assume there are 33 Children's Hospitals (inclusive of sub-units) in Massachusetts. |
| L23 | RFP Section L.10(s) Jurisdiction L Out-of-Jurisdiction Provider Facilities Table, Page120 | Page 120 identifies a total of 705 Out-of-Jurisdiction Providers. Please confirm workload associated with these providers is included in Section L.10(f), Mandatory Workloads. | CMS confirms the workload for the 705 Out-of-Jurisdiction Providers identified in Section L.10.s have been included in Section L.10.f Mandatory Workload Table and Section L.10.g Medical Review Workload Table. |
L24 RFP Section L13, Tab C.4 Medical Review Strategy, Page 130 CMS instructs “the Offeror shall include its proposed Medical Review workloads by the categories identified in section L.10.g. In addition to the workload categories under section L.10.g, the Offeror shall describe its automated Medical Review Strategy, which includes identifying its proposed number of automated reviews by types of services.”
Would CMS please explain and/or provide examples of what is meant by “automated reviews by types of services”.
CMS confirms that the Offeror shall describe by type of service its automated medical review plan. For example, if an Offeror has 5 SNF LCDs that allow for automatic denials in certain situations, then the Offeror shall do the following:
(1) identify and describe the 5 SNF LCDs;
(2) provide the number of auto-denial edits associated with each identified LCD(s); and
(3) provide the resulting number of automated medical reviews anticipated.
The Offeror shall complete the above analysis for each service.
| L25 | RFP Section L.13, Tab C.2.1 Staffing Plan, Page 126 | It is stated that “If the award of the contract for the Jurisdiction L work would result in an Offeror or subcontractor having multiple MAC contracts or both a MAC and legacy contract, then the Offeror and the subcontractors (where applicable) shall complete Attachments J-28 and J-29 to support proposed staffing.” Please confirm that if the award of Jurisdiction L does not result in an Offeror having multiple MAC contracts, Attachments J-28 and J-29 are not required to be completed. | CMS clarifies that in accordance with the instructions provided under L.13 for Tab C.2.1 on page 125, Attachments J-28 and J-29 are required only if the award of the contract for the Jurisdiction L work would result in an Offeror or subcontractor having multiple MAC contracts or both a MAC and legacy contract. |
| L26 | RFP Section L.10.(f) Mandatory Workloads - Participating Physicians Part B Workloads, Page 100, 101 | The "Note" in this section includes what appears to be an out of date reference to mailing enrollment packages. CMS discontinued this practice and MACs do not routinely mail enrollment materials to providers since the information is available on MAC websites. Do the workloads presented represent the number of postcards to be mailed by the J-L MAC? If not, what exactly does this workload represent? | CMS confirms that MACs are only required to mail hard-copy participating physician/supplier enrollment packages as required by the Internet-Only Manual (specifically, Pub. 100-04, Chapter 1, 30.3.12.1.B); that is, the MAC will provide a hard-copy participating physician/supplier package only to physicians and suppliers that do not have internet access, and for all other physicians and suppliers, the MAC will issue the postcard as directed by the IOM. |
For purposes of this solicitation, the Offeror shall assume that 5% of the total workload (defined as “Enrollment Packages Mailed to Providers”) provided for each Option Period under RFP section L.10(f) represents hard-copy enrollment package mailings. The remaining 95% of the workload for each Option Period relates to the number of postcards that the MAC will need to issue to physicians and suppliers.
L27 RFP Section L.10.(f) Mandatory Workloads - Provider Enrollment Part B Workload, Page 103
| CMS instructed us that we may process a Change of Information application as a Revalidation application to reduce duplicate efforts for the provider community and MAC. This would significantly reduce the number of Revalidation applications listed for CLINs 2 - 6. Does CMS intend for Offerors to include all of the Revalidation applications listed for CLINs 2 - 6 as separate, additional workload above and beyond the Changes applications listed for each of those same CLINs? | CMS does not have the ability to estimate how many Change of Information applications may be utilized by the MACs as a means of obtaining a Revalidation. Therefore, the estimates should be based on the separate workload numbers outlined in the revised RFP. | ||
| L28 | RFP Section L.10.(f) Mandatory Workloads - Provider Enrollment Part B Workload, Page 103 | Does the 61,716 workload figure for Revalidations listed for multiple CLINs represent the expected universe of all Revalidations CMS expects the MAC to complete by March 2015 or does the 61,716 Revalidations listed represent the expected number of Revalidations CMS expects the MAC to complete each Option Year? |
Would CMS please clarify exactly how many Revalidation applications it expects the Offerors to utilize to bid the Base Year and each Option Year?
CMS responds that the Mandatory Workload estimates are specific to the number of revalidations for each contracted year. CMS, however, cannot estimate how many revalidations receipts may be transitioned by the incumbent contractor.
Offerors shall note CMS has amended the Part A Providers and Part B Providers Revalidation workload projections for Base Year and Option Years One through Four. Please see the amended RFP for new workload numbers for Part A and Part B Provider Enrollment Revalidations.
L29 Statement of Work, C.7.26, page 159 – C.7.26 C.7.26 provides new requirements that all telephone inquiries, including those formerly answered by other functional areas are to be included in the Provider Contact Center. Will CMS provide a complete listing of all call types/functional area calls to be included and provide workloads for each? CMS confirms that the incumbent contractor has consolidated Appeals, EDI and Provider Enrollment inquiries into the Provider Contact Center. CMS does not have a listing of other functional areas or of the inquiry workloads for other functional areas to be handled by the Provider Contact Center and as a result cannot provide a complete listing of all call types/functional area calls to be included and provide workloads for each.
| L30 | Section L.6., Small Business Subcontracting Plan, page 85 | CMS recommends a total of 28% should go to small businesses. The new 2012 form on the Small Business Website states 33%. Please verify which percentage Offerors should follow. | CMS has ammended Section L.6., Small Business Subcontracting Plan to reflect 33% should go to small business. |
| L31 | Section L.8., Proposal Submission and Delivery, page 88 | Does Attachment J-07, Basis of Estimate, need to be printed as part of Volume IIA? Or only provided electronically on CD-ROM? | CMS clarifies that Offerors shall only provide an electronic submittal of Attachment J-07 with their CD-ROM submission. Offerors are not required to submit hard copies of Attachment J-07. |
L32 Section L.9.h Proposal Submission and Delivery -- Intent to Submit a Proposal, page 92 CMS requested Offerors to send an intent to submit a proposal by January 19, 2012. If an Offeror was unable to submit an intent to bid by January 19th, is it too late to submit an intent to bid or to submit a proposal for Jurisdiction L? CMS clarifies the effect of Section L.9.h. requesting Offerors to submit a notice of intent to submit a proposal by January 19, 2012 is non-binding. CMS will accept all Offerors' proposals submitted by the final Jurisdiction L proposal submission date.
&D A/B MAC Jurisdiction L
&9RFP-CMS-2011-0014 &9&A &9&P
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