JK RFP.pdf

RFP-CMS-2012-0005

SOLICITATION, OFFER AND AWARD

4. TYPE OF SOLICITATION2. CONTRACT NUMBER 3. SOLICITATION NUMBER

7. ISSUED BY CODE 8. ADDRESS OFFER TO (If other than Item 7)

ORDER UNDER DPAS (15 CFR 700)

6. REQUISITION/PURCHASE NUMBER

NOTE: In sealed bid solicitations "offer" and "offeror" mean "bid" and "bidder".

NEGOTIATED (RFP)

SEALED BID (IFB)

5. DATE ISSUED

1. THIS CONTRACT IS A RATED RATING PAGE OF PAGES

1 158

C. E-MAIL ADDRESS

EXT.NUMBERAREA CODE

B. TELEPHONE (NO COLLECT CALLS)A. NAME

10. FOR

INFORMATION

CALL:

CAUTION: LATE Submissions, Modifications, and Withdrawals: See Section L, Provision No. 52.214-7 or 52.215-1. All offers are subject to all terms and conditions contained in this solicitation.

(Date)(Hour) local timeuntildepository located in copies for furnishing the supplies or services in the Schedule will be received at the place specified in Item 8, or if hand carried, in the

SOLICITATION

9. Sealed offers in original and

PART IV - REPRESENTATIONS AND INSTRUCTIONS

OTHER STATEMENTS OF OFFERORS

EVALUATION FACTORS FOR AWARD

INSTRS., CONDS., AND NOTICES TO OFFERORS

REPRESENTATIONS, CERTIFICATIONS AND

LIST OF ATTACHMENTS

CONTRACT CLAUSES

PART III - LIST OF DOCUMENTS, EXHIBITS AND OTHER ATTACH.

I

J

K

L

M SPECIAL CONTRACT REQUIREMENTS

CONTRACT ADMINISTRATION DATA

DELIVERIES OR PERFORMANCE

INSPECTION AND ACCEPTANCE

PACKAGING AND MARKING

DESCRIPTION/SPECS./WORK STATEMENT

SUPPLIES OR SERVICES AND PRICES/COSTS

SOLICITATION/CONTRACT FORM

PART II - CONTRACT CLAUSESPART I - THE SCHEDULE

H

G

F

E

D

C

B

A

SEC. DESCRIPTION PAGE(S) (X) DESCRIPTION SEC. (X)

11. TABLE OF CONTENTS

18. OFFER DATE17. SIGNATURE

SUCH ADDRESS IN SCHEDULE.

IS DIFFERENT FROM ABOVE - ENTER

15C. CHECK IF REMITTANCE ADDRESS

EXT.NUMBERAREA CODE

15B. TELEPHONE NUMBER

(Type or print)AND

ADDRESS

OF

OFFEROR

CODE FACILITY

16. NAME AND TITLE OF PERSON AUTHORIZED TO SIGN OFFER15A. NAME

DATEAMENDMENT NO.DATEAMENDMENT NO.

and related documents numbered and dated):

amendments to the SOLICITATION for offerors

(The offeror acknowledges receipt of

14. ACKNOWLEDGEMENT OF AMENDMENTS

CALENDAR DAYS (%)30 CALENDAR DAYS (%)20 CALENDAR DAYS (%)10 CALENDAR DAYS (%)

(See Section I, Clause No. 52.232.8)

13. DISCOUNT FOR PROMPT PAYMENT

designated point(s), within the time specified in the schedule.

by the offeror) from the date for receipt of offers specified above, to furnish any or all items upon which prices are offered at the price set opposite each item, delivered at the

12. In compliance with the above, the undersigned agrees, if this offer is accepted within ______________ calendar days (60 calendar days unless a different period is inserted

NOTE: Item 12 does not apply if the solicitation includes the provisions at 52.214-16, Minimum Bid Acceptance Period.

OFFER (Must be fully completed by offeror)

IMPORTANT - Award will be made on this Form, or on Standard Form 26, or by other authorized official written notice.

28. AWARD DATE

(Signature of Contracting Officer)

27. UNITED STATES OF AMERICA

25. PAYMENT WILL BE MADE BY

26. NAME OF CONTRACTING OFFICER (Type or print)

CODE 24. ADMINISTERED BY (If other than Item 7)

ITEM

(4 copies unless otherwise specified)

23. SUBMIT INVOICES TO ADDRESS SHOWN IN

41 U.S.C. 253 (c) ( 10 U.S.C. 2304 (c) (

22. AUTHORITY FOR USING OTHER THAN FULL AND OPEN COMPETITION:

21. ACCOUNTING AND APPROPRIATION20. AMOUNT19. ACCEPTED AS TO ITEMS NUMBERED

AWARD (To be completed by government)

CODE

CM-393-2012-008405/24/2012

X

MACG - DEMAC

CMS,OAGM,MACG,DEMAC

7111 SECURITY BLVD., MS: B2-14-21

BALTIMORE MD 21244-1850

1100 ES 07/09/2012

Tasha Logan 410 Tasha.Logan@cms.hhs.gov

786-0219

X

X

X

X

X

X

X

X

X

X

X

X

X

PAGE(S)

Bridget Hamel

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition is unusable

STANDARD FORM 33 (Rev. 9-97)

Prescribed by GSA - FAR (48 CFR) 53.214(c)

See Section L.7

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

2 158

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

RFP-CMS-2012-0005

(A) (B) (C) (D) (E) (F)

FOB: Destination

Period of Performance: 01/25/2013 to 10/17/2013

OPTIONAL FORM 336 (4-86)

Sponsored by GSA

FAR (48 CFR) 53.110

NSN 7540-01-152-8067

RFP-CMS-2012-0005 A/B MAC Jurisdiction K

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TABLE OF CONTENTS

PART I – THE SCHEDULE

SECTION B - SUPPLIES OR SERVICES AND PRICES/COSTS

B.1 BRIEF DESCRIPTION OF SERVICES

B.2 CONTRACT TYPE

B.3 AWARD FEE

B.4 ESTABLISHED COST AND AWARD FEE

B.5 TASK DIRECTIVES

B.6 SCHEDULE OF SUPPLIES/SERVICES

SECTION C - DESCRIPTION/SPECIFICATIONS/WORK STATEMENT

C.1 STATEMENT OF WORK

SECTION D - PACKAGING AND MARKING

D.1 PACKAGING AND MARKING

SECTION E - INSPECTION AND ACCEPTANCE

E.1 FAR 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

E.2 APPROVALS BY THE CONTRACTING OFFICER REPRESENTATIVE

E.3 INSPECTION OF SERVICES – COST-REIMBURSEMENT

SECTION F - DELIVERIES OR PERFORMANCE

F.1 FAR 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

F.2 PERIOD OF PERFORMANCE

F.3 DELIVERABLES

SECTION G - CONTRACT ADMINISTRATION DATA

G.1 ACCOUNTING AND APPROPRIATION DATA

G.2 PAYMENT, SELECTED ITEMS OF COST REIMBURSEMENT CONTRACTS

G.3 DISSEMINATION, PUBLICATION & DISTRIBUTION OF INFORMATION

G.4 SUBCONTRACTING REPORTING

G.5 SUBCONTRACTING PROGRAM FOR SMALL AND SMALL DISADVANTAGED

BUSINESSES

G.6 SUBCONTRACT CONSENT

G.7 SERVICE OF CONSULTANTS/ SUBCONTRACTORS

G.8 GOVERNMENT REPRESENTATIVES

G.9 CONTRACTING OFFICER RESPONSIBILITY

G.10 CONTRACTOR PROJECT MANAGER

G.11 CONTRACTING OFFICER REPRESENTATIVE

G.12 TECHNICAL DIRECTION

G.13 DESIGNATION OF PROPERTY ADMINISTRATOR

G.14 GOVERNMENT FURNISHED PROPERTY

G.15 CONTRACTOR FURNISHED PROPERTY

G.16 INVOICING AND PAYMENT (See Attachment J-4, Billing Instructions)

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G.17 SEPARATION OF MEDICARE INTEGRITY PROGRAM AND PROGRAM

MANAGEMENT FUNDING

G.18 SEPARATION OF TRUST FUND EXPENDITURES/ACCOUNTING FROM

ADMINISTRATIVE EXPENDITURES/ACCOUNTING

G.19 COMPLEMENTARY CREDITS

G.20 METHOD OF PAYMENT

G.21 CORRESPONDENCE PROCEDURES

G.22 DATA TO BE DELIVERED

G.23 PERFORMANCE EVALUATION AWARD FEE PLAN

G.24 WORKING PAPERS

G.25 FINAL INDIRECT COST CEILING RATES – ADVANCE UNDERSTANDING

G.26 USE OF GOVERNMENT DATA (REPORTS/FILES/COMPUTER TAPES OR

DISCS)

G.27 INCORPORATION OF CONFLICT OF INTEREST CERTIFICATE

G.28 INCORPORATION OF REPRESENTATIONS AND CERTIFICATIONS

SECTION H - SPECIAL CONTRACT REQUIREMENTS

H.1 HHSAR 352.242-70 KEY PERSONNEL (JAN 2006)

H.2 CONDITIONS OF PERFORMANCE

H.3 CONFLICT OF INTEREST

H.4 APPROVAL OF CONTRACT ACQUIRED INFORMATION TECHNOLOGY (IT)

H.5 HEALTH INSURANCE PORTABILITY and ACCOUNTABILITY ACT of 1996

(HIPAA) BUSINESS ASSOCIATE PROVISION II

H.6 SECTION 508 – ACCESSIBILITY OF ELECTRONIC AND INFORMATION

TECHNOLOGY

H.7 WAGE DETERMINATION

H.8 INDEMNIFICATION

H.9 DISCLOSURE OF INFORMATION

H.10 PARTICIPATION IN DEMONSTRATIONS

H.11 SEPARATION OF CERTIFICATION AND DISBURSEMENT RESPONSIBILITIES

H.12 SURETY BONDS

H.13 LIABILITY FOR MEDICARE BENEFIT PAYMENTS – CERTIFYING OFFICER

H.14 LIABILITY FOR MEDICARE BENEFIT PAYMENTS – DISBURSING OFFICER

H.15 LIABILITY FOR MEDICARE BENEFIT PAYMENTS – MEDICARE

ADMINISTRATIVE CONTRACTOR

H.16 LIABILITY FOR UNCOLLECTED OVERPAYMENTS

H.17 RECORD RETENTION

H.18 REPORTABLE EVENTS

H.19 SYSTEMS OF RECORDS

H.20 SECURITY CLAUSE -BACKGROUND - INVESTIGATIONS FOR CONTRACTOR

PERSONNEL

H.21 CODE OF CONDUCT

H.22 CONTRACTOR PERFORMANCE EVALUATION(S)

H.23 PRIVACY ACT ‘SYSTEMS NOTICE’

H.24 PUBLICITY

H.25 FEDERAL INFORMATION SECURITY MANAGEMENT ACT (FISMA)

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H.26 REPORTING CHANGES IN CONTRACTOR TEAM ARRANGEMENTS, AND

ACQUISITIONS/DIVESTITURES

SECTION I - CONTRACT CLAUSES

I.1 FAR 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

I.2 DEPARTMENT OF HEALTH & HUMAN SERVICES ACQUISITION

REGULATIONS (HHSAR)

I.3 FAR 52.203-14 – DISPLAY OF HOTLINE POSTER(S) (DEC 2007)

I.4 FAR 52.215-19 NOTIFICATION OF OWNERSHIP CHANGES (OCT 1997)

I.5 FAR 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR

2000)

I.6 FAR 52.222-2 PAYMENT FOR OVERTIME PREMIUMS (JUL 1990)

I.7 FAR 52.252-4 ALTERATIONS IN CONTRACT (APR 1984)

I.8 FAR 52.237-10 IDENTIFICATION OF UNCOMPENSATED OVERTIME (OCT

1997)

I.9 HHSAR 352.224-70 PRIVACY ACT (JAN 2006)

I.10 HHSAR 352.242-73 WITHHOLDING OF CONTRACT PAYMENTS (JAN 2006)

I.11 HHSAR 352.201-70 PAPERWORK REDUCTION ACT (JAN 2006)

I.12 HHSAR 352.203–70 ANTI-LOBBYING (JAN 2006)

I.13 HHSAR 352.239-73 ELECTRONIC INFORMATION AND TECHNOLOGY

ACCESSIBILITY (JAN 2010)

SECTION J - LIST OF ATTACHMENTS

J.1 STATEMENT OF WORK (SOW)

J.1.A. FEE-FOR-SERVICE SHARED SYSTEM BASE FUNCTIONS

J.1.A.A. BASE REPORTS PSCs/ZIPCs NEED

J.1.B. SOW APPENDICES – INCLUDES: 1) KEY DEFINITIONS 2) ACRONYM LIST 3)

DATA RELEASE POLICIES AND PROCEDURES 4) FOIA POLICY AND

PROCEDURES

J.1.C. PERFORMANCE STANDARDS

J.2 DELIVERABLE SCHEDULE

J.3 SMALL BUSINESS SUBCONTRACTING PLAN

J.4 BILLING INSTRUCTIONS

J.5 GOVERNMENT FURNISHED PROPERTY

J.6 AWARD FEE PLAN

J.6.A. AWARD FEE PLAN TEMPLATE

J.7 BASIS OF ESTIMATE*

J.8 PAST PERFORMANCE QUESTIONNAIRE*

J.9 COST PROPOSAL INSTRUCTIONS*

J.10 CLIN SUMMARY TEMPLATE*

J.11 CLIN 0001 COST PROPOSAL TEMPLATE – IMPLEMENTATION*

J.12 CLIN 0002 COST PROPOSAL TEMPLATE – BASE PERIOD*

J.13 CLIN 0003 COST PROPOSAL TEMPLATE – OPTION YEAR 1*

J.14 CLIN 0004 COST PROPOSAL TEMPLATE – OPTION YEAR 2*

J.15 CLIN 0005 COST PROPOSAL TEMPLATE – OPTION YEAR 3*

J.16 CLIN 0006 COST PROPOSAL TEMPLATE – OPTION YEAR 4*

J.17 CLIN 0007 COST PROPOSAL TEMPLATE – CLOSE OUT*

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J.18 PROPOSAL CHECKLIST*

J.19 NON-DISCLOSURE STATEMENT*

J.20.A. WORKLOAD IMPLEMENTATION HANDBOOK – MAC TO MAC*

J.20.B. WORKLOAD CLOSEOUT HANDBOOK – MAC*

J.21 INFORMATION SECURITY ATTESTATION*

J.22 CORPORATE EXPERIENCE ATTESTATION*

J.23 COMPLIANCE ATTESTATION

J.24 DIRECTIONS TO CENTAL OFFICE*

J.25 PROPOSAL ASSUMPTIONS*

J.26 CONTRACTOR FURNISHED PROPERTY

J.27 CONTRACTING GUIDE FOR CONTRACT OF GOV’T PROPERTY (DEC 2008)

J.28 STAFFING MATRIX*

J.29 SERVICE CENTER MATRIX

J.30 CASH COLLECTION WORKSHEET – HIGLAS USERS*

J.31 REPORTABLE EVENTS*

SECTION K - REPRESENTATIONS, CERTIFICATIONS, AND OTHER

STATEMENTS OF OFFERORS OR QUOTERS

K.1 TO BE COMPLETED BY THE OFFEROR: [THE REPRESENTATIONS AND

CERTIFICATIONS MUST BE EXECUTED BY AN INDIVIDUAL AUTHORIZED

TO BIND THE OFFEROR]

K.2 FAR 52.204-7 CONTRACTOR CENTRAL REGISTRATION (CCR) (FEB 2012)

K.3 CONTRACTOR PERFORMANCE ASSESSMENT REPORTING SYSTEM (CPARS)

K.4 FAR 52.204-8 ANNUAL REPRESENTATIONS AND CERTIFICATIONS (MAY

2012)

K.5 FAR 52.209-5 CERTIFICATION REGARDING RESPONSIBILITY MATTERS

(APR 2010)

K.6 FAR 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (FEB

2012)

K.7 FAR 52.215-6 PLACE OF PERFORMANCE (OCT 1997)

K.8 FAR 52.230-1 COST ACCOUNTING STANDARDS NOTICES AND

CERTIFICATION (MAY 2012)

K.9 FAR 52.230-7 PROPOSAL DISCLOSURE – COST ACCOUNTING PRACTICE

CHANGES (APR 2005)

K.10 FINANCIAL INFORMATION

SECTION L - INSTRUCTIONS, CONDITIONS AND NOTICES TO OFFERORS

L.1 FAR 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE

(FEB 1998)

L.2 NORTH AMERICAN INDUSTRY CLASSIFICATION SYSTEM (NAICS) CODE

AND SMALL BUSINESS STANDARD

L.3 FAR 52.216-1 TYPE OF CONTRACT (APR 1984)

L.4 FAR 52.233-2 SERVICE OF PROTEST (SEP 2006)

L.5 SMALL BUSINESS SUBCONTRACTING PLAN

L.6 INTENT TO SUBMIT A PROPOSAL AND SOLICITATION QUESTIONS

L.7 PROPOSAL SUBMISSION AND DELIVERY

L.8 GENERAL INSTRUCTIONS

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L.9 PROPOSAL ASSUMPTIONS

L.10 COMMUNICATIONS PRIOR TO CONTRACT AWARD

L.11 VOLUME I - WRITTEN TECHNICAL PROPOSAL ORGANIZATION

L.12 VOLUME I – WRITTEN TECHNICAL PROPOSAL INSTRUCTIONS (limit of 60 pages)

L.13 VOLUME II – BUSINESS PROPOSAL ORGANIZATION

L.14 VOLUME II - GENERAL BUSINESS PROPOSAL INSTRUCTIONS

L.15 VOLUME III – CONFLICT OF INTEREST PROPOSAL ORGANIZATION

L.16 VOLUME III – CONFLICT OF INTEREST PROPOSAL INSTRUCTIONS

L.17 ORAL PRESENTATION INSTRUCTIONS

L.18 FAR 52.215-20 REQUIREMENTS FOR COST OR PRICING DATA AND DATA

OTHER THAN COST OR PRICING DATA (OCT 2010) – ALT IV (OCT 2010)

L.19 FAR 52.252-3 ALTERATIONS IN SOLICITATION

L.20 SECTION 508 ACCESSIBILITY OF ELECTRONIC AND INFORMATION

TECHNOLOGY (EIT) TO FEDERAL EMPLOYEES AND THE GENERAL PUBLIC

WITH DISABILITIES

SECTION M - EVALUATION FACTORS FOR AWARD

M.1 GENERAL PROCEDURES

M.2 REVIEW OF ATTESTATIONS

Page | 3

SECTION B - SUPPLIES OR SERVICES AND PRICES/COSTS

B.1 BRIEF DESCRIPTION OF SERVICES

The purpose of this contract is to obtain a Medicare Administrative Contractor (hereinafter referred to as “the contractor” or “MAC”) to provide specified health insurance benefit administration services, including Medicare claims processing and payment services, in support of the Medicare program (also known as the Medicare fee-for-service, or FFS, program) for Jurisdiction K (formerly Jurisdictions 13 and 14). Jurisdiction K includes the following states:

New York, Connecticut, Massachusetts, Rhode Island, Vermont, Maine, and New Hampshire.

Jurisdiction K will also include the Home Health and Hospice work for Region A.

B.2 CONTRACT TYPE

CMS anticipates awarding a Cost-Plus-Award-Fee (CPAF) contract.

B.3 AWARD FEE

The amount of award fee the Contractor earns, if any, will be based on an evaluation by the Government of the contractor’s performance in accordance with the Performance Evaluation Award Fee Plan (see Attachment J-6). CMS Fee Determination Official (FDO) will determine the amount of award fee earned by the contractor for the evaluation period. The determination of the amount of the award fee for the evaluation period is a unilateral decision made solely at the discretion of the FDO. Upon receiving written notification from the FDO of the amount of award fee earned for the evaluation period, the Contractor may submit an invoice for the earned award fee. The Government may unilaterally change the Performance Evaluation Award Fee Plan at any time. However, any revisions to the evaluation factors in the Performance Evaluation Award Fee Plan shall be presented to the Contractor prior to the evaluation period in which it will be used. The award fee evaluations will be performed on an annual basis with the actual evaluation taking place in the month immediately following the evaluation period. The award fee available for each period shall be a portion of the total award fee pool available for the entire contract period (see section G.23).

*Note: A sample Performance Evaluation Award Fee Plan (see Attachment J-6) is provided.

The final Performance Evaluation Award Fee Plan will be provided at time of contract award.

B.4 ESTABLISHED COST AND AWARD FEE

The estimated cost of this contract is $TBD. The base fee is $TBD. The maximum available award fee is $TBD. Total cost plus base fee plus award fee is $TBD.

B.5 TASK DIRECTIVES

The Contracting Officer may use individual Task Directives with specifically defined scopes and schedules to direct the contractor to perform special projects. Task Directives may also be issued to request a special administrative or user support services project. This mechanism will be used on a project-by-project basis and will be incorporated into the contract through the Changes clause (FAR 52.243-2 Alternate 1).

Page | 4

Task Directives issued under this contract may be fixed price or cost reimbursement. The contractor is required to establish separate cost accounts for each Task Directive issued and to segregate those costs in their vouchers.

B.6 SCHEDULE OF SUPPLIES/SERVICES

CONTRACT LINE ITEM

NUMBER

ESTIMATED

COST

BASE

FEE

AWARD

FEE

TOTAL

EST.

CPAF

EST.

COMP

CREDITS*

TOTAL CPAF

NET COMP

CREDITS

CLIN 0001

IMPLEMENTATION

TOTAL CLIN 0001 – A/B

MAC

IMPLEMENTATION

TBD TBD TBD TBD TBD TBD

Page | 5

CONTRACT LINE

ITEM NUMBER

ESTIMATED

COST

BASE

FEE

AWARD

FEE

TOTAL

EST.

CPAF

EST.

COMP

CREDITS*

TOTAL CPAF

CLIN 0002 – A/B MAC SERVICES/BASE

PERIOD OPERATIONS OPTION

TBD – TBD

0002AA Part A/Program Management TBD TBD TBD TBD TBD TBD

0002AB Part A/Medicare Integrity Program TBD TBD TBD TBD TBD TBD

0002AC Part B/Program Management TBD TBD TBD TBD TBD TBD

0002AD Part B/Medicare Integrity Program TBD TBD TBD TBD TBD TBD

0002AG Part A/ Program Management; Recovery Audit Contract (RAC)

TBD TBD TBD TBD TBD TBD

0002AH Part B/Program Management; Recovery Audit Contract (RAC)

TBD TBD TBD TBD TBD TBD

0002AJ HITECH Incentive Payments Resulting from

ARRA

TBD TBD TBD TBD TBD TBD

TOTAL CLIN 0002 – A/B

MAC SERVICES/BASE

PERIOD OPERATIONS

OPTION

Page | 6

CONTRACT LINE

ITEM NUMBER

ESTIMATED

COST

BASE

FEE

AWARD

FEE

TOTAL

EST.

CPAF

EST.

COMP

CREDITS*

TOTAL CPAF

CLIN 0003 – A/B MAC SERVICES/OPTION

YEAR 1

TBD – TBD

0003AA Part A/Program Management TBD TBD TBD TBD TBD TBD

0003AB Part A/Medicare Integrity Program TBD TBD TBD TBD TBD TBD

0003AC Part B/Program Management TBD TBD TBD TBD TBD TBD

0003AD Part B/Medicare Integrity Program TBD TBD TBD TBD TBD TBD

0003AG Part A/ Program Management; Recovery Audit Contract (RAC)

TBD TBD TBD TBD TBD TBD

0003AH Part B/Program Management; Recovery Audit Contract (RAC)

TBD TBD TBD TBD TBD TBD

0003AJ HITECH Incentive Payments Resulting from

ARRA

TBD TBD TBD TBD TBD TBD

TOTAL CLIN 0003 – A/B

MAC

SERVICES/OPTION

YEAR 1

Page | 7

CONTRACT LINE

ITEM NUMBER

ESTIMATED

COST

BASE

FEE

AWARD

FEE

TOTAL

EST.

CPAF

EST.

COMP

CREDITS*

TOTAL CPAF

CLIN 0004 – A/B MAC SERVICES/OPTION

YEAR 2

0004AA Part A/Program

0004AB Part A/Medicare Integrity Program TBD TBD TBD TBD TBD TBD

0004AC Part B/Program Management TBD TBD TBD TBD TBD TBD

0004AD Part B/Medicare Integrity Program TBD TBD TBD TBD TBD TBD

0004AG Part A/ Program Management; Recovery Audit Contract (RAC)

TBD TBD TBD TBD TBD TBD

0004AH Part B/Program Management; Recovery Audit Contract (RAC)

TBD TBD TBD TBD TBD TBD

0004AJ HITECH Incentive Payments Resulting from

ARRA

TBD TBD TBD TBD TBD TBD

TOTAL CLIN 0004 – A/B

MAC

SERVICES/OPTION

YEAR 2

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CONTRACT LINE

ITEM NUMBER

ESTIMATED

COST

BASE

FEE

AWARD

FEE

TOTAL

EST.

CPAF

EST.

COMP

CREDITS*

TOTAL CPAF

CLIN 0005 – A/B MAC SERVICES/OPTION

YEAR 3

0005AA Part A/Program

0005AB Part A/Medicare Integrity Program TBD TBD TBD TBD TBD TBD

0005AC Part B/Program Management TBD TBD TBD TBD TBD TBD

0005AD Part A/Medicare Integrity Program TBD TBD TBD TBD TBD TBD

0005AG Part A/ Program Management; Recovery Audit Contract (RAC)

TBD TBD TBD TBD TBD TBD

0005AH Part B/Program Management; Recovery Audit Contract (RAC)

TBD TBD TBD TBD TBD TBD

0005AJ HITECH Incentive Payments Resulting from

ARRA

TBD TBD TBD TBD TBD TBD

TOTAL CLIN 0005 – A/B

MAC

SERVICES/OPTION

YEAR 3

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CONTRACT LINE

ITEM NUMBER

ESTIMATED

COST

BASE

FEE

AWARD

FEE

TOTAL

EST.

CPAF

EST.

COMP

CREDITS*

TOTAL CPAF

CLIN 0006 – A/B MAC SERVICES/OPTION

YEAR 4

TBD

0006AA Part A/Program

0006AB Part A/Medicare Integrity Program TBD TBD TBD TBD TBD TBD

0006AC Part B/Program Management TBD TBD TBD TBD TBD TBD

0006AD Part B/Medicare Integrity Program TBD TBD TBD TBD TBD TBD

0006AG Part A/ Program Management; Recovery Audit Contract (RAC)

TBD TBD TBD TBD TBD TBD

0006AH Part B/Program Management; Recovery Audit Contract (RAC)

TBD TBD TBD TBD TBD TBD

0006AJ HITECH Incentive Payments Resulting from

ARRA

TBD TBD TBD TBD TBD TBD

TOTAL CLIN 0006 – A/B

MAC

SERVICES/OPTION

YEAR 4

CLIN 0007 – A/B MAC

CLOSEOUT TBD TBD TBD TBD TBD TBD

TOTAL CLIN 0007 – A/B

MAC CLOSEOUT TBD TBD TBD TBD TBD TBD

TOTAL – A/B MAC TBD TBD TBD TBD TBD TBD

*Refer to section G.19, Complimentary Credits.

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SECTION C - DESCRIPTION/SPECIFICATIONS/WORK STATEMENT

C.1 STATEMENT OF WORK

The Statement of Work (SOW) is provided under section J as Attachment J-1 and shall be made a part of the contract. The SOW takes precedence over the Internet Only Manuals and Paper- Based Manuals unless otherwise specified.

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SECTION D - PACKAGING AND MARKING

D.1 PACKAGING AND MARKING

All deliverables required pursuant to the terms of the contract must be shipped and marked in accordance with section F. Deliverables and any other requirements are set forth in Attachment J-2.

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SECTION E - INSPECTION AND ACCEPTANCE

E.1 FAR 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this address:

https://www.acquisition.gov/far/ .

Federal Acquisition Regulation (FAR) Clauses:

52.246-5 INSPECTION OF SERVICES – COST REIMBURSEMENT (APR 1984)

E.2 APPROVALS BY THE CONTRACTING OFFICER REPRESENTATIVE

All services or supplies to be delivered to the Contracting Officer Representative (COR) will be deemed to have been accepted 30 calendar days after date of delivery, except as otherwise specified in this contract, if written approval or disapproval has not been provided within such period. The COR's approval or revision to the services or supplies delivered shall be within the general scope of work stated in the contract.

E.3 INSPECTION OF SERVICES – COST-REIMBURSEMENT

A. All work included in this contract is subject to inspection and final acceptance by the Contracting Officer or the duly authorized representative of the Government.

B. The Government's COR is a duly authorized representative of the Government and is responsible for inspection and acceptance of all items required to be delivered by this contract.

C. Inspection and acceptance of the Contractor's performance shall be in accordance with FAR Clause 52.246-5 "Inspection of Services-Cost Reimbursement."

https://www.acquisition.gov/far/

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SECTION F - DELIVERIES OR PERFORMANCE

F.1 FAR 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this address:

https://www.acquisition.gov/far/ .

Federal Acquisition Regulation (FAR) Clauses:

52.242-15 STOP WORK ORDER (AUG 1989) ALTERNATE I (APR 1984)

F.2 PERIOD OF PERFORMANCE

The work and services hereunder shall be completed as follows:

The period of performance for completion of all work included in this contract shall be from the effective date of contract award through 12 months, plus four (4) one (1) year options as follows:

CLIN DESCRIPTION PERIOD OF PERFORMANCE

0001 Implementation Approximately 10.5 months from date of contract award*

0002 Option - Base Period Operations Up to 7 months after exercise of option*

0003 Option - Year 1 Operations 12 months from exercise of option

0004 Option - Year 2 Operations 12 months from exercise of option

0005 Option - Year 3 Operations 12 months from exercise of option

0006 Option - Year 4 Operations 12 months from exercise of option

0007 Option - Outgoing Contractor Workload Transition Activities

Not to exceed 6 months from exercise of option**

*CLIN 0001 and CLIN 0002 may be overlapping periods of performance.

**This option may be exercised approximately 6 months prior to the expiration of the current year of performance.

Note: The option periods delineated above are subject to the FAR option clauses incorporated in Section I of this contract.

https://www.acquisition.gov/far/

Page | 14

F.3 DELIVERABLES

a. The Deliverable Schedule is incorporated as Attachment J-2 and made a part of this contract.

b. All deliverables required pursuant to the terms of this contract shall be packaged, marked and shipped in accordance with U.S. Government specifications. The Contractor shall guarantee that all required materials shall be delivered in immediate usable and acceptable condition.

c. The Contractor shall submit all required deliverables and reports in accordance with the attached schedule. Reports submitted under the contract shall reference and cite the contract number and identify CMS as the sponsoring agency.

d. Except for deliverables containing Protected Health Information (PHI), deliverables shall be submitted to CMS ART. Deliverables containing PHI, as defined in the Health Insurance Portability and Accountability Act (HIPAA), cannot be submitted in CMS ART and shall be submitted electronically using the Deliverable electronic mailbox. For deliverables containing PHI, the email shall include the deliverable title and reference number (if applicable) in the subject line. The contractor will copy the Contracting Officer’s Representative (COR) and Contract Specialist (CS) on all electronic and/or written correspondence. Once the deliverable is received, the Contractor will receive an automatic reply confirmation.

e. For the PHI deliverables, if unable to send electronically, the contractor is to send a notice to the JK MAC Deliverable electronic mailbox (CMS JK_MAC_Deliverables.cms.hhs.gov) stating the deliverable is being mailed in hardcopy, with an expected delivery date. The contractor will mail the hardcopy of the deliverable (excluding implementation deliverables) to the COR.

Hardcopy Implementation deliverables should be sent to the JK Implementation Lead.

Refer to JSM Number_10337 for further instructions.

f. Satisfactory performance under the contract shall be deemed to occur upon delivery and acceptance by the Contracting Officer, or the duly authorized representative, of the following items in accordance with the attached schedule J-2 (reports submitted under the contract shall reference and cite the contract number and identify CMS as the sponsoring agency):

The following abbreviations apply to schedule J-2:

IAW In accordance with NLT Not later than COB Close of business E Electronic copy (e-mail or diskette) H Hard copy CP Cover page COR Contracting Officer’s Representative CS Contract Specialist

Note: Additional deliverables may be assigned as part of the project planning process.

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Individual projects may be released on a flow basis, as necessary by the direction of the Contracting Officer’s Representative (COR).

Addressees:

CONTRACTING OFFICER’S REPRESENTATIVE (COR)

TBD

CONTRACTING OFFICER (CO)

Centers for Medicare & Medicaid Services Office of Acquisition and Grants Management Division of Eastern Medicare Administrative Contracts Attn: Bridget Hamel, Mail Stop B2-14-21 7500 Security Boulevard Baltimore, MD 21244-1850

(410) 786-0185 Email: Bridget.Hamel@cms.hhs.gov

CONTRACT SPECIALIST (CS)

Centers for Medicare & Medicaid Services Office of Acquisition and Grants Management Division of Eastern Medicare Administrative Contracts Attn: Tasha Logan , Mail Stop B2-14-21 7500 Security Boulevard Baltimore, MD 21244-1850

(410) 786-0219 Email: Tasha.Logan@cms.hhs.gov

For the PHI Deliverables, the mailbox address is as follows:

Deliverables email: JK_MAC_Deliverables@cms.hhs.gov

All electronic files shall be submitted in a format that is compatible with Microsoft Office PC-based software. As this requirement is subject to change, the contractor shall be able to adapt to any new CMS standard in order to submit deliverables. Unless specifically denoted as “workday(s),” all timeframes are in calendar days, calendar weeks, calendar months, etc. after the effective date of the contract.

mailto:Bridget.Hamel@cms.hhs.gov mailto:Tasha.Logan@cms.hhs.gov

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SECTION G - CONTRACT ADMINISTRATION DATA

G.1 ACCOUNTING AND APPROPRIATION DATA

(To be incorporated at time of award)

G.2 PAYMENT, SELECTED ITEMS OF COST REIMBURSEMENT CONTRACTS

A. Travel Costs (Including Foreign Travel)

The Contractor shall be reimbursed for travel costs in accordance with FAR 31.205-46.

B. Per Diem

Expenses for subsistence and lodging shall be reimbursed to the Contractor only to the extent where overnight stay is necessary for performance under this contract. Incurred costs shall be considered to be reasonable and allowable only to the extent that they do not exceed, on a daily basis, the maximum per diem rates in effect at the time of travel as set forth in the Federal Travel Regulations. See FAR 31.205-46(2).

C. Cost of Materials

The cost of materials furnished or used under this contract shall be reimbursed in accordance with paragraph (b) of the clause entitled "Allowable Cost and Payment (FAR 52.216-7) (DEC 2002)" for cost reimbursement contracts. Expendable material costs for items such as office supplies, report paper, etc., and tools of the trade shall be priced in accordance with the Contractor’s approved accounting practices or standards, as applicable. The Contractor shall be required to support all material costs claimed.

D. Relocation Costs

In accordance with FAR 31.205-35, relocation costs, either direct charged or included in the contractor's indirect cost pools, associated with an individual not completing a term of service equal to one year working under this contract shall be an unallowable cost under this contract.

G.3 DISSEMINATION, PUBLICATION & DISTRIBUTION OF INFORMATION

A. Data and information either provided to the Contractor, or to any subcontractor or generated by activities under this contract or derived from research or studies supported by this contract, shall be used only for the purposes of the contract. It shall not be duplicated, used or disclosed for any purpose other than the fulfillment of the requirements set forth in this contract. This restriction does not limit the contractor's right to use data or information obtained from a non-restrictive source. Any questions concerning "privileged information" shall be referred to the Contracting Officer.

B. Some data or information may require special consideration with regard to the timing of its disclosure so that preliminary findings which could create erroneous conclusions are not stipulated. Also, some data or information, which relate to policy matters under

Page | 17 consideration by the Government, may also require special consideration with regard to the timing of its disclosure so that the open and vigorous debate, within the government, of possible policy options is not damaged.

C. Any questions about use or release of the data or information or handling of material under this contract shall be referred to the Contracting Officer who must render a written determination. The Contracting Officer's determinations will reflect the results of internal coordination with appropriate program and legal officials.

D. Written advance notice of at least forty-five (45) days shall be provided to the Contracting Officer of the Contractor's desire to release findings of studies or research or data or information described above. If the Contractor disagrees with the Contracting Officer's determination, and if this disagreement cannot be settled by the Contractor and the Contracting Officer in a mutually satisfactory manner, then the issue will be settled pursuant to the "Disputes" clause.

E. Any presentation of any report, statistical or analytical material based on information obtained from this contract shall be subject to review by the COR before dissemination, publication, or distribution. Presentation includes, but is not limited to, papers, articles, professional publications, speeches, testimony or interviews with public print or broadcast media. This does not apply to information that is requested pursuant to the Federal Freedom of Information Act.

F. The COR review shall cover accuracy, content, manner of presentation of the information, and also the protection of the privacy of individuals. If the review finds that the Privacy Act is or may be violated, the release/use of the presentation shall be denied until the offending material is removed or until the Contracting Officer makes a formal determination, in writing, that the privacy of individuals is not being violated.

G. If the review shows that the accuracy, content, or manner of presentation is not correct or is inappropriate in the light of the purpose of the project, the COR shall immediately inform the Contractor, in writing, of the nature of the problem. If the Contractor disagrees, the COR may insist that the presentation contain, in a manner of equal importance, materials, which show the government's problem with the presentation.

H. The Contractor agrees to acknowledge support by CMS whenever reports of projects funded, in whole or in part, by this contract are published in any medium. The Contractor shall include in any publication resulting from work under this contract, an acknowledgment substantially, as follows:

"The analyses upon which this publication is based were performed under Contract Number ________________________, entitled, A/B MAC Jurisdiction K.”

Sponsored by the Centers for Medicare & Medicaid Services, Department of Health & Human Services."

Any deviation from the above legend shall be approved, in writing, by the Contracting Officer.

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G.4 SUBCONTRACTING REPORTING

The Contractor shall report all subcontract awards to small, small disadvantaged, women-owned, HUBZones, veteran-owned and service-disabled veteran-owned small business concerns. The reports shall be prepared using the electronic Subcontracting Reporting System (eSRS) via the internet at http://www.esrs.gov. The Individual Subcontracting Report (ISR), formerly SF294, shall be submitted semi-annually for the periods of October 1 through March 31 and April 1 through September 30. The Summary Subcontracting Report (SSR), formerly, SF 295 shall be submitted annually for the period of October 1 through September 30. The report(s) shall be delivered not more than thirty (30) calendar days following the close of each period covered.

G.5 SUBCONTRACTING PROGRAM FOR SMALL AND SMALL

DISADVANTAGED BUSINESSES

The contractor hereby agrees to implement the conditions of the subcontracting plan submitted and approved by the Contracting Officer for this contract. The Small Business and Small Disadvantaged Business Subcontracting Plan is hereby incorporated and made a part hereof as Attachment J-3 of this contract.

G.6 SUBCONTRACT CONSENT

A. To facilitate the review of a proposed subcontract by the COR and the Contracting Officer, the Contractor shall submit the information required by FAR Clause 52.244-2, "Subcontracts (JUN 2007)" to the Contracting Officer. The Contracting Officer shall review the request for subcontract approval and the COR's recommendation and advise the Contractor of his/her decision to consent or object to the proposed subcontract, in writing.

B. Consent is hereby given to issue the following subcontract(s):

(To be completed at time of award, if applicable)

G.7 SERVICE OF CONSULTANTS/ SUBCONTRACTORS

A. For the purposes of this contract, consultants are considered subcontractors. The Contractor shall follow the procedures established in FAR Clause 52.244-2.

B. The Contractor shall be reimbursed at the rates(s) set forth below for services provided by consultants in connection with this contract:

Name Rate Per Hour Number of Hours Total Cost Not to Exceed

(To be completed at time of award, if applicable)

G.8 GOVERNMENT REPRESENTATIVES

The following CMS personnel are the points of contact for this contract:

http://www.esrs.gov/

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CONTRACTING OFFICER REPRESENTATIVE (COR)

Centers for Medicare & Medicaid Services Attn: TBD

CONTRACTING OFFICER (CO)

Office of Acquisition and Grants Management Division of Eastern Medicare Administrative Contracts Attn: Bridget Hamel, Mail Stop B2-14-21 7500 Security Boulevard Baltimore, MD 21244-1850

(410) 786-0185 Email: Bridget.Hamel@cms.hhs.gov

CONTRACT SPECIALIST (CS)

Office of Acquisition and Grants Management Division of Eastern Medicare Administrative Contracts Attn: Tasha Logan, Mail Stop B2-14-21 7500 Security Boulevard Baltimore, MD 21244-1850

(410) 786-0219 Email: Tasha.Logan@cms.hhs.gov

G.9 CONTRACTING OFFICER RESPONSIBILITY

In accordance with FAR 52.202-1 Definitions (JUL 2004) and FAR 2.101Definitions, the term ‘Contracting Officer’ means a person with the authority to enter into, administer, and/or terminate contracts and make related determinations and findings. The term includes certain authorized representatives of the Contracting Officer acting within the limits of their authority delegated by the Contracting Officer.

Notwithstanding any of the other provisions of this Contract, the Contracting Officer shall be the ONLY individual authorized to:

A. Enter into and commit/bind the Government by contract for supplies or services;

B. Accept nonconforming work or waive any requirement of this Contract;

C. Authorize reimbursement to the Contractor for any costs incurred during the performance of the Contract; and D. Modify any term or condition of this Contract, i.e., make any changes in the SOW;

modify/extend the period of performance; change the delivery schedule.

G.10 CONTRACTOR PROJECT MANAGER

(To be completed at time of award) will serve as Project Manager. It will be his/her responsibility to obtain the staff necessary and to direct the work for the conduct of this project.

The Project Manager shall also keep the Government COR and Business Function Leads (BFLs) mailto:Tasha.Logan@cms.hhs.gov

Page | 20 up to date regarding all technical, cost and schedule-related issues. The Government reserves the right to approve any necessary successor to be designated as Project Manager.

G.11 CONTRACTING OFFICER REPRESENTATIVE

A. The following COR(s) will represent the Government for the purpose of this contract:

Contracting Officer’s Representative (COR) Centers for Medicare & Medicaid Services Center for Medicare Medicare Contractor Management Group Attn: TBD, Mail Stop TBD 7500 Security Boulevard Baltimore, MD 21244-1850

(410) 786-xxxx Email: xxxxx@cms.hhs.gov

B. The COR is responsible for: (1) monitoring the Contractor's technical progress, including the surveillance and assessment of performance and compliance with all substantive project objectives; (2) interpreting the SOW and any other technical performance requirements; (3) performing technical evaluation as required; (4) performing technical inspections and acceptances required by this contract; (5) assisting in the resolution of technical problems encountered during performance; (6) providing technical direction in accordance with section G.12; and (7) reviewing of invoices/vouchers.

C. The COR does not have the authority to act as an agent of the Government under this contract. Only the Contracting Officer has the authority to: (1) direct or negotiate any changes in the SOW; (2) modify or extend the period of performance; (3) change the delivery schedule; (4) authorize reimbursement to the Contractor any costs incurred during the performance of this contract; or (5) otherwise change any terms and conditions of this contract.

D. The Government may unilaterally change its COR designation.

The COR may be assisted by the BFL. The BFLs will not have the authority to provide technical direction in accordance with section G.12, however, they may be responsible for: (1) monitoring the Contractor's technical progress, including the surveillance and assessment of performance and compliance with all substantive project objectives; (2) interpreting the SOW and any other technical performance requirements; (3) performing technical evaluation as required; (4) performing technical inspections and acceptances required by this contract; (5) assisting in the resolution of technical problems encountered during performance; and (6) reviewing of invoices/vouchers.

G.12 TECHNICAL DIRECTION

A. Performance of the work under this contract shall be subject to the technical direction of the COR. The term "technical direction" is defined to include, without limitation, the following:

mailto:xxxxx@cms.hhs.gov

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(1) Directions to the Contractor which redirect the contract effort, shift work emphasis between work areas or tasks, require pursuit of certain lines of inquiry, fill in details or otherwise serve to accomplish the contractual SOW.

(2) Provision of information to the Contractor, which assists in the interpretation of drawings, specifications, or technical portions of the work description.

(3) Review and, where required by the contract, approval of technical reports, drawings, specifications, and technical information to be delivered by the Contractor to the Government under the contract.

B. Technical direction must be within the general Scope of Work stated in the contract. The COR does not have the authority to and may not issue any technical directions which:

(1) Constitutes an assignment of additional work outside the general Scope of Work of the contract.

(2) Constitutes a change as defined in FAR clause 52.243-2 entitled "Changes - Cost Reimbursement."

(3) In any manner causes an increase or decrease in the total estimated contract cost, fixed-fee, or the time required for contract performance.

(4) Change any of the expressed terms, conditions, or specifications of the contract.

C. All technical direction shall be issued in writing by the COR or if provided verbally, shall be confirmed by him/her in writing within five working days after issuance.

D. The Contractor shall proceed promptly with the performance of technical direction duly issued by the COR in the manner prescribed by this article and within his/her authority under the provisions of this article.

E. If, in the opinion of the Contractor, any instruction or direction issued by the COR is within one of the categories as defined in (l) through (4) of Section G.12, B., above, the Contractor shall notify the Contracting Officer in accordance with FAR 52.243-2, Changes-Cost Reimbursement Alt I.

G.13 DESIGNATION OF PROPERTY ADMINISTRATOR

The CMS Property Administrator, Administrative Services Group, Office of Property and Space Management at (410) 786-6462, is hereby designated the property administration function for this contract. The Contractor agrees to furnish information regarding Government Property to the Property Administrator in the manner and to the extent required by the Property Administrator, his duly designated successors, and in accordance with FAR Part 45 and Department of Health & Human Services (DHHS) Manual entitled, Contracting Guide for Contract of Government Property, (DEC 2008). This manual is provided under section J, Attachment J-26 and is hereby made part of this contract.

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G.14 GOVERNMENT FURNISHED PROPERTY

Pursuant to FAR Part 45 – Government Property and FAR Clause 52.245-1, Government Property (AUG 2010), of this contract, the Government will furnish for performance of the work required herein a list of property, which is provided under Attachment J-5 and is hereby made part of this contract.

G.15 CONTRACTOR FURNISHED PROPERTY

A list of Contractor Furnished Property is incorporated as Attachment J-26 (To be completed at time of award).

G.16 INVOICING AND PAYMENT (See Attachment J-4, Billing Instructions)

A. Submission of invoices for payment:

B. Once each month following the effective date of this contract, the Contractor may submit to the Government an invoice for payment, in accordance with FAR Clause 52.216-7 “Allowable Cost & Payment.” The Government shall make provisional payments on all invoices pending the completion of a final audit of the Contractor’s cost records.

(1) To expedite payment, invoices shall be prepared and submitted as follows:

(2) Original and four (4) copies shall be submitted to the address below:

Department of Health & Human Services

OFM/Division of Accounting Operations P.O. Box 7520 7500 Security Boulevard Baltimore, MD 21207-0520

--For overnight delivery:

Department of Health & Human Services

OFM/Division of Accounting Operations 7500 Security Boulevard/Mailstop: C3-11-03 Baltimore, MD 21244-1850

(3) One (1) copy shall be sent to the COR.

(a) Content of invoice:

(b) Contractor’s name;

(c) Invoice date;

(i) Contract number;

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(ii) Description, CLIN, cost or price and quantity of property and/or services actually delivered or rendered, breakout of hours incurred by labor category;

(iii) Travel cost shall be broken down to include number of trips, numbers and name of individuals per trip, mode of transportation, mileage charge and length of stay;

(iv) Other substantiating documentation or information as required by the contract;

(v) Name, title, phone number and complete mailing address of responsible official to whom payment is to be sent and notify in the event of defective invoice; and

(vi) Period of performance or delivery date of goods or services provided.

C. Invoice payment

Reimbursement for invoices submitted under this contract shall be made not later than thirty (30) days after receipt of the original invoice from the Contractor in the copies requested at the paying office designated above.

Payment will be authorized after the Division of Accounting has received a certification of the invoice by the COR and verification that the invoice amount is consistent with the schedule set forth in section B of this contract. Any discrepancies determined as a result of the audit could delay the processing of the invoice and may result in the invoice being returned to the Contractor for corrections. Inquiries relating to payments should be directed to the Office of Financial Management/Accounting Management Group, ATTN:

Janet Kahler on (410) 786-5427 or Suzanne Turgeon on (410) 786-1924.

D. Interest on overdue payment

The Prompt Payment Act, Public Law 97-177 (96 Stat.85.31 U.S.C. 1801) and FAR 52.232-25 Prompt Payment (OCT 2008), is applicable to payments under this contract and requires the payment of interest on payments made more than 30 days after receipt of an invoice by the Division of Accounting Operations, pursuant to FAR 32.907.

Determinations of interest due will be made in accordance with the provisions of the Prompt Payment Act and Office of Management and Budget Circular A-125.

G.17 SEPARATION OF MEDICARE INTEGRITY PROGRAM AND PROGRAM

MANAGEMENT FUNDING

Funding for Medicare Integrity Program activities under Section 1893 of the Social Security Act is derived from a different source than funding for the other functions (called “Program Management functions”) which the Contractor performs pursuant to the authority of Section 1874A of the Social Security Act. Therefore, separate accounts shall be designated for Medicare Integrity Program activities and the Program Management functions which the Contractor performs pursuant to the authority of Section 1874A. The Contractor shall separately account for costs incurred to perform Medicare Integrity Program activities and its Program Management

Page | 24 functions under this contract. In no event shall the Contractor apply funding which is designated for Medicare Integrity Program activities to costs incurred in performing its Program Management functions authorized by Section 1874A; similarly, the Contractor shall not apply funding designated for costs incurred in performing its Program Management functions under Section 1874A to Medicare Integrity Program activities.

G.18 SEPARATION OF TRUST FUND EXPENDITURES/ACCOUNTING FROM

ADMINISTRATIVE EXPENDITURES/ACCOUNTING

Any costs which are properly chargeable by a provider of services, physician, or supplier as benefit costs in accordance with Title XVIII of the Social Security Act, its implementing regulations and this contract, shall not be chargeable to this contract as administrative costs (i.e., either Medicare Integrity Program or Program Management costs). The Contractor shall separately account for benefit payments made by it from costs incurred to perform its Medicare Integrity Program activities and its Program Management functions under this contract.

G.19 COMPLEMENTARY CREDITS

The contractor shall separately account for complementary credits and reflect the current and cumulative totals on their monthly invoice. The estimated amounts for complementary credits shall be shown as a reduction to the total costs amount (i.e. after application of any fees) within each applicable CLIN. Complementary Credits for crossover claims will be accounted for on a cash basis.

G.20 METHOD OF PAYMENT

In accordance with FAR 52.232-33, Payment by Electronic Funds Transfer – Central Contractor Registration (OCT 2003), the Centers for Medicare & Medicaid Services (CMS) shall only make an electronic reimbursement/payment.

In accordance with FAR 52.204-7, Central Contractor Registration (FEB 2012), the contractor must register in the Central Contractor Registration (CCR) database.

The contractor shall notify CMS’ Division of Accounting Operations of all EFT and address changes in CCR via the following email address: CCRChanges@cms.hhs.gov.

G.21 CORRESPONDENCE PROCEDURES

To promote timely and effective administration, correspondence (except for invoices), submitted under this contact shall be subject to the following procedures:

A. Technical Correspondence - Technical correspondence (as used herein, this term excludes correspondence which proposes or otherwise involves waivers, deviations or modifications to the requirements, terms or conditions of this contract) shall be addressed to the COR with an informational copy of the basic correspondence to the Contracting Officer.

mailto:CCRChanges@cms.hhs.gov

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B. Other Correspondence - All other correspondence shall be addressed to the Contracting

Officer with an informational copy of the basic correspondence to the COR.

C. Subject Lines - All correspondence shall contain a subject line, commencing with the contract number and assigning consecutive numbers (serial numbers to permit accountability), as illustrated below:

EXAMPLE: Contract No. - 500-00-XXXX Sequence # - XX (YEAR) – XXXX Subject - Request for Subcontract Consent

G.22 DATA TO BE DELIVERED

Any working papers, interim reports, data provided by the Government or first produced by the Contractor under the contract or collected or otherwise obtained by the Contractor under the contract, or results obtained or developed by the Contractor (subcontractor or consultants) pursuant to the fulfillment of this contract are to be delivered, documented, and formatted as directed by the Contracting Officer in accordance with FAR 52.227-14 (DEC 2007) Alt

In addition, information and/or data, which are held by the Contractor related to the operation of their business and/or institution and which are obtained without the use of Federal funds, shall be considered "PROPRIETARY DATA" and are not "subject data" to be delivered under this contract.

G.23 PERFORMANCE EVALUATION AWARD FEE PLAN

A sample Performance Evaluation Award Fee Plan upon which the determination of award fee is based is identified herein as Attachment J-6.* The award fee plan contains details with respect to how the Contractor will be evaluated periodically for its performance. The general criteria upon which the Contractor will be evaluated, substandard, expected or superior in performing each function includes such elements as efficiency, ingenuity, responsiveness, perceptiveness, thoroughness, timeliness, and resourcefulness.

The Contractor may submit self-evaluations of performance for each period under…