AB MAC JK Solicitation Question Responses 6.22.12.xlsx
XLSX spreadsheet 21 KB Posted
- Solicitation number
- RFP-CMS-2012-0005
About this file
Questions and Answers
View the file
Other files
Show all 19
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Sheet1
| Section | Question | Answer/Action |
| Section B Supplies or Services and Prices/Costs, B.5 Task Directives, page 3. | Text Reference from RFP: |
Task Directives issued under this contract may be fixed price or cost reimbursement.
Question:
| Does the government intend on creating a Fixed Price CLIN to allow for Fixed Price Task Directives during the execution of the contract? | Where the Government issues a fixed price Task Directive after contract award (during contract administration), a fixed price CLIN or SLIN may be negotiated and incorporated in the contract. |
| C.5.4.1.11 Key Personnel |
and
| C.5.12.1.6 Defending Medical Review Decisions at ALJ Hearings | Regarding the new ALJ participation requirement, can a JD be substituted for an MD when deemed best to “litigate” the case? | A JD may be substituted for an MD at an ALJ hearing on a case by case basis, or may accompany the MD at the hearing. This does not reduce the requirement for assigning 1.0 FTE of CMD time at a minimum to participate or take party status at ALJ hearings. |
| C.5.3.1.1.1, HIPAA Compliant Translation Software, page 29 | Text Reference from RFP: |
At this time, CMS is requiring that the Contractor provide a single Commercial off the Shelf (COTS) translation software package to handle all inbound and outbound HIPAA transaction for the Medicare Part A or Part B claims processing and associated EDI activities.
Question/Clarification:
Past direction has been that a single COTS for Part A and a single COTS for Part B was acceptable, Can CMS confirm that a combined single A/B COTS is required.
| CMS confirms that a single COTS transaltor for Part A transactions and a single COTS translator for Part B transactions is acceptable, as is a combined single Part A/B COTS translator. | |
| C.5.3.2.3, EDI Help Desk, page 39-40 | Text Reference from RFP: |
The EDI Help Desk staff shall respond to telephone inquiries in accordance with the IOM Pub. 100-09, Chapter 3.
Question/Clarification:
Chapter 3 of IOM Pub. 100-09 became obsolete as of 9/8/2009 and was incorporated into Chapter 6. In addition, CMS provided direction on 1/27/2012 that the EDI team was not subject to the ASA requirements outlined in Chapter 6 related to telephone inquiries. Please clarify. CMS clarifies that the EDI Help Desk is not subject to the ASA requirements now outlined in IOM Chapter 6. This reference will be removed in Amendment 1.
| C.5.6.1, Reserved, page 84 | What is the status of the CAC section? Will this section be provided as an amendment prior to the proposal due date? | Section C.5.6.1 has been udpated and can be found in the attached Amendment 000001 Statement of Work dated June 21, 2012. |
| C.5.26.5, Other Recovery Audit Program Support Activities, page 164 | Text Reference from RFP: |
The MAC shall work with the Recovery Auditor to develop a communication process as indicated in the IOM 100-06, Chapter 4, §100.2. The MAC shall provide the Recovery Auditor with a provider listing of all provider numbers, names, and addresses within 30 days of the signing of the contract modifications that includes the Recovery Audit Program contract. For future updates, the MAC will comply with the IOM 100-06, Chapter 4, §100.2.
Question/Clarification:
| Final change request (CR) 7733, Validation of Recovery Audit Program New Issues, was issued on May 18, 2012, with an effective date of June 19, 2012. A new IOM section, 100.17 is included in the CR, but is not yet posted in the IOM online as of June 4, 2012. The CR represents additional effort that requires staffing above and beyond the Recovery Audit adjustments and appeals functions. Should we assume that the CR is not to be considered for purposes of this RFP? | CR 7733 should be considered for purposes of this RFP. | |
| Recovery Auditor New Issue Validation | Will all CR7733 requirements apply to this SOW even though the CR’s implementation date is subsequent to the RFP issue date? | |
| Yes, all CR 7733 requirements apply to this SOW. CR 7733 was issued in Final prior to the RFP issue date. | ||
| C.5.10.1.2 Document Imaging and Indexing | The SOW requires all redetermination requests be scanned, including documentation and incoming correspondence supplied in support of the request. Document imaging shall include scanning a claim in its entirety when it reaches the MAC, performing Quality Assurance (QA) on scanned images, indexing the scanned images, and using these scanned images to make a decision on the claim. At a minimum, all images shall be indexed by date scanned, MAC contract number, claim number and beneficiary HICN. The contractor shall electronically image and index all redetermination correspondence upon receipt in the corporate mailroom. |
| Please clarify if using a single, reliable index to accomplish retrieval meets the requirements of this SOW section, versus using multiple indexing references (e.g., HIC, claim number). | The SOW requires that at a minimum, all images shall be indexed by date scanned, MAC contract number, claim number, and beneficiary HICN. | ||
| C.5.4: Administrative Requirements | Throughout Section C.5.4, the SOW specifies that certain key personnel must be “dedicated to Medicare lines of business”, meaning that the individual identified for the position may work on more than one MAC contract, or more than one Medicare contract. This individual may not perform duties on any non-Medicare line of business without approval by the Contracting Officer. When CMS refers to a “non-Medicare line of business” in this statement, is that reference to private commercial lines of business? | Non-Medicare lines of business include private commercial lines of business and all other non-Medicare lines of business. | |
| C.5.1.8 CONSOLIDATION OF PART A AND PART B EDITS - page 21 | The SOW requires a consolidation of edits for all edits. Does the incoming contractor have update access to the UAT environment prior to the cutover period to load and test the consolidated edits? | The awardee will have the option to utilize a separate newly created set of CICS regions (for production and UAT) to establish its reference files, unless the awardee is the incumbent contractor for that specific workload segment, in which case its reference files will already have been established and it can utilize its UAT region if it needs to make any adjustments. Furthermore, in such cases the CMS is open to discussing how best to handle any potential conflicts between the transition and quarterly release user acceptance testing. | |
| Section L.9.h, Provider Enrollment Part B Workload, Page 106 | Question: |
There is no workload provided for Part B Reassignments. Should this activity be priced and if so, what workload assumptions should be utilized?
| CMS-855R Reassignment of Benefit applications fall within “Changes of Information”. See SOW “C.5.5.2 PROCESS CHANGES, UPDATES, REASSIGNMENTS OR CORRECTIONS”. The Changes of Information workload (Part B) includes Part B reassignments. | |
| Section L.9.i, Medical Review Workload for JK A/B MAC, pg 110 | Question: |
The proposed workload number drops in Option Year 2 for Part A Prepay Complex Reviews and again in Option Year3, before going back up again in Option Year 4. Was this variance intentional?
Text Reference from RFP:
| Prepay Complex Reviews BY: 23,238 OY1: 56,102 OY2: 32,530 OY3: 16,265 OY4: 56,102 | The variance was not intentional. CMS confirms that the workload for this category for OY1-OY4 is 56,102. (See Amendment 1 for correction.) The Base Year workload is correct. REMINDER: Offerors may adjust MR workloads based on their MR Strategy as instructed in Section L.9 of the RFP. |
| L.9.h, Mandatory Workloads, pg. 101 | |
| Text Reference from RFP: |
L.9.h:
Note: For the below ALJ Hearings Participation/Support Workload, the Offeror shall provide in the Basis of Estimate (Attachment J-07) and/or the Proposal Assumptions Template (Attachment J-25) the assumptions used to allocate the workload volume between Part A, HH+H, & Part B ALJ Hearings Participation/Support.
Part A, HH&H, & Part B ALJ Hearings Participation/Support 70 120 120 120 120
Text Reference from SOW:
C.5.12.1.6 Defending Medical Review Decisions at Administrative Law Judge (ALJ) Hearings The contractor shall assign a physician(1.0 FTE at a minimum to participate or take party status at the Administrative Law Judge (ALJ) hearings Further rules and procedures related to the ALJ hearing process are contained in 42 CFR 405.1000. Physicians taking party or participant status may be a current CMD, a contractor employed physician or any combination thereof.
Question:
| ALJ participation is included in the SOW and a workload number is provided in the RFP, however it was not included in the cost template. Should ALJ activities defined by the SOW and workload be priced as part of the RFP response? Please clarify. | CMS clarifies that Offerors shall include proposed cost for ALJ activities defined by the SOW and workloads provided in the solicitiation. In addition, CMS reminds Offerors that, in accordance with section L.14 of the solicitation and Attachment J-09 (as amended), CLIN templates should be submitted at the CLIN level only. Offerors are not required to identify cost at the WBS level. For Basis of Estimate purposes, Offerors should identify costs to support the ALJ requirments and workloads under SLINs AB and AD, SOW C.5.12. | ||
| Section L.11 Proposal Assumptions - Workloads, page 98-99 | Please confirm the workload tables provided in the RFP for Part A and Part B Provider Inquiries exclude any inquiry transactions related to Internet portals (any workload handled by Internet portals as well as technical help desk telephone inquiries regarding the portals). If the numbers of inquiries are inclusive of these types of workload volumes, we ask that CMS share the specific volumes for each. | The provider inquiries workload tables do not include internet transactions. | |
| Section L.11 Proposal Assumptions – Workloads, pages 100-101 | Please clarify whether CMS intended that nearly all Complex Probe Reviews be performed as a prepay rather than a postpay basis. | The majority of Complex Probe Reviews and Complex Reviews should be Prepay. However, in accordance with the MR note found in Section L.11, Offeror may elect to modify the workloads of the various Complex Probe and Complex Reviews as long as those changes are supported by the Medical Review Strategy submitted in the written Technical Proposal. | |
| L.9.l Records Retention, page 114 | Text Reference from RFP: |
For A/B MAC Jurisdiction K (currently known as Jurisdictions 13 and 14), the Offeror shall assume a total of 489,968 cubic feet of file storage for Medicare records. The breakout of this total by locale is provided in the chart below. The NARA compliance will be enforced on this procurement. Offerors are to assume that 219,078 cubic feet of storage is located in a NARA compliant facility. Offerors are required to identify and/or negotiate rates with a NARA compliant facility. For proposal purposes, if an Offeror must relocate files they shall assume the file locations provided in the chart below. For proposal purposes, the costs associated with the Medicare files and data transfer will be considered Implementation Costs. For proposal purposes only, please assume a cost of $300,000 in the permanent withdrawal fees for these records. Offerors are to assume the cost of file storage in the operational periods and record costs in the operational cost CLINS (Base and Option Years 1 through 4).
Question:
| Does this statement indicate that the Offeror shall assume that the $300,000 cost will cover the withdrawal and transfer of records from a non-compliant to a compliant facility or is the $300,000 only assumed to be part of the transfer cost? In other words, does the $300,000 include all the removal costs from the current vendor (pulling, palletizing, and shrink wrapping boxes), transit costs from the current vendor to the new vendor (trucking/shipping) and intake costs at the new vendor (receipt, movement into storage). | CMS clarifies that, for Proposal purposes, the $300,000 includes all the removal costs from the current vendor (pulling, palletizing, and shrink wrapping boxes), transit costs from the current vendor to the new vendor (trucking/shipping), and intake costs at the new vendor (receipt, movement into storage). Offerors shall include these costs under CLIN 0001. | |
| L.12.c - C.2 Personnel - Third sub-indenture Bullet, page 121 | Text of Reference from RFP: |
Identify the total number of FTEs required for CLINs 0002 (Base) and 0003 (Option 1) of the contract across the prime and subcontractor(s) broken out by labor category at the third level of the WBS (e.g., C.5.5, C.5.8, etc.), at a minimum. The exception to this is Audit and Reimbursement. The Offeror shall identify its staffing for Audit and Reimbursement separate from C.5.11 at the fourth WBS level (C.5.11.3.).
Question:
The data required to accomplish this requirement, specifically identifying labor categories for each WBS at the third level, fourth level for Audit and Reimbursement, requires a significant amount of pages to provide a format most beneficial to CMS for evaluation purposes. Would CMS consider either removing this particular requirement from page allocations or provide additional pages to accommodate the information being required?
| CMS clarifies that Offerors shall include this information in the 60-page limit. |
| L.12 Tab C.1 Program Management (included in 60-page limit), page 120-121 |
L.14 .a. VOLUME IIA, Business Proposal Cost Templates, Tab A: Cost Templates, Attachments J-10 through J-17, pages 131-132 Text Reference from RFP:
From L.12 Tab C.1 Program Management:
Further, under Tab F.1 of its Business Proposal (Volume IIB), the Offeror shall include cost estimates associated with these specific trips. Costs for these trips shall be included in travel amounts specified for each CLIN in section L.14.a.2. of this solicitation.
From L.14 .a. VOLUME IIA, Business Proposal Cost Templates, Tab A: Cost Templates, Attachments J-10 through J-17:
The Offeror shall use the business proposal spreadsheets for all pricing and include the following:
1. Labor for Prime and Subcontractors: Offeror shall provide labor rates for all labor categories that are expected to be used in the performance of the MAC contract. Such labor rates shall be projected for the base period and all option periods.
2. Travel: All travel costs proposed shall be reimbursed on a cost reimbursement basis in accordance with the Federal Travel Regulation (FTR) and in accordance with FAR 31.205-46.
Question:
The RFP provides projections for travel by CLIN in section L.14. However, section L.12 requires the inclusion of cost estimates associated with travel. Please clarify the requirement in section L.12 to provide travel templates given that the RFP provides projections for travel by CLIN in section L.14. Section L.12 provides the following instructions specific to the Offeror's Technical Proposal for Tab C.1 Program Management: "In addition, where applicable, the Offeror shall describe all travel associated with its proposed technical solutions described in its proposed Innovations (Tab C.3), Medical Review Strategy (Tab C.4), and/or Provider Customer Service Strategy (Tab C.5). The Offeror shall describe the number of trips, labor categories taking the trip, proposed departure cities, and proposed destination cities. "
CMS clarifies that Offerors should not identify costs in its Technical Proposal Volume for any proposed trips. CMS clarifies that this instruction is specific to the Offeror's Technical Proposal. CMS is requesting that Offerors identify proposed trip information (as described in section L.12) to support its proposed Innovations, Medical Review Strategy, and Provider Customer Service Strategy provided in its Volume I, Technical Proposal submission.
Under section L.12, the following instruction is provided specific to travel costs: "Further, under Tab F.1 of its Business Proposal (Volume IIB), the Offeror shall include cost estimates associated with these specific trips. Costs for these trips shall be included in travel amounts specified for each CLIN in section L.14.a.2. of this solicitation."
CMS clarifies that the Offeror should propose travel costs in accordance with the amounts provided under section L.14.a.2.
Section M.1.b.2, Technical Approach, Page 149 Text Reference from RFP:
Section M.1.b.2. Technical Approach – 50% The evaluation of technical approach will be based on the Offeror’s (included in TAB C (inclusive of all sub-tabs) written technical proposal and oral presentation.
Question:
| Can the Government provide relative evaluation importance between the Written and Oral Presentation? | Pursuant to Section M.1.b2., the evaluation of each Offeror's technical approach will be based on the written technical proposal and oral presentation combined. A relative evaluation importance between the written and oral presentation is not applicable. | ||
| L.11 Proposal Assumptions – Workloads, page 100-101 | Please confirm the workload tables provided in the RFP for Part A and Part B Provider Inquiries include IVR transactions. | The workload tables include IVR transactions. | |
| L.14, a. VOLUME IIA - Business Proposal Cost Template Tab A: Cost Templates, Attachments J-10 through J-17, Business Proposal Cost Template Instructions, page 132 |
and Attachment J-09 Cost Proposal Instructions-JK.xlsx, Tab: Instructions Text Reference from RFP:
L.14 a. VOLUME IIA - Business Proposal Cost Template Tab A: Cost Templates, Attachments J-10 through J-17 The Offeror shall use the business proposal templates and instructions (Attachments J-9through J-17) for all business proposal spreadsheet submissions. The business proposal spreadsheet templates indicate the levels of proposed costs that are to be provided to the extent that an Offeror’s accounting system is able to capture cost data for that particular section.
Question/Clarification:
When comparing the instruction between the J-9 instructions and the L.14 instructions, there appears to be conflicting direction on what is required as part of the Volume IIA submission.
In J-9, the instruction reads: as instructed in RFP Business Proposal Instructions, this solicitation requests the breakout at the WBS level for the Base Year and Option Years One and Two only. In L.14, the instruction reads, No WBS breakout is requested for proposal purposes for the Base Period through Option Year 4 (CLINs 0002-0006) in the cost templates.
Our concern is that if we only submit the summary level worksheets, we will break links in the cost model, for the files provided electronically, and have to input data directly into the summaries. Secondly, our concern is, J-9 instructs that the Offerors should use formulas rather than hard code numbers where ever possible.
Please clarify the instruction between J-9 and L.14 on the desire of the government for the contractor to either provide the cost templates in their entirety as provided in the solicitation , for the Base period and Option year 1 and 2(CLIN 0002-0004) or to provide only the summary level Cost Templates.
| CMS clarifies that Offerors shall adhere to the instruction under section L.14 of the solitation. When providing its proposed costs, Offerors are not required to submit WBS breakouts on the CLIN templates for the Base Period through Option Year 4 (CLINs 0002-0006). Attachment J-09 is amended to be consistent with the instructions provided under section L.14. |
| L.12 Volume I – Written Technical Proposal Organization, Tab C.1: Program Management, page 120-121 |
and
L.14.a.2 Volume IIA – Business Proposal Cost Template Text Reference from RFP:
L.12 Volume I – Written Technical Proposal Organization, Tab C.1: Program Management, page 120-121 “The Offeror shall describe the number of trips, labor categories taking the trip, proposed departure cities, and proposed destination cities. Further under Tab F.1 of its Business Proposal (Volume IIB), the Offeror shall include cost estimates associated with these specific trips. Costs for these trips shall be included in travel amounts specified for each CLIN in section L.14.a.2 of this solicitation.”
Question:
This seems to be in direct contradiction to L.14.a.2 Volume IIA – Business Proposal Cost Template, where CMS provides the projected travel cost by CLIN with the instruction not to prepare the travel template in the cost proposal templates.” Please clarify this discrepancy. In the solcitation, section L.12 provides the following instructions specific to the Offeror's Technical Proposal for Tab C.1 Program Management:
"In addition, where applicable, the Offeror shall describe all travel associated with its proposed technical solutions described in its proposed Innovations (Tab C.3), Medical Review Strategy (Tab C.4), and/or Provider Customer Service Strategy (Tab C.5). The Offeror shall describe the number of trips, labor categories taking the trip, proposed departure cities, and proposed destination cities. "
CMS clarifies that Offerors should not identify costs in its Technical Proposal Volume for any proposed trips. CMS clarifies that this instruction is specific to the Offeror's Technical Proposal. CMS is requesting that Offerors identify proposed trip information (as described in section L.12) to support its proposed Innovations, Medical Review Strategy, and Provider Customer Service Strategy provided in its Volume I, Technical Proposal submission.
Under section L.12, the following instruction is provided specific to travel costs: "Further, under Tab F.1 of its Business Proposal (Volume IIB), the Offeror shall include cost estimates associated with these specific trips. Costs for these trips shall be included in travel amounts specified for each CLIN in section L.14.a.2. of this solicitation."
CMS clarifies that the Offeror should propose travel costs in accordance with the amounts provided under section L.14.a.2.
| Section L.11 - Proposal Assumptions - Pages 92 – 105 | The Provider Reimbursement and Audit section (page 104) gives provider counts by the type of provider, and at the bottom of this section are the workloads (i.e. acceptances, tentative, desk reviews, audits and cost report settlements). Will CMS provide the workloads by provider type? For example during the option years 413 audits are required; will CMS provide their expectation as to how many of the 413 audits should be hospitals, SNFs, etc? Or is the offeror to determine how many audits are to be performed by provider type based on their experience and assumptions (as long as the total is 413)? | CMS will not provide workload by provider type. Provider types were provided to assist Offerors in putting together their proposals. Offerors shall determine the number of audits to be performed by provider type based on their experience and assumptions. |
| Section M.1.b.2, Technical Approach, Page 149 | Text Reference from RFP: |
Section M.1.b.2. Technical Approach – 50% The evaluation of technical approach will be based on the Offeror’s (included in TAB C (inclusive of all sub-tabs) written technical proposal and oral presentation. The CMS’ evaluation of Technical Approach will be based on the Offeror’s proposed approach to successfully address the areas identified in L.12 Volume I – Written Technical Proposal Instructions and L.17 Oral Presentations, of this solicitation. These findings may include CMS’ assessment of reasonableness of the offeror’s proposed labor mix and/or level of effort (e.g., whether adequate staffing and other resources proposed to perform the required work.)
SOW Reference: C.4 Objectives, page 15 Question:
| Can the Government provide relative evaluation importance between the Written and Oral Presentation? | Pursuant to Section M.1.b2., the evaluation of each Offeror's technical approach will be based on the written technical proposal and oral presentation combined. A relative evaluation importance between the written and oral presentation is not applicable. | ||
| Section M.1.b.2, Technical Approach, Page 149 | Will the oral presentation be evaluated in the same manner as the written technical proposal? | Pursuant to Section M.1.b2., the evaluation of each Offeror's technical approach will be based on the written technical proposal and oral presentation combined. | |
| Section M.1.b.2, Technical Approach, Page 149 | Text Reference from RFP: |
Section M.1.b.2. Technical Approach – 50% The evaluation of technical approach will be based on the Offeror’s (included in TAB C (inclusive of all sub-tabs) written technical proposal and oral presentation. The CMS’ evaluation of Technical Approach will be based on the Offeror’s proposed approach to successfully address the areas identified in L.12 Volume I – Written Technical Proposal Instructions and L.17 Oral Presentations, of this solicitation. These findings may include CMS’ assessment of reasonableness of the offeror’s proposed labor mix and/or level of effort (e.g., whether adequate staffing and other resources proposed to perform the required work.)
Question/Clarification:
| Can the Government provide relative evaluation importance to significant subfactors, i.e: Program Management, Personnel, Innovations, Medical Review Strategy, Provider Customer Service Program Strategy, Jurisdiction Implementation Project Management Approach | Pursuant to Section M.1.b. Offeror's proposals will be evaluated considering two technical evaluation factors: Past Performance and Technical Approach. There are no subfactors identified in Section M. All components of the written technical proposal and oral presentation mentioned in the question are considered in the technical evaluation factor. | |
| Section M.1.b.2, Technical Approach, Page 149 | Text Reference from RFP: |
Section M.1.b.2. Technical Approach – 50% The evaluation of technical approach will be based on the Offeror’s (included in TAB C (inclusive of all sub-tabs) written technical proposal and oral presentation. The CMS’ evaluation of Technical Approach will be based on the Offeror’s proposed approach to successfully address the areas identified in L.12 Volume I – Written Technical Proposal Instructions and L.17 Oral Presentations, of this solicitation. These findings may include CMS’ assessment of reasonableness of the offeror’s proposed labor mix and/or level of effort (e.g., whether adequate staffing and other resources proposed to perform the required work.)
Question/Clarification:
Does CMS' omission of the SOW Four Objectives (C.4 Objectives) from Section M Evaluation Factors for Award mean that offerors should assume that these objectives are no longer part of the solicitations evaluation? Please Clarify.
Although not included directly in Section M, the four objectives remain as part of the SOW. The objectives continue to be a performance requirement of the SOW.
&"Times New Roman,Bold"RFP-CMS-2012-0005, Amendment Number 000001, A/B MAC JK, SOLICITATION QUESTIONS & ANSWERS page &P of &N
Sheet2
Sheet3
File details come from the government source that posted it. Updated .