MIDS_Q A.docx

Pre-Solicitation Conference Questions and Answers I. Current MIDS contract:

Q: Who are the incumbents on the current MIDS contract?

A: The current contractors are:

Mathematica Policy Research, Inc.

Quality Insights of Pennsylvania Optimal Solutions, LLC Quality Resource Systems, Inc Acumen, LLC RTI International Arbor Research Collaborative for Health Abt Associates, LLC National Opinion Research Center Yale New Haven Health Services Corporation, CORE

Q: What was the dollar figure issued in Task Orders on the current MIDS vehicle?

A: Approximately $250 million to date.

II. Anticipated award:

Q: What will the dollar ceiling be for MIDS?

A: $500 million is estimated over 5 years

Q: How many awards to full and open?

A: The IDIQ contract award is a full and open competition. All offerors, large and small business, are eligible to compete. Awards will be made on a best value basis and the number of awards cannot be determined at this time.

Q: How many awards to small business?

A: The number of IDIQ contract awards cannot be determined at this time. Each task order will be evaluated individually to determine if it will be a small business set-aside.

Q: How many awards do you anticipate?

A: Although the number of awards cannot be determined at this time, the current MIDs contract has 10 awards and given that the program has grown, more than 10 awards could be made.

III. IDIQ and Task Orders:

Q: Must contractors submit proposals for all Task Orders in the IDIQ phase?

A: All contractors will need to submit proposals on the Umbrella IDIQ and any sample Task Orders. Contractors do not need to submit proposals on all of the potential Task Orders with the initial solicitation and are free to choose any task order they want to bid on once the Umbrella IDIQ is awarded. Again, contractors will be required to submit proposals on any sample tasks included in the RFP.

Q: Are the anticipated tasks 1 to 4 included in the IDIQ SOW as sample tasks? Will respondents be required to respond to all of them or only some subset?

A: Any of the tasks 1 through 4 presented at the pre-solicitation conference may be included as a sample task or actual tasks to be issued at contract award. Respondents will need to propose on any sample tasks statements of work and may choose to propose on any other tasks statements of work. CMS may choose to award on the sample task and anticipate making awards on any other tasks.

Q: Will the RFP include more than one technical RFP, in other words will we have more than one option to choose from?

A: No, the Umbrella will have sample task orders that all contractors will have to propose on. After the Umbrella IDIQ has been awarded, awardees will be able to choose Task Orders that they want to propose on.

Q: Does CMS intend to award any/all of the sample task orders associated with this MIDS II IDIQ based on proposals received with the IDIQ proposal?

A: Not yet determined, wait for the RFP for additional instructions.

Q: Must contractors provide capabilities for all chapters of the RFP?

A: Providing capabilities for all chapters may increase your chance for award.

Q: A few of the sample Task Orders sound like continuation of current work. Will those actually be full and open competition or more likely to be awarded to incumbents?

A: This award is intended to be a full and open competition.

IV. Small Business Considerations:

Q: What are the specific requirements for a subcontractor to be considered a small business?

A: Please contact your local Small Business Administration representative for guidance.

Q: Does the subcontractor have to be SBA certified?

A: No

Q: Does the timing of certification have to be before start of subcontract?

A: If the Task Order is being set-aside for small business then yes, the Prime contractor must be certified as a small business at the time of award. The subcontractor does not need to be certified as a small business as long as the Prime is doing at least 51% of the work.

Q: Is there a specific number or percent target for small business participants on a large business prime contractor?

A: RFP will include evaluation criteria for guidance.

Q: Is CMS intending to award small business IDIQ awards and compete the set-aside among the small business IDIQ winners?

A: The IDIQ Umbrella is a full and open competition for large and small businesses. The Task Orders will be evaluated individually for small business set-aside capability.

Q: Can you expand on the awarding of small business set-aside contracts/competition?

A: RFP will include evaluation criteria for guidance on small business preference.

Q: Are there special points for partnering with small businesses?

A: Small business preference will be given. The solicitation will provide specific evaluation criteria.

Q: Any percentage required for small business in the Task Orders?

A: They should conform to standard government goals.

Q: Regarding ‘small business;’ the initial discussion mentioned - full open competition and tasks with small business set-aside. Please clarify the intent and proposal requirements.

A: These will be posted with the solicitation.

V. Partnering and Subcontracting Agreements:

Q: Can subcontractors and/or consultants be added to an awarded MIDS IDIQ on a task by task basis?

A: Yes

Q: Can a company be an official subcontractor in multiple responses (for multiple primes)?

A: Yes, as long as they meet FAR 52.244-2 requirements. Keep in mind that OCI determinations will be made on a case by case basis.

Q: Can two primes (once awarded) team up together?

A: Yes, as long as there is nothing prohibited in the solicitation and does not violate any laws or regulations.

Q: Can a contractor submit as a prime and as a teaming partner (subcontractor) for another prime?

A: Yes

VI. Past Performance Evaluation:

Q: Can the offeror use their subcontractor’s past performance histories?

A: Yes

Q: Will past performance for Primes and all subcontractors (two for each) be considered?

A: Yes

Q: To what extent can past performance be obtained from the team? i.e. Does the prime need to provide all of the past performance references?

A: Yes, it would be in the best interest of the prime to provide past performance for subs as well as primes.

Q: In regards to past performance questionnaires, can it be reformatted for ease of completion by the client?

A: If a contractor wants to provide a “new sample”, CMS would be happy to review it prior to the release of the solicitation.

Q: Will Past Performance Evaluation favor current contractors on the MIDS?

A: No, incumbents’ past performance will be evaluated.

VII. Miscellaneous Topics:

Q: Can you elaborate on the additional audit of our rates that may require 60 days after the technical and business volume review?

A: CMS may use other Government agencies (OIG, DCAA) to evaluate Contractor’s indirect rates if provisional rates have not yet been previously established.

Q: How will sequestration affect this program this year and the next?

A: Unknown at this time

Q: For IDIQ Business Proposals, will teams have to provide labor rates by labor categories? Will those be needed from all subs as well?

A: Yes

VIII. Conflict of Interest:

Q: What types of organization are likely to be disqualified for conflict of interest?

A: Determination will be made on a case by case basis.

Q: Is a Quality Improvement Organization (QIO) precluded from participation in the MIDS program with respect to Conflict of Interest or other requirements?

A: No, not precluded but QIO must go through its compliance team for OCI review. These will be determined on a case by case basis.

Q: What is the timeline for determinations of COI? Can we start the process in conversations before RFP release?

A: Contractors can provide their OCI concerns to CMS prior to the release of the solicitation. CMS may consider them when submitted prior to the release of the solicitation.

Q: Is CMMI certification required to bid on task order for MIDS?

A: It is not expected for CMMI certifications to be required.

Q: “Pre-Evaluation Assessment,” Will CMS review the OCI prior to the development of the RFP, and if so will it be it be a team review?

A: CMS will attempt to identify OCIs prior to the release of the solicitation material. However, these relationships will NOT be all-inclusive. Therefore, offerors must review their own contracts and relationships in light of the OCI rules and CMS’ identified OCIs.

Q: Can you provide some specific examples of COI? For example, would other contracts with providers, hospitals, and industry organizations be considered COI?

A: Contracts with providers, hospitals and industry organizations may be considered OCIs. Each relationship must be analyzed on a case-by-case basis and is highly fact dependent. Your Corporate Compliance Officer should assist in the evaluation.

Q: Can CMS provide examples of what you consider Conflicts of Interest?

A: Each relationship must be analyzed on a case-by-case basis and is highly fact dependent. Therefore, attempting to provide an example under such circumstances would not be helpful. CMS suggests offerors consult the Government Accountability Office (GAO) protest case archives for examples of OCI decisions generally, as well as those involving CMS.

IX. General Technical Questions:

Q: Will Lean expertise be required for MIDS IDIQ holders?

A: CMS is interested in contractors that are interested in innovation and efficiency. Lean is a methodology being used by CMS and NQF, but it is not the only tool to achieve the same result.

Q: Please clarify what you mean by collaboration/coordination?

A: We are referring to collaboration/coordination with other CMS contractors, developers, components of CMS, and other Federal agencies. Each TO will describe the collaboration/coordination required.

Q: Is MIDS focused on Medicare only measures?

A: No. This vehicle may be leveraged for measures-related work in a variety of CMS programs including Medicare, Medicaid, Duals, etc.

Q: Is there interest in expanding quality measure concepts for adverse event reporting? Would this be in or out of scope?

A: In scope. We view Adverse Events as a quality of care issue that warrants measurement. Specific requirements would be identified in a task order.

Q: In the Umbrella overview, focus areas were mentioned. Please elaborate.

A: The focus areas mentioned are the 6 National Quality Strategy priorities: Make care safer, Ensure person and family engagement, Promote effective communication and coordination of care, Promote effective prevention practices, Promote healthy communities, and Make quality care more affordable.

Q: Is creating an eMeasure based on existing paper measures and will this be considered a de novo measure if all but the numerator and denominator are changed?

A: Current task order contracts have addressed retooled, re-engineered, and de novo eMeasures. They are all different but within the scope of the MIDS IDIQ Umbrella.

Q: Will contracts to support programs continue to be issued under the MIDS Umbrella? If so, when?

A: The program support work is within the scope of the MIDS Umbrella. All future TOs have not been determined.

Q: Will all contractors have equal access to CMS claims data sets (e.g. MEDPAR, IDR, SAF, NCH, HPMS)?

A: With a data use agreement in place, contractors will receive access to the data necessary for the work identified in each task order.

Q: Early on will you be issuing a task order to maintain CMS Ambulatory Measures currently used in PQRS, EHR Incentive, and ACO Programs?

A: Maintaining these measures is within scope of the IDIQ and there is a current MIDS contract to perform this work. We cannot comment on all future proposed task orders at this time.

Q: Are any of the 4 TO examples current MIDS TOs?

A: Yes, although the deliverables and requirements are not identical.

Q: What are your expectations for measures that evaluate care across settings? Often data required are present in different settings. How do you foresee requirements addressing the data source complexities?

A: Our expectation is that if CMS issues a TO for the development of measures that cross settings, the contractor will receive access to the necessary CMS data via a data use agreement or the contractor will procure the necessary data to support feasibility and attribution. We acknowledge the complexities in developing measures that cross various health care settings.

Q: Are patient reported outcomes the same as patient experience of care? How are they different?

A: They are not the same. Patient reported outcomes are about the patient’s health status or outcomes over time whereas patient experience is about their experience at a given point in a given healthcare setting. However, both types of measures may involve collection of information directly by patients.

Q: A recent PQRS RFP mentioned the problem of measures gaming. Is source record validation for quality measures in scope or out of scope of this IDIQ?

A: Quality assurance is in scope and TOs issued would further define any related requirements.

Q: When do you think additional RFPs for future TOs will come out?

A: We expect to release additional TOs in the next fiscal year but this is dependent on ongoing needs and adequate funding.

Q: Do you need to have expertise in all 6 domains to bid on the TOs?

A: No, but as the priorities are interrelated, expertise in a majority of the domains would be a consideration in the technical portion based on task order requirements.

Q: Will there be task orders to provide infrastructure across all contractor work (e.g., Blueprint development, feasibility testing for infrastructure, consistency consultation for measure description aligning with the Blueprint and beyond, shepherding of QDM in HL7 or elsewhere)?

A: CMS currently funds a contractor for the Measures Blueprint maintenance and this is not currently under the MIDS. However, broadly this type of work is measures-related and could be in the future.

Q: Please clarify requirements for patient/caregiver participation on TEPs?

A: CMS very much wants patient/caregiver input in the development and selection of quality measures used in its programs. For example, each TEP must have a minimum of one patient or caregiver on the TEP to provide input into quality issues that are important to patients and families. Additionally, contractors may propose alternative ways of meaningfully including patient/caregiver participation such as focus groups and measure concept discussions.

Q: As NQF endorsement processes change and Lean is applied, will TOs allow for flexibility? Is support expected with the NQF MAP project?

A: NQF is using Lean as a tool for efficiency. CMS seeks to allow for this in its task orders. Any support for pre-Rulemaking that feeds the MAP would be identified in individual TOs.

X. Task Order #1:

Q: Is SAS software a pre-determined technology for statistical modeling or is CMS open to new and innovative methodologies?

A: The measure calculation software that has been developed by CMS and AHRQ for their measures are SAS programs, so SAS is a requirement for this task order. However, use of other statistical software in addition to SAS may be proposed as appropriate.

Q: This TO includes analyzing and interpreting data for the hospital pay for performance program. Can you give examples?

A: Examples include analyzing varying time periods for measures for difference in reliability or analysis and interpretation of program impact by hospital characteristics.

Q: What is the size of the data sets to be supported by analytics and is the contractor expected to have expertise in the various programs (e.g., Hospital Value Based Purchasing, Hospital Inpatient Quality Reporting, etc.)?

A: The data sets are several terabytes in size and the exact information is available through ResDAC (Research Data Assistance Center). Expertise in specific programs (the Hospital Inpatient Quality Reporting, Hospital Value Based Purchasing, Hospital Readmission Reduction Program and Hospital Acquired Conditions Reduction) is a requirement for TO 1.

XI. Task Order #2:

Q: You mention that CMS has a standardized process; will this be part of the RFP?

A: The process refers to the Measures Blueprint.

XII. Task Order #3:

(No questions)

XIII. Task Order #4:

Q: What is the purpose of the COR calls and who attends?

A: COR weekly calls include the contractor and GTL. The purpose is to touch base and discuss upcoming deliverables, work, and plans.

Q: Are IHS and DOD, Military Health System or sharing of data now or in the future?

A: Not at this time.

Q: Is this task for logistics support or logistics and policy support?

A: This TO is specific to support of the HQI. It is not specific to logistics or policy. The work does not involve setting policy; rather implementing CMS policy decisions and supporting CMS.

Q: Where does the information to respond to inquiries come from?

A: Questions are triaged to the SMEs or staff leads for responses.

Q: Slide 60 mentions that contractors will provide data in the test plan. Can we use CMS-acquired data or does the contractor take responsibility to simulate data?

A: Data for UAT will be provided by CMS depending on the scope of UAT.