RFP-CMS-2015-8A-0101.docx
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Contents
| SECTION B – SUPPLIES OR SERVICES AND PRICES/COSTS | 2 | |
| B.1 | Description of Services | 2 |
| B.2 | Type of Contract | 2 |
| B.3 | Firm-Fixed-Price (FFP) | 2 |
| B.4 | Schedule for Payment for Fixed Price | 3 |
| B.5 | Transition Services | 3 |
| SECTION C – STATEMENT OF WORK/SERVICES | 4 | |
| C.1. | CONTRACT PURPOSE | 4 |
| C.2. | BACKGROUND AND OVERVIEW | 4 |
| C.3 | STATEMENT OF WORK | 5 |
| SECTION D – PACKING AND MARKING | 20 | |
| D.1 | Packing, Marking and Shipping | 20 |
| SECTION E – INSPECTION AND ACCEPTANCE | 21 | |
| E.1 | Clauses Incorporated by Reference FAR 52.252-2 (FEB 1998) | 21 |
| E.2 | Acceptance by the Contracting Officer’s Representative | 21 |
| E.3 | Performance Improvement Plan (PIP) | 21 |
| SECTION F – DELIVERABLES OR PERFORMANCE | 22 | |
| F.1 | Acceptance of Deliverables | 22 |
| F.2 | Period of Performance | 22 |
| F.3 | Items to be Furnished and Delivery Schedule | 22 |
| SECTION G - CONTRACT ADMINISTRATION | 28 | |
| G.1 | Accounting Information – To be completed at time of award | 28 |
| G.2 | PAYMENTS - INVOICES (FIRM FIXED PRICE CONTRACTS) (AUG 2013) | 28 |
| G.3 | AUDIT OF HOURS | 30 |
| G.4 | CONTRACTING OFFICER’S REPRESENTATIVE (COR) | 30 |
| G.5 | TECHNICAL DIRECTION | 31 |
| G.6 | CONTRACTING OFFICER (CO) RESPONSIBILITY | 32 |
| G.7 | CORRESPONDENCE PROCEDURES | 32 |
| G.8 | SUBCONTRACT CONSENT | 33 |
| G.9 | USE OF GOVERNMENT DATA (REPORTS/FILES/COMPUTER TAPES OR DISCS) | 33 |
| G.10 | DISSEMINATION, PUBLICATION AND DISTRIBUTION OF INFORMATION | 34 |
| G.11 | WORKING PAPERS | 34 |
| G.12 | DATA TO BE DELIVERED | 34 |
| G.13 | PROPERTY ADMINISTRATION | 34 |
| G.14 | CONTRACTOR PERFORMANCE EVALUATION(S) | 35 |
| G.15 | ANNUAL WAGE DETERMINATIONS | 36 |
| SECTION H SPECIAL CONTRACT REQUIREMENTS | 37 | |
| H.1 | CONFLICT OF INTEREST | 37 |
| H.2 | HHSAR 352.242-70 KEY PERSONNEL (JAN 2006) | 48 |
| H.3 | HHSAR 352.224-70 PRIVACY ACT (JAN 2006) | 48 |
| H.4 | HIPPA BUSINESS ASSOCIATE CLAUSE (SEPT 2013) | 49 |
| H.5 | CMS INFORMATION SECURITY (APR 2013) | 55 |
| H.6 | APPROVAL OF CONTRACT ACQUIRED INFORMATION TECHNOLOGY | 56 |
| H.7 | SECTION 508 – ACCESSIBILITY OF ELECTRONIC AND INFORMATION TECHNOLOGY | 57 |
| H.8 | REHABILITATION ACT, SECTION 508, ACCESSIBILITY STANDARDS | 58 |
| H.9 | DATA USE AGREEMENT | 58 |
| H.10 | COSTS FOR CONFERENCES, MEETING AND RELATED TRAVEL | 58 |
| SECTION I - CONTRACT CLAUSES | 59 | |
| I.1 | FAR 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998) | 59 |
| I.2 | HHSAR 352-252-20 DEPARTMENT OF HEALTH AND HUMAN SERVICES ACQUISITION REGULATIONS (HHSAR) http://knownet.hhs.gov/acquisition/hhsar/default.html | 64 |
| I.3 | DEFINITIONS HHSAR 352.202-1 (JAN 2006) | 65 |
| I.4 | APPROVAL OF CONTRACT FAR 52.204-1 (DEC 1989) | 65 |
| I.5 | INCORPORATION BY REFERENCE OF REPRESENTATIONS AND CERTIFICATIONS FAR 52.204-19 (DEC 2014) | 65 |
| I.6 | UPDATES OF PUBLICLY AVAILABLE INFORMATION REGARDING RESPONSIBILITY MATTERS FAR 52.209-9 (JUL 2013) | 66 |
| I.7 | FAR 52.215-19 NOTIFICATION OF OWNERSHIP CHANGES (OCT 1997) | 67 |
| I.8 | Far 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000) | 67 |
| I.9 | FAR 52.219-17 Section 8(a) Award (DEC 1996) | 68 |
| I.10 | FAR 52.222-42 Statement of Equivalent Rates for Federal Hires (MAY 2014) | 69 |
| I.11 | FAR 52.232-40, Providing Accelerated Payment to Small Business Subcontractors (DEC 2013) | 69 |
| SECTION J LIST OF ATTACHMENTS | 70 | |
| SECTION K REPRESENTATIONS, CERTIFICATIONS, AND OTHER STATEMENTS OF OFFERORS | 71 | |
| K.1 | SAM Registration | 71 |
| K.2 | Annual Representations and Certifications FAR 52.204-8 (JUL2013) | 71 |
| K.3 | Proposal Disclosure – Cost Accounting Practice Changes FAR 52.230-7 (APR 2005) | 76 |
| K.4 | Certification of Proposal Preparation | 76 |
| K.5 | Valid Offer | 76 |
| K.6 | Representations and Instructions Financial | 77 |
| K.7 | Certificate of Current Cost or Pricing Data FAR 15.406-2 | 81 |
| K.8 | Certificate of Independent Price Determination FAR 52.203-2 (APR 1985) | 81 |
| K.9 | Certification Regarding Responsibility Matters FAR 52.209-5 (APR 2010) | 83 |
| K.10 | Place of Performance FAR 52.215-6 (OCT 1997) | 85 |
| K.11 | Small Business Program Representations FAR 52.219-1 (APR 2012) | 86 |
| SECTION L - INSTRUCTIONS, CONDITIONS, AND NOTICES TO OFFERORS | 91 | |
| L.1 | Solicitation Provisions Incorporated By Reference Far 52.252-1 (FEB 1998) | 91 |
| L.2 | FAR 52.215-1 Instructions to Offerors -- Competitive Acquisition (Jan 2004) | 91 |
| L.3 | Type of Contract FAR 52.216-1 (APR 1984) | 97 |
| L.4 | FAR 52.233-2 Service of Protest (SEP 2006) | 98 |
| L.5 | Section 508 Accessibility of Electronic and Information Technology (EIT) Compliance | 98 |
| L.6 | Representations and Certifications | 98 |
| L.7 | Solicitation Questions | 98 |
| L.8 | NAICS Code and Small Business Size Standard | 99 |
| L.9 | General Instructions | 99 |
| L.10 | Instructions to Offerors – System Award Management (SAM) | 100 |
| L.11 | Communication Prior to Contract Award | 100 |
| L.12 | General Instructions | 101 |
| L.13 | Proposal Format | 102 |
| L.14 | Proposal Instructions for Competitive Proposals | 103 |
| L.15 | Proposal Delivery | 115 |
| L.16 | General Proposal Instructions | 116 |
| SECTION M - EVALUATION FACTORS FOR AWARD | 117 | |
| M.1. | General | 117 |
| M.2 | Evaluation Factors | 118 |
| M.3 | Award/Selection Process | 122 |
End Stage Renal Disease Network CMS-2012-Contractor-DQC Firm Fixed Price (FFP) Renewal
RFP-CMS-2015-8A-0101: Inpatient Rehabilitation Facility (IRF), Long Term Care Facility (LTCH), and Hospice Quality Reporting Programs Analytics, Outreach, and Support Data Analysis iv
SECTION B – SUPPLIES OR SERVICES AND PRICES/COSTS
B.1 Description of Services
The purpose of this contract is to competitively award a 12 month base year contract plus two (2), one (1) year options, entitled: “Inpatient Rehabilitation Facility (IRF), Long Term Care Facility (LTCH), and Hospice Quality Reporting Programs Analytics, Outreach, and Support Data Analysis” to support Affordable Healthcare Act 3004 Program Support and Analysis.
This work pertains to support tasks needed for the programs created by Section 3004. Primary functions of this work include data analysis, support data validation methodologies, implement program evaluation activities, support public reporting of quality data, quality assurance, policy support, annual payment update determination, and technical assistance, and provide education and outreach to providers in support of the Long Term Care Hospital (LTCH), Inpatient Rehabilitation Facility (IRF), and Hospice quality reporting programs.
Additionally this support contract shall support stakeholders including, but not limited to providers, CMS, and other Federal partners to achieve success in the public reporting of quality measures and the direct improvement of quality of care. A support contractor for these programs is necessary so that CMS can continue performance measurement and quality improvement at the National level.
B.2 Type of Contract
The Government is awarding one (1) Firm-Fixed-Price (FFP) contract.
B.3 Firm-Fixed-Price (FFP)
A. The total firm fixed price for the base year is $TBD.
B. The total firm fixed price for Option 1 is $TBD.
C. The total firm fixed price for Option 2 is $TBD.
D. Reimbursement
Monthly vouchers shall be submitted in accordance with contract Section G.2, Payments - Vouchers.
E. Table of Total Estimated Firm Fixed Price
| The contractor shall provide the necessary personnel, materials, services, facilities and supplies(except as may be otherwise specified in the contract) and otherwise do all things necessary for, or incident to, the performance of the work as set forth in Section C, Statement of Work/Services. In consideration of successful contract performance, based on the evaluation criteria set forth in Section C, the contractor will be reimbursed as stated in B.4, Schedule for Payment for Fixed Price. | |
| B.4 | Schedule for Payment for Fixed Price |
The Government shall pay the contractor for performing this contract the fixed price specified in the schedule below. Payment of the fixed price will be made in accordance with the schedule provided below:
Base Year Performance Period
| Month | Payment | Total | |
| 1-11 | $TBD | $TBD | |
| 12 | $TBD | $TBD | |
| Total | $TBD |
A. Option 1
| Month | Payment | Total | |
| 13-23 | $TBD | $TBD | |
| 24 | $TBD | $TBD | |
| Total | $TBD |
B. Option 2
| Month | Payment | Total | |
| 25-35 | $TBD | $TBD | |
| 36 | $TBD | $TBD | |
| Total | $TBD |
B.5 Transition Services In the event that CMS requires transition services from the Contractor to a successor Contractor, CMS will request a separate technical and business proposal for these services. These services will be incorporated into the contract if applicable.
SECTION C – STATEMENT OF WORK/SERVICES
C.1. CONTRACT PURPOSE
This statement of work pertains to support needed for the programs created by Section 3004. Primary functions of this work include data analysis, support data validation methodologies, implement program evaluation activities, support public reporting of quality data, quality assurance, policy support, annual payment update determination, and technical assistance, and provide education and outreach to providers in support of the LTCH, IRF, and Hospice quality reporting programs. Additionally this contract shall support stakeholders including, but not limited to providers, CMS, and other Federal partners, to achieve success in the public reporting of quality measures and the direct improvement of quality of care. A support contractor for these programs is necessary so that CMS can continue performance measurement and quality improvement at the National level.
C.2. BACKGROUND AND OVERVIEW
The Centers for Medicare & Medicaid Services (CMS) is the Federal agency that administers the Medicare, Medicaid and Children’s Health Insurance Program (CHIP) programs. CMS seeks to promote higher quality and more efficient health care for Medicare beneficiaries, and our efforts are furthered by quality reporting programs coupled with public reporting of that information. Quality reporting programs already exist for various settings such as hospital inpatient services via the Hospital Inpatient Quality Reporting (IQR) Program, hospital outpatient services via the Hospital Outpatient Quality Data Reporting Program, and physicians and other eligible professionals’ services via the Physician Quality Reporting System (PQRS).
The work under this contract aligns with the work and mission under Section 3004 of Health Care Reform H.R. 3590, Quality Reporting for Long-Term Care Hospitals, Inpatient Rehabilitation Hospitals, and Hospice Programs amending Sections 1886(j)(m) and 1814(i) of the Social Security Act (42 U.S.C. 1395).
Quality reporting programs have been established for LTCH, IRF, and Hospice programs. Under the new quality reporting programs (QRP) for Hospices, IRFs, and LTCHs, providers began data collection on October 1, 2012 for payment determination in Fiscal Year 2014. CMS implemented these new programs with a very small number of quality measures for the first year. CMS has been expanding these QRPs and will continue to do so over the next several years.
Primary functions of this work include data analysis, support data validation methodologies, implement program evaluation activities, support public reporting of quality data, quality assurance, policy support, annual payment update determination, and technical assistance, and provide education and outreach to providers in support of the LTCH, IRF, and Hospice quality reporting programs. Additionally this support contract shall support stakeholders including, but not limited to providers, CMS, and other Federal partners, to achieve success in the public reporting of quality measures and the direct improvement of quality of care. A support contractor for these programs is necessary so that CMS can continue performance measurement and quality improvement at the National level.
C.3 STATEMENT OF WORK
Task 1: Task Management
The Contractor shall manage its work programs in support of this tasking and provide the Government necessary feedback regarding progress. The Contractor shall complete the following:
a) Kickoff Meeting:
Within ten (10) business days of the award of this task, the Contractor shall conduct an orientation meeting and briefing for CMS. The completion of this briefing shall result in (but is not limited to) the following:
1. Introduction of both Contractor staff and Government personnel performing work related to this contract
1. Brief overview of contract administration and reporting
1. Review by the Contractor of its understanding of the work to be accomplished under this Statement of Work (SOW) to ensure that all parties have a common understanding of the work to be performed and of the respective responsibilities and obligations of the parties to that end
1. Review by both CMS and the Contractor of the agreed-upon method to resolve, track, and report on issues
1. Delivery to the Contractor of any Government-Furnished Equipment, Information, or Materials unless specifically provided at contract award
1. Development of a list of any additional Government-Furnished Information required
The Contractor shall record and deliver minutes from this Kickoff, with an action item summary, within two (2) business days following the Kickoff Meeting.
Deliverable 1: Kickoff Meeting Deliverable 2: Kickoff Meeting Agenda and Meeting Materials Deliverable 3: Kickoff Meeting Minutes
b) Project Work Plan and Reporting The Contractor shall develop a proposed project work plan. The Contractor shall identify the resources that CMS needs to provide for this effort. CMS will approve the project work plan or provide comments for revision within ten (10) business days of delivery of the project plan. The project work plan may be revised as needed throughout the period of delivery; however, the project work plan may not be revised more than monthly, as mutually agreeable to CMS and the Contractor. In addition, the Contractor shall provide:
· An executive level dashboard for each program, the Contractor shall update each program’s dashboard on a monthly basis day of month as agreed upon by COR weekly schedule updates in Microsoft Project that will be included in CMS’ integrated program master schedule. This project schedule must be baseline, and shall include each task’s status notated as percent complete
· Maintain a tracking log of risks, issues, and action items
· Provide monthly status reports to ensure that the expenditure of resources is consistent with and will lead toward successful completion of all tasks within projected cost and schedule limitations.
· This detailed report shall contain all relevant progress information of the preceding month, progress expected during the next month, resources expended, any significant problems or issues encountered, recommended actions to resolve identified problems, and any variances from the proposed schedule.
· The report shall list all of the updates regarding each task, subtask, or deliverable and place emphasis on substantive information, progress, and changes to the SOW including:
· Achievements and accomplishments
· Upcoming milestones and events in the next four months
· Staffing changes
· Funds expended to date and remaining balance
· Summary report of the project progress (one to three pages) including the details of the monthly activities and accomplishments, financial overview, and upcoming timeline and deliverables.
Deliverable 4: Project Work Plan Deliverable 5: Executive Level Dashboard Deliverable 6: Monthly Status Report Deliverable 7: Monthly Financial Report
c) Weekly Contract Management Call The Contractor shall participate in a weekly contract management call with the CMS COR. The Contractor shall review the risks and issues tracking log at these weekly meetings, and shall document the meeting outcomes and action items
Deliverable 8: Weekly Contract Management Call
Task 2: Program Education and Communication
Education and Outreach are an important part of ensuring provider success with the Quality Reporting Programs. In order to ensure providers have the necessary information to successfully and accurately report data to CMS, the contractor shall:
a) Develop Provider Communications The Contractor shall support any new measures with development of domains (if established) and other activities relevant to the program requirements and needs, develop reports, develop supporting materials, provide input and recommendations, and participate in meetings as directed by the COR. Supporting materials include but are not limited to:
· email blasts
· website announcements
· frequently asked questions documents
· how to/quick reference guides
· newsletters
· ListServ support
· All content will be delivered in a 508 compliant format unless otherwise directed by the COR
Deliverable 9: Provider Communications
b) Arrange, facilitate, and conduct quarterly National conference calls/webinars.
The Contractor shall arrange National conference calls or webinars with providers by program area.
· Quarterly; (approximately 1 hour in length) 12 calls expected annually (4 IRF, 4 LTCH and 4 Hospice)
· Annually, to review both the Notice of Proposed Rulemaking and the Final Rule.
· 1 each for the NPRM and the Final Rule (approximately 1 hour in length) 6 calls expected annually
· Materials to be provided for each scheduled call to include but not limited to:
· Agenda
· PowerPoint Presentations if applicable
· A list of anticipated questions and responses
· Any calendar or schedule updates to be shared with the participants.
· Maintain, administer, and archive relevant list serve(s). The Contractor will be responsible for providing direction to participants on list serve etiquette, including support for how to subscribe, unsubscribe, and use the resource appropriately. The Contractor will monitor and troubleshoot the Listserv for technical issues as needed.
Deliverable 10: National Provider call/webinars Deliverable 11: Webinar/Provider call materials Deliverable 12: Listserv Status
c) Conduct semi-annual reviews of the program websites and provide recommendations and mockups including:
· Conduct an initial review of content on CMS.gov and QIES and create a survey of resources available to be downloaded.
· Inventory these resources in a spreadsheet that summarizes all attachments by URL location, summary of the purpose of that URL landing page, the intended audience, the downloadable file name, file type, associated program name, file content, file size, and a Contractor-provided recommendation for expiration date for the attachment and/or the date that the content must be updated to remain viable on the website. Report on activities.
· Maintain this spreadsheet and include it in a semi-annual report to CMS. The Contractor will use the recommended expiration/update field to suggest and to execute updates to resources or change how Web content is organized for the benefit of the users of the content, at CMS request or with CMS approval. The Contractor is expected to work with other CMS Contractors to facilitate these changes. Report on activities.
Deliverable 13: Report on website reviews
d) Maintain the Program Specific Websites for each program including;
· Ensure timely and accurate content
· Archive historical content
· Prepare and post new content for the website with CMS approval
Deliverable 14: Report on Program Website Updates
Task 3: Determining Payment Status for LTCH, IRF, and Hospice Quality Reporting Programs
In order to assist CMS in determining compliance with, the Contractor shall make arrangements to access this data or to receive a copy of the data in order to perform the analysis described in this SOW. The contractor shall:
a) Register for, obtain an account in QualityNet, and work with the Centers for Disease Control (CDC) to receive scheduled HAI reports. Within 60 days of the contract award
b) Develop and execute a process for combining the results of the HAI data from the CDC with the data being reported on the LTCH and IRF assessment instruments for the pressure ulcer quality measure in order to generate the compliance determination files
c) Reconcile quality reporting data, from separate data collection systems for each provider to determine compliance with CMS’ quality reporting requirements
d) Monitor facilities-submitted quality data to provide support to reporting facilities and CMS regarding the completeness of data submissions
e) Submit quarterly program level electronic lists, by program area, to CMS of facilities that have not submitted data: “Facilities Not Submitting Assessments”; “Facilities not Submitting Complete National Healthcare Safety Network (NHSN) data” and “Facilities Not Submitting CAHPS data” as appropriate. Additional lists may be identified or frequency of lists may be changed as requirements/measures change, for example a monthly report may be needed to ensure compliance with the first reporting quarter of a new measure, but may be decreased to quarterly after the initial measure submission. Examples of additional monthly lists may include: facilities that have closed, future close dates, and facilities that have not submitted records for validation. Examples of annual lists may include facilities at risk of not meeting the Annual Payment Update (APU).
Deliverable 15: Quarterly program level electronic lists, by program area
f) Facilities not meeting the assessments or NHSN requirements are to be contacted directly no later than 10 business days prior to the data submission deadline if an issue of incomplete data submission is detected. No outreach is required for facilities that request not to be contacted.
Deliverable 16: Report on Outreach.
g) Provide a list to CMS of facilities that meet or do not meet each APU criteria, the list should be provided in a tool that will allow CMS to view determinations by the APU requirements. The tool should identify the percentage of facilities that do not meet the APU for each criteria as stratified to allow CMS to determine the final decision list.
Deliverable 17: Quarterly APU list
h) Provide all communications with providers to the reconsideration contractor in a format agreed upon by both contractors. Provide any additional documentation the reconsideration contractor may need in order to make well informed decisions regarding reconsideration requests.
Deliverable 18: Weekly communications tracking log
i) Once all reconsideration requests are completed, provide CMS with a final file of providers that includes initial APU status, final APU status and all relevant information regarding any change in status.
Deliverable19: Final APU file Task 4: Help Desk Support
Maintain a Help Desk for questions that require knowledge of the quality reporting program compliance programs. The inquiries are provider-specific and often are related to calculation/submission of the quality measures. The Help Desk would be staffed with program subject matter experts, able to assistance with program compliance issues. The Contractor will work closely with other help desks that may also support different aspects of the programs such as quality measure support or data collection systems support. The contractor shall:
a) Monitor responses to providers including but not limited to:
· grammar
· spelling
· formality of style
· completeness and extent of addressing asked questions
· filtering of inappropriate and unrelated questions
· timeliness
· filtering of duplicate questions
b) Develop a tracking tool for questions/responses
c) Review and update answers contained in the tool either directly or with subject matter input, and
d) Develop timeline and format for reporting, to CMS or other contractors, questions received by the mailbox
e) Work with other contractors that may need regular, timely reporting of questions submitted to the mailbox, especially during high volume periods of reconsiderations
f) Assist CMS by drafting answers for CMS approval in response to questions received in the mailbox Ninety-five percent of public questions shall be answered and submitted to CMS for approval within 5 business days following receipt unless forwarded to another, appropriate party or as otherwise directed; questions that require forwarding to another party shall be forwarded within 5 business days. Problems and significant issues must be reported as soon as possible to the COR
g) Anticipate questions and prepare answers that may occur following an event (natural disaster or reconsideration period closure) or Program change.
h) Provide all operational support of the CMS-designated 3004 Program Reconsideration/Exemption/Exception Mailboxes questions
i) Work with CMS or designated security contractor and coordinate activities related to security issues
· All noted security issues must be discussed within 2 business days with notification of the COR
Deliverable 20: Monthly Report of Help Desk activities Task 5: Support for Validation of Facilities Quality Data
The 3004 QRP programs are intended to equip consumers with quality of care information to make more informed decisions about their health care. It is also intended to encourage facilities and clinicians to improve the quality of care provided to all patients. The data collected via the 3004 QRP programs will be reported to the public on a website similar to Hospital Compare. In order to ensure the data provided to the public is as useful as possible, CMS intends to validate the data. To support this validation, the contractor shall:
a) Review clinical information from approximately 500 medical records annually and compare the information to associated patient assessment. The records will be provided to the contractor for review. The contractor shall collect the match rate for each data element.
b) Using the results of prior medical record reviews, the Contractor shall propose validation scientifically valid methodologies that would apply to the entire assessment warehouse. These methodologies should include all data resources available to CMS including claims or site survey results. For each methodology proposed, the Contractor will develop a data collection plan that will include the following:
· Collaboration with CMS data partners to obtain access to data sources identified
· Method of submission and collection of data meeting required security protocols associated with exchange of sensitive data, if necessary
· Tracking, storage, and disposal of Program data and security protocols and ability to meet Federal and CMS information security requirements
· Researched data availability including HIPAA or System of Records applicability.
c) Support the warehouse validation proposals in the option years of the contract, including records sampling methodologies or data element matching algorithms.
Deliverable 21: Report on medical record reviews annually Deliverable 22: Propose validation methodologies by December 15th, 2015
d) Work with CMS and any designated CMS contractor(s) to develop and support the validation processes for Facilities data:
· Assist with the documentation and implementation of the validation sampling methodology, and verification of data completeness
· Track the ongoing validation process flow
· Conduct analyses of the validation results and create reports for CMS quarterly
· Work with the validation contractor to create documentation and conduct training for CMS and facilities on the validation processes, as needed. (2 per year expected)
· Provide technical assistance to assist facilities regarding validation concerns, such as data interpretation and notification if requested medical record documentation has not been received. Requests for technical assistance should be resolved within 2 business days. For instances involving medical record documentation requests, 5 business days is allowable.
Deliverable 23: Report summarizing activities and results quarterly Deliverable 24: Validation Training Materials
e) Provide claims matching, diagnosis matching and other data element matching to provide a first level assessment of data accuracy.
Deliverable 25: Report of the results of accuracy assessment completed via claims matching
Task 6: Internal and External Communications
Communication is the key to the success of the quality reporting programs. In order to ensure success the contractor shall:
a) Keep CMS informed of any external activities by State and National organizations as well as legislative initiatives that may impact quality reporting programs
b) Create and edit presentations for training sessions and external conferences.
c) Work in a close and coordinated manner with CCSQ’s Information Systems Group, Division of Quality Systems for Assessments and Surveys (DQSAS), DQSAS support Contractor, DCPAC’s project leads for QRPs, DCPAC’s Quality Measures Development Contractor, and personnel at the Centers for Disease Control supporting the NHSN
Deliverable 26: Report on internal and external communications Deliverable 27: Presentation
Task 7: Support for Data Collection; Public Reporting and Rule Writing:
CMS is required to establish procedures for making data available to the public and to ensure LTCH, IRF, and Hospice quality reporting programs have the opportunity to review that data prior to public reporting. Support CMS during the Notice of Proposed Rulemaking (NPRM) and the Final Rule processes specifically regarding the form and manner sections of the rules pertaining to LTCH, IRF, and Hospice quality reporting programs. To ensure the CMS meets these requirements, the contractor shall:
a) Provide subject matter expertise on all procedures necessary for providers and vendors to submit data to CMS including:
· Standard data format
· Import and export of data for the CMS data abstraction tool and the repository
· Access to reports and other resources on the QIES portal
· Coordination with other CMS contractors on responses to questions related to data submission
· Electronic specifications for measures submission as it becomes available
b) Assist with ongoing development and implementation of public reporting
c) The contractor shall assist in developing business requirements for reports and final data files for all quarterly and annual public reporting releases. This task includes, but is not limited to:
· Understanding the Program’s data requirements for publication
· Providing program specifications information for the development of business requirements
· Participating in multiple reviews of the requirements to assure accurate interpretation for implementation of the business requirements
d) The Contractor shall perform quality assurance testing of data prior to initial publication. This includes, but is not is not limited to:
· Preview file quality assurance testing; i.e., ensure the data received in the files from the designated contractor are displaying in the reports according to all approved business requirements, timeframes for testing to be established at a later date
· Testing that the provider demographic information is displaying correctly
· Coordinate efforts with other, designated CMS contractor
e) Provide technical/subject matter expertise for inclusion in regulatory preamble, regulatory text and in response to public comments submitted during the comment period after the publication of the Notices for Proposed Rulemaking
f) Maintain public comment/response artifacts
g) Provide direct rulemaking support through the preparation of timeline/submission deadline spreadsheets for the CMS COR
h) Prepare/assist in the development of briefing documents/materials
Deliverable 87: Public Reporting Support Deliverable 29: Rule Making Task 8: Administrative Tasks
The Contractor shall provide the following administrative support:
a) Assist the COR in Program Management
· Schedule weekly teleconference calls with CMS staff
· Provide a brief weekly summary of key issues/milestones in MS Project
· Prepare agendas, minutes and attachments
· Review the project timeline with the COR and update as necessary
· Serve as a point of contact as assigned and coordinate with other CMS contractors supporting the 3004 Programs, and other CMS components, such as CSIO and CM
· Assist with preparation of materials for use by the COR in presentations and other official communications, and
· Assist with making arrangements for any “in person” or VTC meetings
Deliverable 30: Program Management Summary
b) Prepare a final report summarizing activities over the contract, assessing the programs that includes description of what has worked, what has not worked, and recommendations for improvement
Deliverable 31: Prepare a final report summarizing activities over the contract
Task 9: Business Requirements and Business Process Modeling
The Contractor shall advise information technology contractors when policy changes may require further assessment of infrastructure to accommodate successful submissions.
a. The Contractor shall assist in developing and updating of IT business process models for the Quality Reporting for each systems release
b. Create business requirements for reports or other system changes necessary to support quality reporting program policy changes:
· participate in all business requirement elicitation, development and overview for finalization meetings for all system releases
Deliverable #32: Assist in developing business process models Deliverable #33: Assist or create business requirements for reports or other system changes necessary to support policy changes
Task 10: Data Analyses
The Contractor shall develop templates and data analytic methodologies necessary to produce reports to identify each provider’s compliance with CMS’ quality reporting requirements.
a) Perform quarterly and annual data analysis and create options papers to support future policy decisions for quality reporting
b) The Contractor shall provide ad hoc data analyses in support of Quality Reporting as requested by the COR, with appropriate negotiation of due dates based on existing workload under this Statement of Work
· Approximately 20 ad hoc analyses per year expected
Deliverable 34: Perform quarterly and annual data analysis to support policy decisions Deliverable 35: Provide Ad Hoc data analysis
Task 11: Monitoring and Evaluation
It is essential to perform monitoring and evaluation (M&E) activities over the life of a program to understand how well the program is meeting its intended goals and to discover any need for program improvement. Monitoring, defined as an “early warning” system, is implemented at the start of a program to track the positive, negative, or unanticipated effects of the program in real time. Evaluation is designed to determine the causes of outcomes. Statistical analysis is used to explain the significance of factors that may or may not influence the program’s ability to meet its stated goals. Evaluation is typically performed one year after the start of a program. The contractor shall:
a) Conduct meetings with CMS to discuss the CMS-provided M&E strategy and reconcile any questions regarding evaluation scope, data availability, and other considerations before conducting any monitoring or evaluation analysis.
b) Develop evaluation implementation plan
a. Scope of the evaluation
b. List of data elements required for evaluation
c. Performance measures and targets
d. A data collection plan
e. Data analysis techniques and methods that will be used for the evaluation
f. Report template, including a description of graphics and tables that will be used to communicate evaluation results.
c) Perform monitoring activities as described in the M&E strategy. These activities may include, but are not limited to:
· Analysis of providers meeting all, some, or none of the reporting requirements
· Analysis of provider progress towards performance measure targets, as defined in the M&E strategy
· Analysis of Program updates, challenges, and successes that impact provider participation and compliance
· Year-over-year trend analysis of outcomes relating to implemented quality measures
· Results of analysis reported to CMS no less than annually
Deliverable 36: Monitoring and Evaluation Implementation Plan Deliverable37: Monitoring and Evaluation Activities Task 12: Quality Measures Data Element Specifications Support
a. Work with other designated CMS Contractors, including, but not limited to, QIES system development contractors and the Measure Development Contractor(s) to provide input and expertise in the development, maintenance and/or revision of the standard specifications and documentation (including measures descriptions and data transmission specifications manual, data element definitions and dictionaries, draft versions of the manual, analytic flowcharts, and crosswalks with other measures) for:
1. Specified IRF, LTCH and Hospice quality of care measures
1. Potential new IRF, LTCH and Hospice measures within these topics and
1. Background and history sections
1. Missing data policy section (e.g., minimum case threshold)
1. Additional topics as directed by CMS
Deliverable 38: Provide input in data element specifications
Deliverable Requirements:
The Contractor shall provide the deliverables listed under the Schedule of Deliverables.
The Contractor shall submit documents formatted ready to print, in Times New Roman 12 point font. Except for drafts of letters, all files shall include header information with a succinct description of the file’s content, including the applicable program name fully spelled out the first time it is used, with the acronym in parentheses. File headers must also include a description of data presented, including the data source and the data time period (the time period must be specific to type of time period, i.e., encounter/discharge period, deadline, payment determination, etc.). Documents shall include footer information with the page number (out of total pages); contact information including a phone number for questions, and the date content was updated.
Contractors must use good grammar, clear writing, and order of ideas. This includes spelling out acronyms the first time they are used, writing in active voice, writing in plain language whenever possible, and clearly identifying time periods (e.g. discharge period, payment period, deadline, etc.). This also includes fully articulating the range of months and years in a quarterly period. (for example, a reference to Q1 – Q3, 2013 must also additionally provide parentheses to explain that this indicates the time period January 1, 2013 through September 30, 2013). All reports and analysis shall include a cover page with a brief description of the content, any relevant history that preceded the report and a full description of the methodology utilized to collect/analyze data. The methodology description shall be a dedicated section/paragraph of the cover letter and shall include such items as: all data sources, specific data elements (as appropriate), inclusion criteria, exclusion criteria, When using a CMS template, the Contractor shall ensure that it is using the most up to date version of the template.
Documents shall not include Contractor logos or business names. In education and outreach materials, the Contractor shall refer to itself by role, e.g. “IRF, LTCH or Hospice Support Contract” or another working title as approved by CMS.
Transition Plan:
The Contractor shall submit a transition plan containing:
· An approach for training or acquiring necessary staff to ensure that there is no lapse in technical and educational support to CMS and all stakeholders
· A mapping of staff into a skills matrix demonstrating those necessary for completing all tasks under the current and new contracts
· An approach for completing task order planning without affecting ongoing work and work management
· A quality assurance plan and performance metrics for the transition
· A scheduling of action items required to complete the transition, including a plan for management of all meetings, interviews, events/milestones, and exchanges of documents/ information.
C.3.1 KEY PERSONNEL QUALIFICATIONS
A. Project Director Demonstrates experience in project management that includes strategic planning, risk management, change management, data analyses, project management techniques and tools, defining project tasks and resource requirements, assembling and coordinating project staff, managing resource allocation, providing direction and support to a project team, coordination, implementation, execution, control and successful completion of projects. Has the proven ability to manage the contract at a strategic level including managing and navigating internal and external customer relationships. Demonstrates experience with having authority and accountability for meeting all contract deliverables and requirements within budget and the use of appropriate tools to track project deliverables such as project plans, and timelines. Demonstrates experience in the implementation and management of project changes, interventions to achieve project outputs, constant monitoring and report of project progress, and development of constructive reports defining project progress, problems and solutions. Possess both experience and skills in excellent oral and written communication spanning executives to the general public.
B. Project Specialist(s) Demonstrates experience in healthcare quality and the ability to motivate and lead a Task team to provide quality services and deliverables in a timely manner. Possess proven skill and experience in project management, managing people, project planning and coordination of daily activities, data analysis, constructive reporting, project management techniques and tools. Possess the skills and experience in critical-thinking, innovation, and problem-solving, recommending successful solutions, which include, but are not limited to the spread and implementation of such solutions for large scale change. Possess proven skills and experience in excellent oral and written communication spanning executives to the general public.
C. Communications Specialist Has the proven ability to build and maintain awareness of a program(s) by using a variety of communications tools (including social media) and tactical methods to spread information about a program and its work within local communities. Demonstrates experience in the development and execution of comprehensive and robust communication plans. Has the proven ability to conduct a communications health initiative that uses change management principles to move intended audiences from a current to a future state in ways that are efficient, sustainable, memorable, and actionable. Possess exceptional oral and written communication skills with the ability to leverage research and analysis. Demonstrates advanced writing, public relations, and technology skills to plan and execute professional communications.
D. Statistician Demonstrates experience in the healthcare industry and/or quantitative work experience related health research. Possess experience with outcomes research using administrative claims, survey data, or other patient level data, economic modeling, patient report outcomes, and health technology assessments are highly preferred. Has proven experience with manipulating and processing administrative data.
E. Clinical Records Reviewer
Possess experience in screening medical records against the criteria set forth in the SOW for initial decisions regarding accuracy of clinical data submissions. Demonstrates experience in entering clinical data or information into assessment software.
SECTION D – PACKING AND MARKING
D.1 Packing, Marking and Shipping
All deliverables shall be marked clearly using the contract number and shall follow any directions provided in Section F.3, Items to be Furnished and Delivery Schedule. All deliverables required under this contract shall be packaged, marked and shipped in accordance with the Statement of Work, and any additional requirements set forth by the COR in concert with the CO. The Contractor shall guarantee that all required materials shall be delivered in immediate usable and acceptable condition.
SECTION E – INSPECTION AND ACCEPTANCE
E.1 Clauses Incorporated by Reference FAR 52.252-2 (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: www.arnet.gov/far/fac.html
52.246-4 Inspection of Services – Fixed-Price (AUG 1996)
E.2 Acceptance by the Contracting Officer’s Representative
All items to be delivered to the COR will be deemed to have been accepted 45 calendar days after date of delivery, except as otherwise specified in this contract if written approval or disapproval has not been given within such period. The COR acceptance or revision to the items submitted shall be within the general scope of work in this contract.
E.3 Performance Improvement Plan (PIP)
Performance Improvement Plan is a description of the work to be performed by the Contractor to improve its performance and eliminate noted deficiencies. In the event a Contractor fails to meet its contract requirements for acceptability, a PIP may be required. The PIP is developed by the Contractor at the direction of the COR and must be approved by the COR and CO prior to implementation. Each Performance Plan will contain a specified timeframe in which the Contractor must correct the noted deficiency.
RFP-CMS-2015-8A-0101: Inpatient Rehabilitation Facility (IRF), Long Term Care Facility (LTCH), and Hospice Quality Reporting Programs Analytics, Outreach, and Support Data Analysis
SECTION F – DELIVERABLES OR PERFORMANCE
F.1 Acceptance of Deliverables
All required contract deliverables shall be reviewed by the COR to determine acceptance. The COR will respond, in writing, within 45 days of receipt of any contract deliverable indicating if final acceptance has been granted. If deficiencies in the Contractor’s deliverable are identified, the COR shall provide feedback to the Contractor prior to the 45 day timeframe for final acceptance. If the Contractor does not received a written indication from the COR within the 45 days, then the Contractor shall consider the deliverable to be accepted. The Contractor is responsible for ensuring the COR is in receipt of the deliverables. Receipt can be acknowledged in any form of writing (mail or electronic). The 45 day timeframe begins on receipt of deliverable, not acknowledgment of receipt.
F.2 Period of Performance
The period of performance is a base period of twelve (12) months from the date of award with two (2) – one (1) year option periods. The Contractor shall commence work immediately upon notice of award.
F.3 Items to be Furnished and Delivery Schedule Patient Protection and Affordable Care Act Section 3004 Program Support and Analysis
The Contractor shall submit all required reports and deliverables in accordance with the following schedule:
| COR = Contracting Officer’s Technical Representative |
| HC = hard copy |
| EC = electronic copy |
| Task # |
| Deliverable # |
| Deliverable |
| Format |
| Due Date |
| Base Year |
| Option Year 1 |
| Option Year 2 |
| Task 1.a |
| 1 |
| Kickoff Meeting |
| In person or by teleconference |
| Within 10 business days of the contract award |
| Yes |
| No |
| No |
| Task 1.a |
| 2 |
| Kickoff Meeting Agenda and Meeting Materials |
| EC to COR |
| 2 business days prior to the Kickoff Meeting |
| Yes |
| No |
| No |
| Task 1.a |
| 3 |
| Kickoff Meeting Minutes |
| EC to COR |
| 2 business days following the Kickoff Meeting |
| Yes |
| No |
| No |
| Task 1.b |
| 4 |
| Project Work Plan |
| EC to COR or Delegate |
| Within 30 days of the contract award and updated monthly, Weekly schedule updates for the CMS integrated program master schedule |
| Yes |
| Yes |
| Yes |
| Task 1.b |
| 5 |
| Executive Level Dashboard |
| EC to COR |
| Within 30 calendar days of the contract award and updated monthly |
| Yes |
| Yes |
| Yes |
| Task 1.b |
| 6 |
| Monthly Status Report |
| EC to COR |
| Monthly, within 5 business days of the last day of the month |
| Yes |
| Yes |
| Yes |
| Task 1.b |
| 7 |
| Monthly Financial Report |
| EC to COR |
| Monthly, within 5 business days of the last day of the month |
| Yes |
| Yes |
| Yes |
| Task 1.c |
| 8 |
| Weekly Contract Management Call |
| In person or by teleconference |
| Weekly; minutes and action item tracking due within 2 business days of the weekly meeting |
| Yes |
| Yes |
| Yes |
| Task 2.a |
| 9 |
| Provider Communications |
| EC to COR |
| As new measures are developed and as directed by the COR. |
| Yes |
| Yes |
| Yes |
| Task 2.b |
| 10 |
| National Provider calls/webinars |
| Webinar or teleconference or other as approved by COR |
| Quarterly Status calls and Annual calls for both the NPRM and Final rule for each program (6 calls for each setting annually/18 total calls annually) |
| Yes |
| Yes |
| Yes |
| Task # |
| Deliverable # |
| Deliverable |
| Format |
| Due Date |
| Base Year |
| Option Year 1 |
| Option Year 2 |
| Task 2.b |
| 11 |
| Webinar/Provider call materials |
| EC to COR |
| No later than 15 business days prior to the call. |
| Yes |
| Yes |
| Yes |
| Task 2.b |
| 12 |
| Listserv Status |
| EC to COR |
| Ongoing, status update of listserv no later than 30 calendar days prior to each webinar/provider call |
| Yes |
| Yes |
| Yes |
| Task 2.c |
| 13 |
| Report on website reviews |
| EC Notification to the COR |
| Semi-annually, April and August, unless alternatives are agreed upon by the COR. |
| Yes |
| Yes |
| Yes |
| Task 2.d |
| 14 |
| Report on Program Website Updates |
| EC and teleconference to COR |
| Ongoing, updates to be discussed at the weekly status meeting |
| Yes |
| Yes |
| Yes |
| Task 3.e |
| 15 |
| Quarterly program level electronic lists, by program area |
| EC to the COR and Program Leads as directed by COR |
| Quarterly: 35 calendar and 15 calendar days prior to the quarterly submission deadline and 10 days after the close of each quarter |
| Yes |
| Yes |
| Yes |
| Task 3.f |
| 16 |
| Report on Outreach |
| telephone or e mail |
| Report on activities quarterly within 15 business days of the deadline. |
| Yes |
| Yes |
| Yes |
| Task 3.g |
| 17 |
| Quarterly APU list |
| EC to the COR |
| Within 5 business days of the close of each APU data collection period |
| Yes |
| Yes |
| Yes |
| Task 3.h |
| 18 |
| Weekly communications tracking log. |
| EC to COR or delegate |
| Annually during reconsideration |
| Yes |
| Yes |
| Yes |
| Task 3.i |
| 19 |
| Final APU file |
| EC to the COR |
| Within 15 business days of the receipt of reconsideration determinations. |
| Yes |
| Yes |
| Yes |
| Task 4 |
| 20 |
| Monthly Report of Help Desk activities |
| Email and Telephonic as necessary |
| Monthly |
| Yes |
| Yes |
| Yes |
| Task # |
| Deliverable # |
| Deliverable |
| Format |
| Due Date |
| Base Year |
| Option Year 1 |
| Option Year 2 |
| Task 5.a |
| 21 |
| Report on medical record reviews annually |
| EC to COR |
| Annually |
| Yes |
| Yes |
| Yes |
| Task 5.b |
| 22 |
| Propose validation methodologies |
| EC to COR |
| December 15th 2015, 2016, 2017 |
| Yes |
| Yes |
| Yes |
| Task 5.d |
| 23 |
| Report summarizing activities and results quarterly CMS |
| EC to COR |
| Quarterly |
| Yes |
| Yes |
| Yes |
| Task 5.d |
| 24 |
| Validation Training Materials |
| EC to COR |
| Up to twice annually as directed by COR |
| Yes |
| Yes |
| Yes |
| Task 5.e |
| 25 |
| Report of the results of accuracy assessment completed via claims matching. |
| EC to COR |
| Quarterly and Annually |
| Yes |
| Yes |
| Yes |
| Task 6 |
| 26 |
| Report on internal and external communications |
| EC to COR |
| Monthly |
| Yes |
| Yes |
| Yes |
| Task 6.b |
| 27 |
| Presentation |
| EC to COR |
| As directed by COR, Maximum of 12 annually |
| Yes |
| Yes |
| Yes |
| Task 7 |
| 28 |
| Public Reporting Support |
| EC to COR |
| As directed, report on public reporting activities monthly. |
| Yes |
| Yes |
| Yes |
| Task 7.e-h |
| 29 |
| Rule Making |
| EC to COR |
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