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HHSM-500-2015-RFP-0122

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

1 116

C. E-MAIL ADDRESS

EXT.NUMBERAREA CODE

B. TELEPHONE (NO COLLECT CALLS)A. NAME10. 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

07/17/2015X

ASG - DPIFMC

CMS,OAGM,ASG,DPIFMC7500 SECURITY BLVD., MS: B3-30-03BALTIMORE MD 21244-1850

4

B3-30-03 1200 ES 08/18/2015

GINA ROMANO [email protected]

786-8372

X

X

X

X

X

X

X

X

X

X

X

X

X

PAGE(S)

Michael Connors

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition is unusable

STANDARD FORM 33 (Rev. 9-97)

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

) )

17

8910111228

55

64

66

77

108

Unified Program Integrity Contractor (UPIC) HHSM-500-2015-RFP-0122

2 Back to Table of Contents

TABLE OF CONTENTS PART I - THE SCHEDULE SECTION B - SUPPLIES OR SERVICES AND PRICES/COSTS

B.1 DESCRIPTION OF SERVICES B.2 TASK ORDER AWARDS B.3 GUARANTEED MINIMUMS & ESTIMATED MAXIMUMS

B.4 DETERMINATION OF ORDER TYPE/PRICES/COSTS SECTION C - DESCRIPTION/SPECIFICATIONS/WORK STATEMENT

C.1 STATEMENT OF WORK SECTION D - PACKAGING AND MARKING

THIS SECTION IS INTENTIONALLY LEFT BLANK SECTION E - INSPECTION AND ACCEPTANCE

E.1 FAR 52.252-2 CLAUSES INCORPORATED BY REFERENCE (1998) E.2 INSPECTION AND ACCEPTANCE E.3 ACCEPTANCE BY THE CONTRACTING OFFICER’S REPRESENTATIVE (COR)

SECTION F - DELIVERIES OR PERFORMANCE F.1 FAR 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998) F.2 PERIOD OF PERFORMANCE (JAN 2014) F.3 ITEMS TO BE FURNISHED AND DELIVERY SCHEDULE

SECTION G - CONTRACT ADMINISTRATION DATA G.1 ACCOUNTING AND APPROPRIATION DATA G.2 PAYMENTS – INVOICES – FIRM FIXED PRICE CONTRACTS (AUG 2013) G.3 PAYMENTS – VOUCHERS - COST REIMBURSEMENT CONTRACTS (AUG 2013) G.4 INDIRECT COST RATES (SEP 2014) G.5 CONTRACTING OFFICER’S REPRESENTATIVE (COR) G.6 TECHNICAL DIRECTION G.7 CONTRACTING OFFICER RESPONSIBILITY G.8 HHSAR 352.242-70 KEY PERSONNEL (JAN 2006) G.9 CORRESPONDENCE PROCEDURES G.10 SERVICE OF CONSULTANTS / SUBCONTRACTORS G.11 SUBCONTRACTING REPORTING (Only for Large Businesses) G.12 SUBCONTRACTING PROGRAM FOR SMALL AND DISADVANTAGED

BUSINESSES G.13 SUBCONTRACT CONSENT G.14 USE OF GOVERNMENT DATA (REPORTS/FILES/COMPUTER TAPES OR DISCS) G.15 DISSEMINATION, PUBLICATION AND DISTRIBUTION OF INFORMATION G.16 DATA TO BE DELIVERED



G.17 PROPERTY ADMINISTRATION G.18 CONTRACTOR PAST PERFORMANCE EVALUATION(S) (OCT 2014)

SECTION H - SPECIAL CONTRACT REQUIREMENTS H.1 BUSINESS ETHICS, CONFLICT OF INTEREST AND COMPLIANCE (JUNE 2015) H.2 HIPAA BUSINESS ASSOCIATE CLAUSE (OCT 2014)

H.3 OPEN GOVERNMENT PROACTIVE PREDISCLOSURE NOTIFICATION (OCT 2013)

H.4 CONTRACT RENEWAL H.5 CONFIDENTIALITY OF INFORMATION

H.6 REPORTABLE EVENTS H.7 DISCLOSURE OF INFORMATION H.8 SYSTEMS OF RECORDS H.9 EMPLOYMENT OF CMS PERSONNEL RESTRICTED H.10 APPROVAL OF CONTRACT ACQUIRED INFORMATION TECHNOLOGY (IT) H.11 HHSAR 352.239-73(b) ELECTRONIC AND INFORMATION TECHNOLOGY

ACCESSIBILITY (JANUARY 2010) H.12 SECURITY CLAUSE-BACKGROUND-INVESTIGATION FOR CONTRACTOR

PERSONNEL H.13 REVOKING SYSTEM ACCESS UPON EMPLOYEE DEPARTURE H.14 CONTRACTOR TERMINATION CMS BUILDING PASS H.15 ON-BOARDING PROCEDURES H.16 CMS INFORMATION SECURITY (APRIL 2013)

PART II - CONTRACT CLAUSES SECTION I - CONTRACT CLAUSES

I.1 FAR 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998) I.2 DEPARTMENT OF HEALTH AND HUMAN SERVICES ACQUISITION

REGULATIONS (HHSAR) CLAUSES INCORPORATED BY REFERENCE I.3 FAR 52.216-18 ORDERING (OCT 1995) I.4 FAR 52.216-19 ORDER LIMITATIONS (OCT 1995) I.5 FAR 52.216-22 INDEFINITE QUANTITY (OCT 1995) I.6 FAR 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000) I.7 FAR 52.222-42 STATEMENT OF EQUIVALENT RATES FOR FEDERAL HIRES

(MAY 2014) I.8 FAR 52.232-19 AVAILABILITY OF FUNDS FOR THE NEXT FISCAL YEAR (APR

1984) I.9 FAR 52.252-4 ALTERATIONS IN CONTRACT (APR 1984) I.10 FAR 52.252-6 AUTHORIZED DEVIATIONS IN CLAUSES (APR 1984) I.11 HHSAR 352.228-7 INSURANCE--LIABILITY TO THIRD PERSONS (DECEMBER

1991)

PART III - LIST OF DOCUMENTS, EXHIBITS AND OTHER ATTACHMENTS SECTION J - LIST OF ATTACHMENTS AND EXHIBITS

ATTACHMENTS



J.1 UNIFIED PROGRAM INTEGRITY CONTRACT (UPIC) UMBRELLA STATEMENT OF WORK (USOW)

J.2 UNIFIED PROGRAM INTEGRITY CONTRACT (UPIC) UMBRELLA STATEMENT

OF WORK (USOW) APPENDICES

J.3 REPORT AND DELIVERABLE TEMPLATES J.3.A UPIC ANALYTIC FINDINGS REPORT J.3.B UPIC DATA ANALYSIS PROJECT MANAGEMENT PLAN J.3.C UPIC DATA MATCHING PROTOCOL J.3.D UPIC FREEDOM OF INFORMATION ACT (FOIA) LOG J.3.E UPIC FREEDOM OF INFORMATION ACT (FOIA) REQUEST LOG J.3.F UPIC INFORMATION TECHNOLOGY (IT) SYSTEMS PLAN J.3.G UPIC JURISDICTION IMPLEMENTATION PROJECT PLAN J.3.H UPIC MONTHLY STATUS REPORT J.3.I UPIC RISK MANAGEMENT PLAN

J.3.J UPIC REGIONAL OFFICE (RO) FREEDOM OF INFORMATION ACT (FOIA) FORM

J.3.K UPIC STATE EDUCATION REPORT

J.4 UNIFIED PROGRAM INTEGRITY CONTRACT (UPIC) INDEFINITE DELIVERY INDEFINITE QUANTITY (IDIQ) ORDERING GUIDE

J.5 RESERVED FOR INCORPORATION OF CONTRACTOR’S ORGANIZATIONAL

CONFLICT OF INTEREST CERTIFICATE (INCORPORATED BY REFERENCE)

J.6 UNIFIED PROGRAM INTEGRITY CONTRACT (UPIC) JURISDICTION 1 (J1) TASK ORDER

J.6.A UNIFIED PROGRAM INTEGRITY CONTRACT (UPIC) J1 TASK ORDER

REQUEST FOR PROPOSAL (RFP) J.6.B UNIFIED PROGRAM INTEGRITY CONTRACT (UPIC) J1 TASK ORDER

STATEMENT OF WORK (SOW) J.6.C UNIFIED PROGRAM INTEGRITY CONTRACT (UPIC) J1 TASK ORDER

STATEMENT OF WORK (SOW) ATTACHMENT A J.6.D SMALL BUSINESS SUBCONTRACTING PLAN

J.7 UNIFIED PROGRAM INTEGRITY CONTRACT (UPIC) TECHNICAL

EVALUATION SCENARIOS

J.8 BUSINESS ETHICS, CONFLICT OF INTEREST AND COMPLIANCE SUBMISSION BY OFFEROR/CONTRACTOR

J.9 PERSONAL CONFLICT OF INTEREST FINANCIAL DISCLOSURE

J.10 PAST PERFORMANCE QUESTIONNAIRE J.11 RESPONSIBILITY QUESTIONNAIRE J.12 VIRUS DETECTION CERTIFICATION



J.13 SUBCONTRACT CHECKLIST – CONSENT TO SUBCONTRACT

J.14 UNIFIED PROGRAM INTEGRITY CONTRACT (UPIC) MAP OF JURISDICTIONS (NOTE: ALSO AN APPENDIX (B) TO THE USOW APPENDICES)

J.15 UNIFIED PROGRAM INTEGRITY CONTRACT (UPIC) AWARD FEE PLAN EXHIBITS E.1 UNIFIED PROGRAM INTEGRITY CONTRACT (UPIC) PRIME PROPOSAL

CHECKLIST E.1.A UNIFIED PROGRAM INTEGRITY CONTRACT (UPIC) SUBCONTRACTOR

PROPOSAL CHECKLIST E.2 UNIFIED PROGRAM INTEGRITY CONTRACT (UPIC) JURISDICTION 1 (J1)

BUSINESS PROPOSAL SPREADSHEETS E.2.A UPIC J1 BUSINESS PROPOSAL SPREADSHEET CLIN 0001 E.2.B UPIC J1 BUSINESS PROPOSAL SPREADSHEET CLIN 0002 E.2.C UPIC J1 BUSINESS PROPOSAL SPREADSHEET CLIN 0003 E.2.D UPIC J1 BUSINESS PROPOSAL SPREADSHEET CLIN 0004 E.2.E UPIC J1 BUSINESS PROPOSAL SPREADSHEET CLIN 0005 E.3 UNIFIED PROGRAM INTEGRITY CONTRACT (UPIC) QUESTIONS TEMPLATE E.4 ANSWERS TO DRAFT SOLICITATION QUESTIONS E.5 DRAFT UNIFIED CASE MANAGEMENT FUNCTIONAL REQUIREMENTS

DOCUMENT E.6 DRAFT PROGRAM INTEGRITY MANUAL CHAPTER 4 E.7 DRAFT PROGRAM INTEGRITY MANUAL CHAPTER 8 E.8 DRAFT PROGRAM INTEGRITY MANUAL CHAPTER 16 SECTION K - REPRESENTATIONS, CERTIFICATIONS, AND OTHER STATEMENTS OF

OFFERORS OR QUOTERS K.1 FAR 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE

(FEB 1998) K.2 FINANCIAL INFORMATION

K.3 FAR 52.204-8 ANNUAL REPRESENTATIONS AND CERTIFICATIONS (DEC 2014) K.4 FAR 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (JUL

2013) K.5 FAR 52.230-1 COST ACCOUNTTING STANDARDS NOTICES AND

CERTIFICATIONS (MAY 2012) K.6 FAR 52.230-7 PROPOSAL DISCLOSURE – COST ACCOUNTING PRACTICE

CHANGES (APR 2005)



SECTION L - INSTRUCTIONS, CONDITIONS, AND NOTICES TO OFFERORS OR QUOTERS

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

(FEB 1998) L.2 DEPARTMENT OF HEALTH AND HUMAN SERVICES ACQUISITION

REGULATIONS (HHSAR) PROVISIONS INCORPORATED BY REFERENCE L.3 FAR 52.215-1 INSTRUCTIONS TO OFFERORS - COMPETITIVE ACQUISITION

(JAN 2004) (DEVIATION) L.4 FAR 52.215-20 REQUIREMENTS FOR COST OR PRICING DATA OR

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

L.5 FAR 52.216-1 TYPE OF CONTRACT (APR 1984) L.6 FAR 52.233-2 SERVICE OF PROTEST (SEP 2006) L.7 FAR 52.252-3 ALTERATIONS IN SOLICITATION (APR 1984) L.8 FAR 52.252-5 AUTHORIZED DEVIATIONS IN PROVISIONS (APR 1984) L.9 SUBMISSION OF QUESTIONS AND INTENT TO SUBMIT A PROPOSAL L.10 GENERAL L.11 PROPOSAL SUBMISSION AND DELIVERY L.12 GENERAL PROPOSAL INSTRUCTIONS

L.13 BUSINESS PROPOSAL (VOLUME I) INSTRUCTIONS L.14 TECHNICAL PROPOSAL (VOLUME II) INSTRUCTIONS L.15 BUSINESS ETHICS, ORGANIZATIONAL AND PERSONAL CONFLICTS OF

INTEREST AND COMPLIANCE (MAY 2015) (VOLUME III) INSTRUCTIONS

SECTION M - EVALUATION FACTORS FOR AWARD

M.1 FAR 52.217-5 EVALUATION OF OPTIONS (JUL 1990) M.2 EVALUATION METHODOLOGY M.3 RELEVANCE OF EVALUATION FACTORS M.4 TECHNICAL PROPOSAL EVALUATION M.5 BUSINESS PROPOSAL EVALUATION M.6 CONFLICTS OF INTEREST (OCI) EVALUATION M.7 CLARIFICATION/COMMUNICATIONS WITH OFFEROR’S BEFORE

ESTABLISHMENT OF THE COMPETITIVE RANGE M.8 COMPETITIVE RANGE M.9 DISCUSSIONS



PART I – THE SCHEDULE

SECTION B – SUPPLIES OR SERVICES AND PRICES/COSTS

B.1 DESCRIPTION OF SERVICES This is a Multiple Award Indefinite Delivery Indefinite Quantity (MA IDIQ) contract which will be awarded in support of the Centers for Medicare and Medicaid Services’ (CMS) audit, oversight and anti-fraud, waste and abuse efforts. The Unified Program Integrity Contractor (UPIC) shall provide and furnish the necessary and qualified personnel, facilities, equipment, materials, and supplies not otherwise provided by the Government, as needed to perform the requirements set forth in the Statement of Work (SOW), Section J, Attachment J.1.

B.2 TASK ORDER AWARDS This is a Multiple Award Indefinite Delivery Indefinite Quantity (MA IDIQ) Contract in which task orders will be competed among the IDIQ holders. Ordering procedures are provided at Attachment J.4.

The predominance of task orders anticipated to be awarded under this MA IDIQ will be Cost Reimbursement (CR). If the Offeror does not have an accounting system that is deemed adequate for determining costs applicable to the contract (FAR 16.301-3) and for accumulating and segregating costs under a CR contract, it will not be eligible for award. This requirement extends to subcontractors who are anticipated to have Cost Reimbursement contracting arrangements including Time and Materials type contracts.

B.3 GUARANTEED MINIMUMS & ESTIMATED MAXIMUMS

During the contract period of performance, inclusive of any contract renewal periods, the Government shall place orders totaling a:

Minimum of $25,000 (inclusive of all costs and fees); and

Maximum amount not to exceed $2,500,000,000 (inclusive of all costs and fees).

B.4 DETERMINATION OF ORDER TYPE/PRICES/COSTS

To be determined on individual task orders



SECTION C – DESCRIPTION/SPECIFICATIONS/WORK STATEMENT

C.1 STATEMENT OF WORK Independently and not as an agent of the Government, the Contractor shall furnish all the necessary services, qualified personnel, material, equipment, and facilities, not otherwise provided by the Government, as needed to perform the Statement of Work (SOW) as identified in Section J, Attachment J.1, entitled “UPIC SOW”, which is attached and made a part of this solicitation.



SECTION D – PACKAGING AND MARKING THIS SECTION IS INTENTIONALLY LEFT BLANK



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: http://www.acquisition.gov/far/ The following clauses apply to cost reimbursement task orders:

Clause No. Title Date 52.246-5 Inspection of Services - Cost-Reimbursement Apr 1984 The following clauses apply to firm fixed price task orders:

Clause No. Title Date 52.246-4 Inspection of Services - Fixed Price Aug 1996

E.2 INSPECTION AND ACCEPTANCE

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

b. The Contracting Officer Representative or Alternate Contracting Officer Representative is a duly

authorized representative of the Government and is responsible for inspection and acceptance of all items to be delivered under this contract.

c. Inspection and acceptance of the Contractor's performance shall be in accordance with the

applicable FAR Clauses in Section E.1 above.

E.3 ACCEPTANCE BY THE CONTRACTING OFFICER’S REPRESENTATIVE (COR)

All items to be delivered to the Contracting Officer’s Representative (COR) will be deemed to have been accepted 60 calendar days after the date of delivery, except as otherwise specified in this contract if written approval or disapproval has not been given within such period. The COR’s acceptance or revision to the items submitted shall be within the general scope of the work stated in this contract.

http://www.acquisition.gov/far/



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: http://www.acquisition.gov/far/ The following clauses apply to all task orders:

Clause No. Title Date 52.242-15 Stop-Work Order AUG 1989 The following clauses apply to cost reimbursement task orders:

Clause No. Title Date 52.242-15 Stop-Work Order – Alternate I (Apr 1984) AUG 1989 The following clauses apply to firm fixed price task orders:

Clause No. Title Date 52.242-17 Government Delay of Work APR 1984

F.2 PERIOD OF PERFORMANCE (JAN 2014) The period of performance of this contract is February 29, 2016 through February 28, 2017. This contract includes the following Option Periods: Option Period 1 March 1, 2017 through February 28, 2018 (Estimated) Option Period 2 March 1, 2018 through February 28, 2019 (Estimated) Option Period 3 March 1, 2019 through February 29, 2020 (Estimated) Option Period 4 March 1, 2020 through February 28, 2021 (Estimated) Option Period 5 March 1, 2021 through February 28, 2022 (Estimated) Option Period 6 March 1, 2022 through February 28, 2023 (Estimated) Option Period 7 March 1, 2023 through February 29, 2024 (Estimated) Option Period 8 March 1, 2024 through February 28, 2025 (Estimated) Option Period 9 March 1, 2025 through February 28, 2026 (Estimated)

F.3 ITEMS TO BE FURNISHED AND DELIVERY SCHEDULE The Contractor shall furnish the items required under this contract in accordance with the reporting instructions and delivery schedule set forth in Section J.1, UPIC USOW, Appendix A, Deliverables.



SECTION G – CONTRACT ADMINISTRATION DATA G.1 ACCOUNTING AND APPROPRIATION DATA

DESIGNATED ON TASK ORDERS G.2 PAYMENTS – INVOICES - FIRM FIXED PRICE CONTRACTS (AUG 2013)

a. GENERAL: The Contractor may submit to the Government an invoice for payment in accordance with the instructions below.

b. METHOD OF PAYMENT: CMS shall only make an electronic payment of invoices in accordance with FAR 52.232-33, Payments by Electronic Funds Transfer – System for Award Management. In order to receive payments, the contractor shall register in the System for Award Management (SAM) database, in accordance with FAR 52.204-7, System for Award Management. Failure to register in SAM may prohibit CMS from making payments to your organization. ADDRESS CHANGES: The contractor shall notify CMS’ Division of Accounting Operations of all EFT and address changes in SAM via the following email address: [email protected].

c. CONTENT OF INVOICE - Invoices shall include, at a minimum:

• Contractor’s name and address; • Contractor’s Tax Identification Number (TIN); • Contractor’s DUNS Number; • Invoice date; • Invoice Number to include the designation of the Contract Payment Category Type as

follows: Contract Payment Category Type I, II, IV (TBD upon award)

mailto:[email protected]



Contract and Order Number, as applicable; Contract line item number and/or Subcontract line item number; Description, quantity, unit of measure, unit price and extended price of the items actually

delivered or services rendered; Shipping and payment terms; Terms of any discount for prompt payment offered; Other substantiating documentation or information as required by the contract; Name, title, phone number and complete mailing address of responsible official to whom

payment is to be sent; Name, title, phone number of person to notified in the event of a defective invoice; and, Period of performance or delivery date of goods or services provided.

d. MAILINGS: Invoices shall be submitted as follows:

1. ELECTRONIC MAIL: The contractor shall submit an electronic copy of the invoice to

both of the following individuals: • Contract Specialist – [email protected]; and • COR - [email protected].

2. REGULAR MAIL: An original and one (1) hard copy shall be submitted to the address

below:

Department of Health & Human Services Centers for Medicare & Medicaid Services

INVOICE/VOUCHER REVIEW/APPROVAL PROCESSING TIME FRAMES

Contract Payment Category Types ($ = Total Contract Value)

Days = Calendar Days

TYPE I TYPE II TYPE III TYPE IV

Type IA Type IB Type IIIA Type IIIB

TEAM MEMBER

All Small Businesses (No $ Limit)

All QIOs (No $ Limit)

All Other Contracts (No $ Limit)

Simplified Acquisitions $3K to $150K (Small Businesses)

Simplified Acquisitions $3K to $6.5M (Large Businesses)

All Large Business Prime Contracts with Small Business Subcontractors (from July 11, 2012 through July 10, 2014)

OFM/DAO 7 Days 7 Days 14 Days 7 Days 22 Days 12 Days

COR 4 Days 0 Days 8 Days 8 Days 8 Days 8 Days

CS/CO 4 Days 8 Days 8 Days N/A N/A 8 Days

Total Processing Time

15 Days Not-to-Exceed 30 Days

15 Days Not-to-Exceed 30 Days 30 Days







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

3. OVERNIGHT MAIL: If the contractor chooses to use an overnight mail carrier, the

original and one (1) hard copy of the invoice shall be submitted to the address below:

Department of Health & Human Services Centers for Medicare & Medicaid Services OFM/Division of Accounting Operations 7500 Security Boulevard/Mailstop: C3-11-03 Baltimore, MD 21244-1850

e. PAYMENTS: The Government shall make payment of all invoices in accordance with

• FAR 52.232-1 Payments, and • FAR 52.212-4 Contract Terms and Conditions – Commercial Items (If applicable)

Upon acceptance by the Contracting Officer’s Representative (COR) in accordance with the applicable FAR Inspection and Acceptance clause and the Contracting Officer’s approval, as appropriate.

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

f. INTEREST ON OVERDUE PAYMENT

The Prompt Payment Act, Public Law 97-177 (96 Stat.85.31 U.S.C. 1801) is applicable to payments under this contract and requires the payment of interest on payments made more than 30 calendar days after receipt of an invoice by the Division of Accounting Operations. 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.3 PAYMENTS – VOUCHERS - COST REIMBURSEMENT CONTRACTS (AUG 2013)

a. GENERAL: The Contractor may submit to the Government a voucher or Standard Form 1034, Public Voucher for Purchases and Services Other Than Personal, for payment in accordance with the instructions below.

b. METHOD OF PAYMENT: CMS shall only make an electronic payment for reimbursement of voucher submissions in accordance with FAR 52.232-33, Payments by Electronic Funds Transfer – System for Award Management. In order to receive payments, the contractor shall register in the System for Award Management (SAM) database, in accordance with FAR 52.204-7, System for Award Management. Failure to register in SAM may prohibit CMS from making payments to your organization.



ADDRESS CHANGES: The contractor shall notify CMS’ Division of Accounting Operations of all EFT and address changes in SAM via the following email address: [email protected].

c. CONTENT OF VOUCHER - Vouchers shall include, at a minimum:

• Contractor’s name and address • Contractor’s Tax Identification Number (TIN) • Contractor’s DUNS Number • Voucher Number to include the designation of the Contract Payment Category Type as

follows: Contract Payment Category Type I, II, III, IV (TBD upon award)

Contract and Order Number, as applicable; Contract line item number and/or Subcontract line item number; Description, quantity, unit of measure, unit price and extended price/cost of the items

actually delivered or services rendered, i.e., Labor category and labor hours x labor rate = total direct labor dollars, subcontractor costs, travel, other direct costs, overhead rate(s), etc.;

Shipping and payment terms; Terms of any discount for prompt payment offered; Other substantiating documentation or information as required by the contract; Name, title, phone number and complete mailing address of responsible official to

whom payment is to be sent; Name, title, phone number of person to notified in the event of a defective voucher;

and,

INVOICE/VOUCHER REVIEW/APPROVAL PROCESSING TIME FRAMES

Contract Payment Category Types ($ = Total Contract Value)

Days = Calendar Days

TYPE I TYPE II TYPE III TYPE IV

Type IA Type IB Type IIIA Type IIIB

TEAM MEMBER

All Small Businesses (No $ Limit)

All QIOs (No $ Limit)

All Other Contracts (No $ Limit)

Simplified Acquisitions $3K to $150K (Small Businesses)

Simplified Acquisitions $3K to $6.5M (Large Businesses)

All Large Business Prime Contracts with Small Business Subcontractors (from July 11, 2012 through July 10, 2014)

OFM/DAO 7 Days 7 Days 14 Days 7 Days 22 Days 12 Days

COR 4 Days 0 Days 8 Days 8 Days 8 Days 8 Days

CS/CO 4 Days 8 Days 8 Days N/A N/A 8 Days

Total Processing Time








Period of performance for delivery date of goods or services provided.

d. MAILINGS: Vouchers shall be submitted as follows: 1. ELECTRONIC MAIL: The contractor shall submit an electronic copy of the voucher to

both of the following individuals: • Contract Specialist – [email protected]; and • COR - [email protected].

2. REGULAR MAIL: An Original and one (1) hard copy of the voucher shall be submitted to

the address below:

Department of Health & Human Services Centers for Medicare & Medicaid Services OFM/Division of Accounting Operations P.O. Box 7520 Baltimore, MD 21207-0520

3. OVERNIGHT MAIL: If the contractor chooses to use an overnight mail carrier, the

original and one (1) hard copy of the voucher shall be submitted to the address below:

Department of Health & Human Services Centers for Medicare & Medicaid Services

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

e. PAYMENTS: The Government shall make provisional payments on all vouchers (pending the

completion of a final audit of the Contractor's cost records) in accordance with:

• FAR 52.216-7, Allowable Cost and Payment, and • FAR 52.232-1, Payments, and

Upon acceptance by the Contracting Officer’s Representative (COR) of the required supplies/services in accordance with the applicable FAR Inspection and Acceptance clause and the Contracting Officer’s approval.

Reimbursement for vouchers submitted under this contract shall be made not later than thirty (30) calendar days after receipt of an acceptable voucher from the Contractor in the copies requested at the paying office designated above. Any discrepancies determined as a result of the audit could delay the processing of the voucher and may result in the voucher being returned to the Contractor for corrections.

f. INTEREST ON OVERDUE PAYMENT

The Prompt Payment Act, Public Law 97-177 (96 Stat.85.31 U.S.C. 1801) is applicable to payments under this contract and requires the payment of interest on payments made more than 30 calendar days after receipt of an voucher by the Division of Accounting Operations. Determinations of interest due will be made in accordance with the provisions of the Prompt





Payment Act and 5 CFR Part 1315.

G.4 INDIRECT COST RATES (SEP 2014) (applicable to Cost Reimbursement Task Orders)

a. INDIRECT COST BILLING, CEILING and FINAL RATES (To be completed at time of award):

1. Billing Rates:

i. Federal Acquisition Regulation (FAR) 52.216-7(e) Billing rates, states, “Until

final annual indirect cost rates are established for any period, the Government shall reimburse the Contractor at billing rates established by the Contracting Officer or by an authorized representative (the cognizant auditor), subject to adjustment when the final rates are established.

These billing rates—

(1) Shall be the anticipated final rates; and, (2) May be prospectively or retroactively revised by mutual

agreement, at either party’s request, to prevent substantial overpayment or underpayment.”

Therefore, the Government shall reimburse the Contractor at the established Billing Rates, as established by the Cognizant Federal Agency (CFA) or cognizant auditor. Any change(s) to the Billing Rate(s) established, shall be approved by the CFA or cognizant auditor. In the event the Billing Rate(s) exceed any Ceiling Rate(s) established in G.4.a.2. below, the Government shall reimburse the Contractor at the Ceiling Rate(s).

ii. Interim Billing Rates: In the event that the Contractor does not have

Contracting Officer or authorized representative (cognizant auditor) established Billing Rates, the following Interim Billing Rates apply to this contract:

INTERIM BILLING RATES:

Indirect Cost Pool Billing Rate Rate Base

Contractor Fiscal Year

Fringe (Ceiling NA)

TBD (a)

Overhead TBD (b) G&A TBD (c) Other TBD (d)

Rates are applied to the following rate base(s):

a. Fringe rate is applied to …



b. Overhead rate is applied to… c. G&A rate is applied to…

The above rates shall be used for reimbursement on contractor billings, pending review of a well-supported Billing Rate proposal, which is required to be submitted to the mailbox identified below, by the Contractor within six (6) months of contract award. The proposal shall be based upon at least four (4) months of actual costs and estimated costs for the current fiscal year and out-years of this contract. If you have prior year actuals, submit at least two (2) years, if available.

For information about the proposal submission, refer to “Information for Contractors” at http://www.DCAA.Mil/Audit_Process_Overview.html.

CMS, or another CFA official or cognizant auditor, shall review the proposed rates in accordance with FAR 52.216-7(e) and FAR 42.704 Billing rates, to establish Billing rates for the current fiscal year and to provide current recommendations on the out-year rates. After receiving the established CFA or cognizant auditor Billing Rate Agreement, the Interim Billing Rates no longer apply.

Submit Billing Rate Proposals to: [email protected]

2. Indirect Cost Ceiling Rate(s):

a) Indirect Cost Ceiling Rate(s) established (as applicable) for this contract are in

accordance with FAR 42.707, Cost Sharing Rates and Limitations on Indirect Cost Rates, and are as indicated below in the chart.

INDIRECT COST “CEILING” RATES

Indirect Cost Pool

Indirect Cost Ceiling Rate

Contractor’s Fiscal Year

Rate / Allocation Base

Overhead (a) G&A (b) Other (c) Overhead (a) G&A (b) Other (c) Overhead (a) G&A (b) Other (c) Overhead (a) G&A (b) Other (c)

http://www.dcaa.mil/Audit_Process_Overview.html




Rates are applied to the following rate/allocation base(s): Rate/Allocation Base a. Overhead rate is applied to …TBD Rate/Allocation Base b. G&A rate is applied to…TBD

b) When a ceiling rate(s) is/are established -

(1) The Government will not be obligated to pay any additional amount, should the final indirect cost rate(s) exceed the negotiated ceiling rate(s).

(2) In the event a final indirect cost rate is less than the negotiated ceiling rate, costs will be reimbursed at the final indirect cost rate.

3. Final Indirect Cost Rates: Pursuant to the provisions of FAR 52.216-7, Allowable Cost and

Payment, the allowable Indirect Costs under this contract shall be obtained by applying the CFA approved Final Indirect Cost Rate(s) or the Ceiling Rate(s) (whichever are lower) to the appropriate cost base.

b. INDIRECT COST RATE (ICR) PROPOSAL: Pursuant to FAR 52.216-7, Allowable Cost and

Payment, paragraph (d)(2), Final indirect cost rates, the Contractor shall submit an adequate final annual Indirect Cost Rate proposal within the 6-month period following the expiration of each of its fiscal years.

FAR 42.003(a) provides that the CFA, “…normally will be the agency with the largest dollar amount of negotiated contracts, including options.” FAR 42.703-1 further provides that a single agency shall be responsible for establishing final indirect cost rates for each business unit. This single agency is the CFA and may be DHHS, a delegated component of DHHS or another Federal Agency.

The Contractor shall submit its certified annual Indirect Cost Rate proposal to the following (both

CMS and the CFA) as identified below: CMS:

Electronic proposals shall be submitted in MS Word and Excel formats, with .pdf signed Certification, to (Do not .pdf the entire proposal):

Centers for Medicare & Medicaid Services Office of Acquisition & Grants Management Acquisition Business & Services Group Division of Financial Services at -

[email protected] AND

COGNIZANT FEDERAL AGENCY:

TBD Any questions about CFA responsibilities may be submitted to the OAGM, ABSG, Division of

Financial Services at:




[email protected]. G.5 CONTRACTING OFFICER’S REPRESENTATIVE (COR) CMS reserves the right to restructure how Contracting Officer’s Representatives (COR’s) are appointed.

a. Contracting Officer’s Representative (COR)

The Contracting Officer’s Representative (COR) is authorized to monitor the Contractor performance as set forth in the provisions of the contract. The Contracting Officer’s Representative’s Technical Direction responsibilities shall include continuous overall monitoring of the Contractor’s compliance with all substantive project objectives. Specific duties and responsibilities are identified in G.6 Technical Direction. In the event that a technical direction dispute cannot be settled between the COR and the Contractor, the matter will be elevated to the Contracting Officer for resolution. The Contracting Officer will be responsible for settling the dispute. Please also see FAR 52.243-7, Notification of Changes.

b. Alternate Contracting Officer’s Representative (ACOR)

In the absence of the COR, the ACOR is empowered with the same abilities, responsibilities, and limitations of the COR.

G.6 TECHNICAL DIRECTION

The COR shall be responsible for issuing technical guidance to the Contractor, which is within the scope of the contract, as written, in order to ensure proper development of requirements and assist Contracting Officers in managing their contracts. Although not all inclusive, the COR shall be responsible for providing technical guidance and oversight as follows:

a. Performance of the work under this contract shall be subject to the Technical

Guidance/Monitoring of the COR. The term “Technical Guidance/Monitoring” is defined to include, without limitation, the following:

1. Directions to the Contractor that 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 clarify the contractual statement of work.

2. Provision of information to the Contractor that assists in the interpretation of drawings,

specifications, or technical portions of the work description.

Name TBD Phone Number E-mail





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 guidance must be within the general Statement of Work stated in the contract. The

Contracting Officer’s Representative does not have the authority to, and may not issue, any technical guidance which:

1. Constitutes an assignment of additional work outside the general Statement of Work of the contract.

2. Constitutes a change as defined in FAR Clause 52.243-2 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 guidance shall be issued in writing by the Contracting Officer’s Representative or shall be confirmed by him/her in writing within 5 working days after verbal issuance.

1. Technical direction which is not in writing within the 5 day period must cease until written direction is received from the COR.

2. Technical direction received from individuals other than the COR will not be executed until such time as the contractor has received the proper documentation instructing the contractor to comply with said direction from either the COR or CO.

The contractor and not the Government is responsible for any costs incurred as a result of technical direction which was initiated prior to receiving proper authorization from those individuals who have the authority to provide such direction.

d. The Contractor shall proceed promptly with the performance of technical direction duly issued by the Contracting Officer’s Representative 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 Contracting

Officer’s Representative is within one of the categories as defined in G.6, b(l) through (4) above, the Contractor shall not proceed but shall notify the Contracting Officer in accordance with FAR 52.243-7, Notification of Changes.

G.7 CONTRACTING OFFICER RESPONSIBILITY


In accordance with FAR 52.202-1 Definitions, 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 Statement of Work;

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

G.8 HHSAR 352.242-70 KEY PERSONNEL (JAN 2006)

The key personnel specified in this contract are considered to be essential to work performance. At least 30 days prior to diverting any of the specified individuals to other programs or contracts (or as soon as possible, if an individual must be replaced, for example, as a result of leaving the employ of the Contractor), the Contractor shall notify the Contracting Officer and shall submit comprehensive justification for the diversion or replacement request (including proposed substitutions for key personnel) to permit evaluation by the Government of the impact on performance under this contract. The Contractor shall not divert or otherwise replace any key personnel without the written consent of the Contracting Officer. The Government may modify the contract to add or delete key personnel at the request of the Contractor or Government.

The following individuals are considered “key” under this contract:

Name Labor Category Phone E-Mail Address *

* Key Personnel will be denoted at the task order level for this effort.

G.9 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

technical 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 and ACOR with an informational copy of the basic correspondence to the Contracting Officer and Contracting Specialist.

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

and Contracting Specialist, in duplicate, with an informational copy of the basic correspondence to the COR and ACOR.

c. Subject Lines - All correspondence shall contain a subject line, commencing with the contract



number as illustrated below:

EXAMPLE: Contract No. HHSM 500-2015-XXXX Request for Subcontract Consent

G.10 SERVICE OF CONSULTANTS / SUBCONTRACTORS

a. For the purposes of this contract, consultants are considered subcontractors. b. The Contractor shall follow the appropriate procedures established in the Federal Acquisition

Regulation (FAR) when requesting Contracting Officer consent to subcontract for Consultants and/or other subcontracts (see FAR 52.244-2, 52-244-5, and 52.244-6).

G.11 SUBCONTRACTING REPORTING (Only for Large Businesses) The Contractor shall report all subcontract awards to small, small disadvantaged, women-owned, HUBZones, veteran owned small businesses, 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.12 SUBCONTRACTING PROGRAM FOR SMALL AND DISADVANTAGED BUSINESSES In accordance with FAR 19.704, Subcontracting Plan Requirements, the subcontracting plan submitted for work under this contract with small, small disadvantaged, woman-owned, HUBZone, veteran owned small businesses, and service-disabled veteran-owned small business concerns, shall be approved by the Contracting Officer and incorporated as part of this contract. Contractors should strive to achieve the following Department of Health and Human Services minimum small business utilization goals when developing its small business subcontracting plan:

Small Business (Overall) 33% Small Disadvantaged Business 5% Women-Owned Small Business 5% HUBZone 3% Veteran-Owned Small Businesses 3% Service Disabled Veteran Owned Small Business 3%

G.13 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 the FAR Clause 52.244-2, Subcontracts 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 to or dissent from the proposed subcontract in writing.

(b) In the event that proposed subcontracts are intended to be cost reimbursement it is requested that proof of an adequate accounting system be provided to the CO as part of the contractor’s

http://www.esrs.gov/



request for consent.

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

TBD

G.14 USE OF GOVERNMENT DATA (REPORTS/FILES/COMPUTER TAPES OR DISCS)

Any data given to the contractor by the Government shall be used only for the performance of the contract unless the Contracting Officer specifically permits another use, in writing. Should the Contracting Officer permit the contractor the use of Government-supplied data for a purpose other than solely for performance of this contract and if such use could result in a commercially viable product, the Contracting Officer and the contractor must negotiate a financial benefit to the Government. This benefit should most often be in the form of a reduction in the price of the contract; however, the Contracting Officer may negotiate any other benefits he/she determines are adequate compensation for the use of these data. Upon the request of the Contracting Officer or the expiration date of this contract, whichever shall come first, the contractor shall, upon instructions from the Contracting Officer, return or destroy all data given to the contractor by the Government. However, the Contracting Officer may direct that the data be retained by the contractor for a specific period of time, which period shall be subject to agreement by the contractor. Whether the data are returned, retained, or destroyed shall be the decision of the Contracting Officer with the exception that the contractor may refuse to retain the data. The contractor shall retain no data, copies of data, or parts thereof, in any form, when the Contracting Officer directs that the data be returned or destroyed. If the data are to be destroyed, the contractor shall directly furnish evidence of such destruction in a form the Contracting Officer shall determine is adequate. In absence of direction from the CO, the Contractor shall assume data will need to be returned to the Government.

G.15 DISSEMINATION, PUBLICATION AND 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 disclosed. Also, some data or information, which relate to policy matters under 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 made available under 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 project funding

levels, 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 acknowledgement substantially, as follows:

"The analyses upon which this publication is based were performed under Contract Number [ ], entitled, "[ ]," sponsored by the Centers for Medicare and Medicaid Services, Department of Health and Human Services."

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

G.16 DATA TO BE DELIVERED

a. Any working papers, interim reports, data given 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.

b. 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.17 PROPERTY ADMINISTRATION

a. General: The CMS Contract Property Administrator, Property and Distribution Management Section,



Division of General Services, 7500 Security Blvd., Baltimore, Md. 21244, 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 DHHS Manual entitled, Contractor's Guide for Control of Government Property, (2007). If equipment is procured in order to provide services, CMS will retain title to the equipment. CMS must be notified as part of the itemized billing arrangement if there is an equipment acquisition, included in the cost of the contract. All original tapes, video, CD ROM(s), manual, brochures, pamphlets shall remain the property of the CMS. The contractor shall provide to CMS all final, complete and editable web-based training course files.

b. Notice of Non-Allowability of Costs for General Purpose Office Equipment:

General Purpose Office Equipment (GPOE) means those equipment’s normally found in a business office such as desks, chairs, typewriters, calculators, file cabinets, etc., that are obtainable in the open market. Contractors are expected to have the necessary facilities to perform the requirements of this solicitation/contract. This includes any GPOE necessary to perform the requirements herein. Notwithstanding the "Allowable Cost and Payment" clause of this contract, costs for the acquisition of GPOE shall not be considered as an allowable direct charge to this contract.

G.18 CONTRACTOR PAST PERFORMANCE EVALUATION(S) (OCT 2014)

a. General: In accordance with Federal Acquisition Regulation (FAR) 42.15, Contractor Performance Information, past performance evaluations shall be prepared at least annually and at the time the work under a contract or order is completed. Additional interim performance evaluations may be prepared at Contracting Officer discretion, as necessary. CMS will utilize the Contractor Performance Assessment Reporting System (CPARS), the Government-wide evaluation reporting tool for all past performance reports on contracts and orders, as appropriate. CPARS is a secure Internet website located at https://www.cpars.gov.

b. CPARS Process: 1. CPARS Training: Contractors may obtain CPARS training material and register for on-line

training https://www.cpars.gov.

2. Post-Award Contract Registration: CMS is responsible for registering the contract in CPARS within 30 calendar days of contract award. The Contractor shall:

i. Designate at least one (1) point of contact that will be responsible for serving as the

Contractor’s Representative (CR). Additional CRs may also be identified; and,

ii. Provide the CMS Contract Specialist with the name(s) and email address(es) of the

https://www.cpars.gov/

https://www.cpars.gov/



CPARS point(s) of contact. Once CMS registers the contract in CPARS, the CR(s) will receive an automated CPARS email message that contains User IDs and instructions for creating a password for future past performance evaluation processing.

3. Interim, Annual and Final Past Performance Evaluation Reports:

i. Issuing the Evaluation: Once the CMS Assessing Official (AO) issues an evaluation to the Contractor in CPARS, the CR(s) will receive an email instructing them to login to CPARS to review the evaluation.

ii. Contractor Comments: The CR has the option to provide comments on the

evaluation, indicate if they concur or do not concur with the evaluation, sign, and then return the evaluation to the AO. The CR has a total of 60 days following the AO’s evaluation signature date to submit comments. If the CR submits comments within the first 14 days following the AO’s signature date and the AO closes the evaluation, the evaluation will become available in Past Performance Information Retrieval System - Report Card (PPIRS-RC) within 1 day.

On day 15 following the AO’s evaluation signature date, the evaluation will become available in PPIRS-RC with or without CR comments and whether or not it has been closed by the AO. If no CR comments have been sent and the evaluation has not been closed, it will be marked as “Pending” in PPIRS-RC. If the CR sends comments at any time prior to 61 days following the AO’s evaluation signature date, those comments will be reflected in PPIRS-RC within 1 day. On day 61 following the AO’s evaluation signature date, the CR will be “locked out” of the evaluation and may no longer send comments.



SECTION H – SPECIAL CONTRACT REQUIREMENTS H.1 BUSINESS ETHICS, CONFLICT OF INTEREST AND COMPLIANCE

(JUNE 2015)

a. General: It is imperative that the Contractor and the services provided under this contract be free, to the greatest extent possible, of all Organizational and Personal Conflicts of Interest. In this clause, all references to Organizational and/or Personal Conflicts of Interests will be referred to individually or collectively, as the text justifies, as Conflicts of Interest (COI). Except as provided below, the Contracting Officer shall not maintain a contract with a Contractor that the Contracting Officer determines has, or has the potential for, an unresolved COI. However, in accordance with FAR 9.503 Waiver, the Contracting Officer may contract with a Contractor that has an unresolved COI if the Contracting Officer determines that it is in the best interest of the Government to do so.

b. Definitions:

Actual COI– means that the COI is currently in existence as determined by the Offeror’s or Contractor’s Compliance Officer and/or as determined by CMS. This form of COI will require avoidance, neutralization or mitigation acceptable to CMS. Affiliates – As defined in FAR 2.101 means associated business concerns or individual(s) if, directly or indirectly either one controls or can control the other; or a third party controls or can control both.

For purposes of this contract, affiliate control or influence may include, but is not limited to:

(a) Interlocking management or ownership (e.g., individuals serving in similar capacities in several companies);

(b) Identity of interests among family members such as spouse/domestic partner and/or any dependent of the respondent;

(c) Shared facilities and equipment;

(d) Common use of employees; or

(e) A business concern organized just prior to, or immediately following, the release of a solicitation or request for information, which has the same or similar management, ownership, or principal employees as the offeror or Contractor.

Any business, whether or not it is organized for profit or located in the United States or its outlying areas, or person may be found to be an affiliate. Control may be affirmative or negative and it is immaterial whether it is exercised so long as the power to control exists.

Apparent (Perceived) COI – means that the COI on first observation appears to be an actual or potential COI, but may or may not be after analysis. Even if the apparent COI is determined to be non-existent, this perception may still require further explanation.



Avoidance – means Government action taken in one acquisition that is intended to prevent a COI in that acquisition or in a future action. Methods of avoiding COIs include, but are not limited to:

• Drafting the statement of work (SOW) to exclude tasks that require Contractors

to utilize subjective judgment; or

• Obtaining advice from more than one source on any issue on which there are concerns about an COI so that there is no area in which the Government is relying solely on the advice of any one of the sources; or

• Excluding an offeror from participation in a contract award.

Financial Interests/Relationships – means a healthcare related direct or indirect ownership or investment interest (including an option or non-vested interest) in any entity that exists through equity, debt, or other means and includes any indirect ownership or investment interest no matter how many levels removed from a direct interest.

A financial interest/relationship may arise from the following non-exclusive examples:

(a) Compensation, including wages, salaries, commissions, professional fees, or fees for

business referrals;

(b) Current or known future arrangements or requirements for which you are defined as an interested party, including, but not limited to, an entity that may create one or more of the three forms of COI;

(c) Consulting relationships, including commercial and professional consulting and service arrangements, scientific and technical advisory board memberships, or serving as an expert witness in litigation;

(d) Services provided in exchange for honorariums including travel expense reimbursements;

(e) Research funding or other forms of research support;

(f) Healthcare related investment in the form of stock or bond ownership, including healthcare sector investment only mutual funds;

(g) Healthcare business ownership or partnership interests;

(h) Patents, copyrights, and other intellectual property interests;

(i) Seeking or negotiating for prospective employment or business; or

(j) Gifts, including travel.

Mitigation– means action taken by the Contractor to eliminate the COI risk to a level acceptable to CMS on a present contract.

Neutralization – means excluding or restricting a Contractor from offering, as a prime or



subcontractor, on future contracts while allowing the Contractor to perform on the instant contract. This method protects the Government’s interests in cases where the Contractor’s work on the instant contract could be biased or impaired by virtue of its expectation of future work, or when the Contractor would have an unfair advantage in competing for award of the future work. Organizational Conflict of Interest – In accordance with FAR 2.101 Definitions, means that because of other activities or relationships with other persons, a person is unable, or potentially unable, to render impartial assistance or advice to the Government, or the person’s objectivity in performing the contract work is, or might be, otherwise impaired, or a person has an unfair competitive advantage.

For purposes of this contract, the conflict of interest definition includes direct or indirect relationships including, but not limited to, the Contractor and its parent company, subsidiaries, affiliates, subcontractors, clients and principals.

Personal Conflicts of Interest – A situation in which a person has a financial interest, personal activity, or relationship that could impair the person’s ability to act impartially and in the best interest of the Government when performing under this contract.

(a) Among the sources of personal conflicts of interest are—

(i) Financial interests of the person, spouse/domestic partner and/or any other dependent of the person, as defined for Federal tax purposes;

(ii) Other employment or financial relationships (including seeking or negotiating for prospective employment or business) and,

(iii) Gifts, including travel.

(b) For example, financial interests referred to in paragraph (a)(i) of this definition may arise from—

(i) Compensation, including wages, salaries, commissions, professional fees, or fees for business referrals;

(ii) Consulting relationships;

(iii) Services provided in exchange for honoraria or travel expense reimbursements;

(iv) Research funding or other forms of research support;

(v) Healthcare related investments;

(vi) Real estate investments;

(vii) Patents, copyrights, and other intellectual property interests; or

(viii) Business ownership and investment interests.



Potential COI – means that the COI could become an actual COI due to contingency events and/or as determined by CMS. This form of COI will require avoidance, neutralization or mitigation acceptable to CMS.

Principal – As defined in FAR 52.203-13, Contractor Code of Business Ethics and Conduct, means an officer, director, owner, partner, or a person having primary management or supervisory responsibilities within a business entity (e.g., general manager, plant manager, head of a division or business segment, and similar positions).

Three (3) Types of COIs include: Conflict Types Definitions

Biased Ground Rules

Consists of situations in which a firm, as part of its performance of a Government contract, has helped (or is in a position to help) set the ground rules for another Government contract by, for example, writing the statement of work or the specifications, or establishing source-selection criteria. In these “biased ground rules” cases, the primary concern is that the firm could skew the competition, whether intentionally or not, in favor of itself and/or its affiliates.

Impaired Objectivity

Consists of situations where a firm's ability to render impartial advice to the Government would be undermined by the firm's competing interests. The concern in impaired objectivity situations, including evaluation of services, is that a firm's ability to render impartial advice to the Government will be undermined by the firm’s relationship to the service being evaluated. These types of situations involve cases where a firm's work under one Government contract could entail the firm evaluating itself, either through an assessment of performance under another contract or an evaluation of proposals.

Unequal Access to Information

“Unfair” access to non-public information – Consists of situations in which a firm has access to nonpublic information (including proprietary information and non-public source-selection information) as part of its performance of a Government contract and that information may provide the firm with a competitive advantage in a later competition for a Government contract. In these “unequal access to information” cases, the concern is limited to the risk of the firm gaining an unfair competitive advantage; there is no issue of bias. Note: Incumbency alone does not constitute “unequal access to information.”

c. Significant Potential Conflict of Interest: The Contracting Officer has determined that this

contract may involve significant potential COIs.

1. Nature of Potential Conflict: Although not all inclusive, the Contracting Officer has determined that the following activities are considered to be an actual, potential or apparent



COI with the work to be performed under this contract. The Contractor/Subcontractor shall promptly notify the Contracting Officer of any relationships with any of the following entities:

For the purpose of identifying entities with actual, potential or apparent COIs, at a minimum, the Contractor/Subcontractor is an entity that—

(a) Provides, insures, or pays for health benefits, with the exception of health plans provided

as the entity’s employee fringe benefit; or

(b) Conducts audits of health benefit payments or cost reports; or

(c) Would review or does review, under the contract, Medicare or Medicaid services furnished by a provider or supplier that is a direct competitor of the Contractor/Subcontractor; or

(d) Prepared work or is under contract to prepare work that would be reviewed under the Medicare or Medicaid program integrity contract; or

(e) Is affiliated or has a financial relationship, as these terms are explained above, with a provider or supplier to be reviewed under the contract.

2. Proposed Restraint on Future Contractor/Subcontractor Activities: CMS is proposing to restrain future Contractor/Subcontractor activities as follows:

CMS considers it a conflict to become a MAC or ESRD at any time in the jurisdiction where it holds a UPIC contract. Offerors should be aware that performing the same or similar functions as the MAC or ESRD programs for a state at any time in the jurisdiction where it holds a UPIC contract will also be considered a conflict. A UPIC may not become a RAC, QIC or BFCC-QIO at any time in the jurisdiction where it holds a UPIC contract. Offerors should be aware that a UPIC may not perform the same or similar functions as the RAC, QIC or BFCC-QIO programs for a state at any time in the jurisdiction where it holds a UPIC contract.

d. Contractor Business Ethics, Conflict of Interest and Compliance Program Requirements: FAR 3.10 and FAR 52.203-13, Contractor Code of Business Ethics and Conduct, identify “…policies and procedures for establishment of Contractor codes of business ethics and conduct, and display of agency Office of Inspector General (OIG) hotline posters.” (See Section I, FAR 52.203-14 fill-in information for the website where you can find the HHS OIG fraud hotline poster). The following chart is provided to clarify requirements under this contract:



FAR 52.203-13 Requirements Applicability (X = Applicable)

Contracts < $5 Million

Contracts ≥$5Million

With a Small Business OR for

Commercial Items (as

Defined in FAR 2.101)

Contracts ≥$5Million

With a Large Business (No Commercial

Item Contracts)

CMS COI DISCLOSURES X X X PLAN FOR MONITORING/REPORTING COIs (Large Businesses Shall Incorporate COI Monitoring/Reporting as Part of Its Compliance Program) X X X CODE OF CONDUCT Not Required X X COMPLIANCE PROGRAM Not Required Not Required X

The following details are provided for respective COI disclosure expectations: 1. COI Oversight Program: The Contractor shall maintain an effective COI Oversight

Program. As part of the program, the contractor shall implement company business practices, procedures, polices and internal controls for compliance with COI requirements, such as:

a. Preventing conflicts of interest, prohibiting the use of non-public information accessed through this contract for personal gain, and obtaining a signed non-disclosure agreement to prohibit disclosure of non-public information accessed through this contract;

b. Conducting Internal and External Audits;

c. Policy Enforcement and Employee Disciplinary Actions;

d. Retention of Records;

e. Management of Subcontractors;

f. Internal control systems;

g. Display of Fraud Hotline Poster(s) in accordance with FAR 52.203-14 Display of Hotline Poster(s).

h. Reviewing the information required by Attachment J.9, Personal Financial Disclosure Template, for each principal, officer and director of the organization, as well as managers and key personnel who would be, or are involved with, the performance of this contract. It is recommended that individuals who have not disclosed changes within the reporting period, submit an annual disclosure update to their Compliance Officer for review;



i. Informing employees, through an employee education and training program, of their obligation to disclose and prevent conflicts of interest, not to use non-public information accessed through performance of this contract for personal gain, and to avoid even the appearance of personal conflicts of interest; and,

j. Reporting to the Contracting Officer any conflict of interest violations.

2. Conflict of Interest:

In accordance with FAR 3.10 and 52.203-13, Contractor Code of Business Ethics and Conduct, and this solicitation/contract, the Contractor shall have procedures in place to monitor and disclose all Organizational and Personal Conflicts of Interest throughout the life of the contract. COI information shall be submitted as follows:

(a) Initial Submission of COI Information: The Contractor shall submit Conflict of Interest information identified in –

• Attachment J.8, Conflict of Interest Submission by Offeror/Contractor (follow the format identified in the Attachment J.8).

(b) Personal Conflict Information: It is the offeror/contractor’s responsibility to have a COI plan in place (see H.1.d.2. COI Oversight Program) to ensure that actual, potential, or apparent personal conflicts of interest are identified, analyzed and mitigated for performance of this contract.

COI information shall be obtained by the Offeror/Contractor for each: Manager or Key personnel who would be, or are involved with, the

performance of this contract;

Board of Director members (if applicable); and,

Principals of the organization as defined by FAR 52.203-13, Contractor Code of Business Ethics and Conduct.

Attachment J.9, Personal Conflict of Interest Financial Disclosure is provided as a “sample” for the offeror/contractor to follow when identifying, analyzing and mitigating actual, potential, or apparent COIs for this contract.

(c) Mitigation/Resolution: The Contracting Officer determines whether a COI has been identified and whether the actual, potential or apparent COI has been mitigated/resolved to the Government’s satisfaction. The Contractor's approved COI Mitigation/Resolution plan shall be incorporated into the contract. Notwithstanding, Personal COI information obtained from the above individuals shall not be submitted to the Government.



In cases whereby a COI cannot be, or has not been, mitigated to the Contracting Officer’s satisfaction, the Contracting Officer may take the following action including, but not limited to:

i. Request a waiver in accordance with FAR 9.503 Waiver, from the Head of the Contracting Activity; or

ii. Make changes to the requirements of the contract; or

iii. Terminate the contract.

(d) Conflict of Interest Disclosure During Contract Performance: COI Disclosure Revisions shall be submitted to the Contracting Officer as follows:

i. When Revisions are Required:

• At any time during the performance of this contract, if the Contractor learns of any actual, potential, or apparent COI, whereby a reasonable business person might equate the COI to one (1) of the three (3) types of COIs identified in H.1.b Definitions, the Contractor shall notify the Contracting Officer in writing within five (5) business days of the identification of the actual, potential, or apparent COI. Within 30 calendar days, or as otherwise negotiated with the Contracting Officer, the Contractor shall submit a COI Disclosure Revision in accordance with 2. (d) ii below.

If, as a result of the Government or Contractor independent auditor review, any findings require a change in the previous disclosure, submit a COI Disclosure Revision, in accordance (d) ii below, to the Contracting Officer within 30 calendar days of the final audit report.

• Within 30 calendar days when the Contracting Officer requests a revision.

• At least 45 calendar days prior to a change due to proposed or planned business actions, e.g., acquiring or selling a business or business segment, changes in ownership of the organization holding the contract, etc.

ii. What is Required in a Revision:

• When COI disclosures require revision, the Contractor shall provide a revised Attachment J.8, Conflict of Interest Submission by Offeror/Contractor. Red-lined versions are preferred.

3. Independent Audit: Unless otherwise instructed, when a mitigation plan is required to be submitted, the Contractor shall obtain the services of an External/Independent auditor to conduct an audit of the “Mitigation Strategy.” If the Government chooses to execute the audit in lieu of the contractor independent audit, the Contracting Officer will notify the Contractor within 60 days of the anniversary date of the contract.



Such auditor shall have expertise in conducting compliance program and conflict of interest audits. The Contractor’s records may also be subject to audit by the Government to ensure compliance with this contract’s H.1 clause requirements and/or ensure that any corrective action, if necessary, has been implemented.

a. Subcontractors: A COI independent audit shall be required at the discretion of the

Prime Contractor. If the Prime Contractor requires an audit of the subcontractor(s), the subcontractor’s audit shall be included with the Prime Contractor’s audit submission.

b. First Audit: When a mitigation plan is required, an independent audit of the COI program is due 90 days after the first anniversary date of the contract or as otherwise negotiated with the Contracting Officer. The independent audit will be submitted by the auditor directly to the Contracting Officer with a copy to the Contractor.

c. Subsequent Audits: Additional audits are at the discretion of the Contracting Officer. The Contracting Officer will consider previous audit findings, any corrective action(s) and any new COI information, when making the decision to require subsequent audits.

d. Audit Findings: When Contractor Conflict of Interest Oversight findings are disclosed in an independent audit, the Contractor shall submit a corrective action plan to the Contracting Officer 30 days after receipt of the audit findings. The Contracting Officer may require a revised COI mitigation plan to be submitted as a result of the audit findings.

e. Independent Audit Requirements:

1. The auditor shall decide what processes it will use to review, verify and confirm the information, processes and policies disclosed by the Contractor to the Government. The audit shall include a process for the contractor to review audit findings and provide a response to the auditor, which shall be included in the final audit submitted to the CMS Contracting Officer.

2. The audit shall confirm that any and all COI mitigation plans, approved by the Government, have been implemented and are functioning as anticipated. Although not all inclusive, the auditor may also want to consider the following:

(i) Review of all COI disclosures submitted to the Government to validate the accuracy and completeness of such disclosures;

(ii) Conducting appropriate interviews with principals, key personnel and independent members of the board of directors, as appropriate;

(iii) Reviewing the Contractor’s organizational chart(s), articles of incorporation, bylaws and/or other documents, to validate the accuracy and completeness of COI disclosures to the Government;

(iv) Confirming that the Contractor annually, at a minimum, collects and reviews for assessment and appropriate action by the Compliance Officer, personal



conflict information from its principals, key personnel (on the relevant contract(s)) and board of director members;

(v) Confirming whether the Contractor is in compliance with its internal Contractor Conflict of Interest Oversight program(s); and,

(vi) For its Subcontractors, confirming whether the prime Contractor is monitoring Subcontractor compliance with the required contract flow-down provisions and disclosed practices, in accordance with contract H.1. The auditor may review other information as it deems appropriate to ensure that COI issues have been identified and resolved, in accordance with Contractor disclosures.

(vii) The auditor will also examine the Contractor’s records to verify that all of the requirements specified in FAR 52.203-13(c)(2)(ii), Contractor Code of Business Ethics and Conduct, are met.

3. Reporting Requirements: The audit report, inclusive of all auditor findings and proposed corrective actions, shall be delivered via email or the US Postal Service to the Contracting Officer directly from the auditor.

e. Subcontractor Flow-Down Clause: The prime Contractor is responsible for avoiding, neutralizing and mitigating all actual, potential, or apparent COI’s of its Subcontractors, in accordance with this clause. Therefore, the prime Contractor shall flow-down H.1 Business Ethics, Conflict of Interest and Compliance, of this contract in all subcontracts. For Subcontractors, wherever the term “Contractor” is used, insert “Subcontractor.”

H.2 HIPAA BUSINESS ASSOCIATE CLAUSE (OCT 2014) All Protected Health Information (PHI), as defined in 45 C.F.R. §160.103, that is relevant to this Contract, shall be administered in accordance with the Health Insurance Portability and Accountability Act of 1996 ("HIPAA," 42 U.S.C. § 1320d), as amended, as well as the corresponding implementing regulations and this HIPAA Business Associate Clause.

a. Definitions:

All terms used herein and not otherwise defined, shall have the same meaning as in HIPAA, as amended, and the corresponding implementing regulations. Non-HIPAA related provisions governing the Contractor's duties and obligations, such as those under the Privacy Act and any applicable data use agreements, are generally covered elsewhere in the Contract. The following definitions apply to this Contract Clause:

"Business Associate'' shall mean the Contractor (and/or the Contractor’s subcontractors or agents) if/when it uses individually identifiable health information on behalf of CMS, i.e. PHI, to carry out CMS’ HIPAA-covered functions.

"Covered Entity" shall mean the portions of CMS that are subject to the HIPAA Privacy Rule.



"Secretary" shall mean the Secretary of the Department of Health & Human Services or the Secretary's designee.

b. Obligations and Activities of Business Associate:

Except as otherwise provided in this Contract, Business Associate, as defined above, shall only use or disclose PHI on behalf of, or to provide services to, Covered Entity in accordance with this Contract and the HIPAA Privacy and Security Rules. Business Associate shall document in writing the policies and procedures that will be used to meet HIPAA requirements. The policies and procedures shall include the following, at a minimum:

1. Business Associate shall not:

a. Use or disclose PHI that is created, received, maintained or transmitted by Business

Associate from, or on behalf of, Covered Entity other than as permitted or required by this Contract or as required by law;

b. Sell PHI; or,

c. Threaten, intimidate, coerce, harass, discriminate against, or take any other retaliatory

action against any individual for: i. Filing a complaint under 45 CFR § 160.306;

ii. Testifying, assisting or participating in an investigation, compliance review, proceeding or hearing under 45 CFR Part 160; or

iii. Opposing any act or practice that is unlawful under HIPAA, provided there is a

good faith belief that the practice is unlawful, the manner of opposition is reasonable, and the opposition does not involve the disclosure of PHI in violation of subpart E of Part 164.

2. Business Associate shall:

a. Have a security official who will be responsible for development and implementation

of its security policies and procedures, including workforce security measures, to ensure proper security awareness and training (including security incident response and reporting), and security incident procedures, in accordance with this Contract, including this HIPAA Business Associate Clause and the Contract’s clause entitled “CMS Information Security.”

b. Use administrative, physical and technical safeguards to prevent use or disclosure of

PHI created, received, maintained or transmitted by Business Associate from, or on behalf of Covered Entity only as provided for by this Contract. In doing so, it shall implement policies and procedures to address the following and, where applicable, ensure that such policies and procedures are also in conformance with this Contract’s clause entitled “CMS Information Security:”

i. Prevent, detect, contain and correct security violations through the use of:



1. Risk analyses (including periodic technical and nontechnical evaluations);

2. Appropriate risk management strategies, including system activity review;

3. Information access procedures for approving individual’s access rights to PHI (including the implementation of workforce security measures to ensure continued appropriate role-based access to PHI), and technical policies and procedures to ensure compliance with grants of access (including unique user identification and tracking of users) and;

4. The imposition of sanctions for violations.

ii. Limit physical access to its electronic information systems and the facility or facilities in which they are housed.

iii. Implement policies, procedures and physical security measures that will limit

access to PHI through workstations and other devices, including access through mobile devices.

iv. Implement media controls covering the movement of devices containing PHI

within or outside of the Business Associate’s facility as well as the disposal and reuse of media containing PHI.

v. Implement appropriate administrative, physical and technical safeguards that reasonably and appropriately protect the confidentiality, integrity and availability (including the use of contingency plans) of any electronic protected health information ("EPHI") it creates, receives, maintains or transmits from, or on behalf of the Covered Entity to prevent impermissible use, disclosure, maintenance or transmission of such EPHI. In the establishment of such safeguards, Business Associate shall consider its size, complexity and capabilities, as well as its technical infrastructure, and its hardware and software security capabilities.

c. Assess, and implement, where appropriate, any addressable implementation

specifications associated with applicable PHI security standards.

d. Mitigate, to the extent practicable, any harmful effect that is known to Business Associate of a use or disclosure of PHI by Business Associate in violation of the requirements of this Contract.

e. Comply with the following Incident Reporting:

(a) Report to Covered Entity any security incident/breach involving unsecured PHI, of

which it becomes aware, including those of its agents and subcontractors. The Business Associate shall report any violation of the terms of this contract involving PHI and any security incidents/breaches involving unsecured PHI to CMS within one (1) hour of discovery in accordance with the CMS Risk Management Handbook (RMH), specifically “RMH Vol II Procedure 7-2 Incident Handling Procedure” and “RMH Vol III Standard 7-1 Incident Handling.” These procedures can be found at http://www.cms.gov/Research-Statistics-Data-and-Systems/CMS-Information-Technology/InformationSecurity/Information-Security-Library.html In addition, the Business Associate will also notify the CMS Contracting Officer

http://www.cms.gov/Research-Statistics-Data-and-Systems/CMS-Information-Technology/InformationSecurity/Information-Security-Library.html

http://www.cms.gov/Research-Statistics-Data-and-Systems/CMS-Information-Technology/InformationSecurity/Information-Security-Library.html



and the Contracting Officer’s Representative (COR) by email within one (1) hour of identifying such violation or incident.

(b) Upon Covered Entity's knowledge of any material security incident/breach by

Business Associate, Covered Entity will provide an opportunity for Business Associate to cure the breach or end the violation consistent with the termination clause of this Contract. See also paragraph D. Term of Clause below.

f. Ensure that any agent or subcontractor agrees through a written contract, or other

legally enforceable arrangement, to the same restrictions and conditions that apply through this HIPAA Contract Clause, when creating, receiving, maintaining or transmitting PHI from, or on behalf of, Covered Entity.

g. Upon Covered Entity’s request:

i. Provide the Covered Entity or its designee with access to the PHI created,

received, maintained or transmitted by Business Associate from or on behalf of the Covered Entity in the course of contract performance in order to ensure Covered Entity’s ability to meet the requirements under 45 CFR § 164.524.

ii. Amend PHI as Covered Entity directs or agrees to pursuant to 45 CFR §

164.526.

h. Make its facilities and any books, records, accounts, and any sources of PHI, including any policies and procedures, that are pertinent to ascertaining its own compliance with this contract or the Covered Entity’s compliance with the applicable HIPAA requirements, available to Covered Entity, or, in the context of an investigation or compliance review, to the Secretary for purposes of the Secretary determining Covered Entity's compliance with the various rules implementing the HIPAA.

i. Document disclosures of PHI and information related to such disclosures as would be

required for Covered Entity to respond to a request by an Individual for an accounting of disclosures of PHI in accordance with 45 CFR § 164.528.

j. Provide to Covered Entity, or an individual identified by the Covered Entity,

information collected under this Contract, to permit Covered Entity to respond to a request by an Individual for an accounting of disclosures of PHI in accordance with 45 CFR § 164.528.

k. Make reasonable efforts to limit the PHI it uses, discloses or requests to the minimum

necessary to accomplish the intended purpose of the permitted use, disclosure or request.

c. Obligations of Covered Entity

Covered Entity shall notify Business Associate of any:

1. Limitation(s) in its Notice of Privacy Practices in accordance with 45 CFR § 164.520, to the

extent that such limitation may affect Business Associate's use or disclosure of PHI;

2. Changes in, or revocation of, permission by an Individual to use or disclose their PHI, to the



extent that such changes may affect Business Associate's use or disclosure of PHI; and,

3. Restriction to the use or disclosure of PHI that Covered Entity has agreed to in accordance with 45 CFR § 164.522, to the extent that such restriction may affect Business Associate's use or disclosure of PHI.

d. Term of Clause

1. The term of this Clause shall be effective as of date of Contract award, and shall terminate

when all of the PHI provided to Business Associate by the Covered Entity or a Business Associate of the Covered Entity, or created or received by Business Associate on behalf of Covered Entity, is destroyed or returned to Covered Entity in accordance with “CMS Information Security” procedures. Business Associate shall not retain any PHI.

2. Security Incident/Breach: Upon Covered Entity's knowledge of a material breach by Business Associate, Covered Entity shall take action consistent with the terms of this Contract, and, as appropriate, the following:

i. Federal Acquisition Regulation (FAR) Contracts – Covered Entity may:

A. Terminate this Contract in accordance with FAR Part 49, Termination of Contracts, if the Business Associate does not cure the security incident/breach within the time specified by Covered Entity and/or cure is not possible; or,

B. If neither termination nor cure is feasible, Covered Entity shall report the violation to the Secretary.

ii. Other Agreements –Covered Entity shall either:

A. Provide an opportunity for Business Associate to cure the breach or end the violation

consistent with the termination terms of this Contract. Covered Entity may terminate this Contract for default if the Business Associate does not cure the breach or end the violation within the time specified by Covered Entity; or,

B. Consistent with the terms of this Contract, terminate this Contract for default if

Business Associate has breached a material term of this Contract and cure is not possible; or,

C. If neither termination nor cure is feasible, Covered Entity shall report the violation to

the Secretary.

3. Returning or Destroying PHI:

Business Associate, as defined above, which includes subcontractors or agents of the Contractor, shall: ii. Upon expiration or termination of this Contract, for any reason, return or destroy all PHI

received from Covered Entity or another Business Associate of the Covered Entity, as well as any PHI created, received, maintained or transmitted from or on behalf of Covered Entity, or another Business Associate of the Covered Entity, in accordance with



this contract, including the “CMS Information Security” clause. iii. In the event that Business Associate determines that returning or destroying the PHI is

infeasible, provide to Covered Entity notification of the conditions that make return or destruction infeasible. Upon such notice that return or destruction of PHI is infeasible, Business Associate shall extend the protections of this Contract to such PHI and limit further uses and disclosures of such PHI to those purposes that make the return or destruction infeasible, for so long as Business Associate maintains such PHI.

e. Miscellaneous

1. A reference in this Contract to a section in the Rules issued under HIPAA means the section

as in effect or as amended.

2. The respective rights and obligations of Business Associate under paragraph D.3.b of the section entitled "Term of Clause" shall survive the termination of this Contract.

Any ambiguity in this Contract clause shall be resolved to permit Covered Entity to comply with the Rules implemented under HIPAA.

H.3 OPEN GOVERNMENT PROACTIVE PREDISCLOSURE NOTIFICATION (OCT 2013) In order to reduce the administrative burden of responding to Freedom of Information Act (FOIA) requests for high visibility/high public interest contracts throughout contract administration, the Contractor shall submit its review of the awarded contract (and contract modifications, if requested) for FOIA disclosure exemptions within thirty (30) calendar days of contract award. The review will substantiate “…Trade secrets and commercial or financial information obtained from a person and privileged or confidential…” information, in accordance with 5 U.S.C. §552 FOIA, Exemption (b)(4), which could reasonably be expected to cause substantial competitive harm.

Submissions: The Contractor shall submit one (1) Compact Disc (CD) or Digital Video Disc (DVD) with all 5 U.S.C. §552 FOIA, Exemption (b)(4), “…Trade Secrets, Commercial or Financial Information Which is Privileged or Confidential…,” otherwise known as public release/non-Confidential Business Information (non-CBI), with the information identified as follows:

a. CBI Highlighted Copy of Contract: One copy of the contract with all CBI highlighted for CMS FOIA review.

b. Contractor Proposed Redacted Public Release Copy of Contract: An additional copy of the contract will be provided for public release with all the identified information redacted. Redactions shall be made using “black” boxes, which cannot be removed or uncovered by a reader.

c. Pre-Disclosure Concerns - Comments/Rationale for Non-Disclosure of Trade Secrets, Commercial or Financial Information Which is Privileged or Confidential: The Contractor shall provide, in a separate file, rationale for why disclosure of “…Trade Secrets, Commercial or Financial Information Which is Privileged or Confidential…” would cause the Contractor organization substantial competitive harm if disclosed to other entities. Rationale shall be provided for each individual recommended redaction. Generalized conclusions of competitive harm are not a sufficient basis for the CMS FOIA office to invoke the exemption and thereby



protect the Contractor’s interest.

All CD/DVDs shall be mailed to the CMS FOIA Officer (address below) within thirty (30) calendar days of contract award and within thirty (30) calendar days of a CMS request, i.e. existing or modified contracts. All CD/DVD files shall be submitted as Portable Document Format (.pdf) files.

CD/DVD and File Naming Conventions: The Contractor shall name the CD/DVD with the Contract Number and utilize the following CD/DVD file naming conventions:

HHSM-500-2013-xxxxxx – Highlighted

HHSM-500-2013-xxxxxx – Redacted

HHSM-500-2013-xxxxxx – Pre-Disclosure Concerns

CD/DVD shall be mailed to the CMS FOIA Officer at:

Centers for Medicare & Medicaid Services

Freedom of Information Act Office

ATTN: CMS FOIA Officer

Mailstop: N2-20-16

7500 Security Boulevard

Baltimore, MD 21244-1850

Copy– Correspondence Only (No CD/DVD): Contracting Officer Contracting Officer’s Representative (COR)

It should be noted that the CMS FOIA Office makes the final determination as to what information is released to the public, after considering any feedback from OAGM and/or the Contractor. H.4 CONTRACT RENEWAL

a. Pursuant to 42 CFR 400 and 421, “Medicare Integrity Program” if this contract is funded by

Medicare Integrity Program appropriated funding, the Contracting Officer may unilaterally renew this contract annually by giving the Contractor written notice, within 60 days of the expiration date of this contract (after exercise of all option or renewal years), of its intent to do so. The contract renewal period of performance will be established at the time a renewal determination is made.

b. The Contracting Officer may renew this contract under this provision without competition if--

1. The Contractor continues to meet the requirements set forth in Subpart D of 42 CFR Part

421, FAR and HHSAR; 2. The Contractor meets or exceeds all of the performance requirements established in this

contract; and 3. It is in the best interest of the Government.



c. If the Contracting Officer does not renew this contract, the contract will end in accordance

with its terms and the Contractor does not have the right to a hearing or judicial review of the non-renewal decision.

d. The Contractor may notify the Contracting Officer of its intent to not renew its contract under

this provision (after all option periods or renewal years expire) by providing written notice 60 days prior to the expiration of the contract.

H.5 CONFIDENTIALITY OF INFORMATION

(a) Confidential information, as used in this clause, means information or data of a personal nature about an individual or proprietary information or data submitted by or pertaining to an institution or organization.

(b) The Contracting Officer and the Contractor may, by mutual consent, identify elsewhere in this contract specific information and/or categories of information which the Government will furnish to the Contractor or that the Contractor is expected to generate which is confidential. Similarly, the Contracting Officer and the Contractor may, by mutual consent, identify such confidential information from time to time during the performance of the contract. Failure to agree will be settled pursuant to the ‘‘Disputes’’ clause.

(c) If it is established elsewhere in this contract that information to be utilized under this contract, or a portion thereof, is subject to the Privacy Act, the Contractor will follow the rules and procedures of disclosure set forth in the Privacy Act of 1974, 5 U.S.C. 552a (New Window), and implementing regulations and policies, with respect to systems of records determined to be subject to the Privacy Act.

(d) Confidential information, as defined in paragraph (a) of this clause, shall not be disclosed without the prior written consent of the individual, institution, or organization.

(e) Whenever the Contractor is uncertain with regard to the proper handling of material under the contract, or if the material in question is subject to the Privacy Act or is confidential information subject to the provisions of this clause, the Contractor should obtain a written determination from the Contracting Officer prior to any release, disclosure, dissemination, or publication.

(f) Contracting Officer determinations will reflect the result of internal coordination with appropriate program and legal officials.

(g) The provisions of paragraph (d) of this clause shall not apply to conflicting or overlapping provisions in other Federal, State, or local laws.

H.6 REPORTABLE EVENTS The Contractor shall submit instances of reportable events to the CMS Contracting Officer and the CMS Contracting Officer’s Representative within three (3) days of discovery of a known, probable or suspected reportable event, as defined below. Reports to CMS shall be in accordance with the procedures set forth below. (Note: the reportable events disclosed herein are separate and distinct from the reportable events

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described in the BPSSM)

a. Definition of “Reportable Event:” A “Reportable Event” is anything that involves the following: (1) a matter that a reasonable person would consider a violation of criminal, civil or administrative laws applicable to the contract or Federal health care program; or (2) integrity violations, including any known, probable or suspected violation of any contract term or condition. A reportable event may be the result of an isolated event or a series of occurrences. Reportable events that are subject to reporting under these procedures include events that occur at the Contractor or any of its subcontractors.

b. Initial Report: If the Contractor discovers, through any means, a known, probable or

suspected reportable event, the Contractor shall provide to CMS an initial written report within 3 calendar days of discovering the reportable event.

The Contractor’s initial written report shall include, at a minimum, the following information:

1. The law, regulation or contract term implicated. 2. The persons involved and the department(s) within the Contractor’s operation that are

affected. 3. The time period of the reportable event. 4. A determination as to the extent that the reportable event has affected, or is affecting

performance under the contract. 5. Any corrective action taken, or intended to be taken, by the Contractor.

c. Final Report: Within 30 calendar days of the date of the initial report, the Contractor shall provide to CMS a written final investigative report.

The final written report shall include the following information:

(1) All information in the initial report. (2) Outcome of the investigation including the name(s) of the person(s) who conducted

the investigation. (3) Steps taken to correct the reportable event identified. (4) A statement as to whether the Contractor considered changing any policies and

procedures to prevent the recurrence of this or other similar reportable events. If policies and procedures were changed, or will occur, the Contractor shall describe the changes.

(5) Required training if necessary. (6) A statement that the Contractor’s internal investigative file on the reportable event is

available to CMS for audit, inspection or reproduction.

H.7 DISCLOSURE OF INFORMATION The Contractor shall establish and maintain procedures and controls for the purpose of assuring that information contained in its records and obtained from CMS or from others in carrying out functions under this contract will be used by it and disclosed solely as provided in section 1106 of the Social Security Act and its implementing regulations (42 CFR Part 401, subpart B).

H.8 SYSTEMS OF RECORDS The Privacy Act of 1974, Public Law 93-579, and the Regulations and General Instructions issued by the



Secretary pursuant thereto, are applicable to this contract, and to all subcontractors there under to the extent that the design, development, operation or maintenance of a system of records as defined in the Privacy Act is involved.

The following Systems of Records may apply to this contract:

Enrollment Data Base (EDB) 09-70-0502 Fraud Investigation Database (FID) 09-70-0527 Health Plan Management System (HPMS) 09-70-4004 Medicare Beneficiary Database (MBD) 09-70-0536 Medicare Exclusion Database (MED) 09-70-0534 National Claims History (NCH) 09-70-0005 Provider Enrollment Chain and Ownership System (PECOS) 09-70-0532 Medicare Advantage Prescription Drug (MARx) System 09-70-4001

One Program Integrity Data Repository (One PI) 09-70-0568

National Provider System (NPS), 09-70-0008

Medicare Provider Analysis and Review (MEDPAR), 09-70-0009

Carrier Medicare Claims Record, 09-70-0501

Intermediary Medicare Claims Records (IMCR), 09-70-0503

Intern and Resident Information System (IRIS), 09-70-0524

Medicare Physician Identification and Eligibility System (MPIES),

09-70-0525

Common Working File (CWF), 09-70-0526

Medicare Supplier Identification File (MSIF), 09-70-0530

Medicare Retiree Drug Subsidy Program (RDSP), 09-70-0550

Medicare Premium Withhold System (PWS) 09-70-0552

Medicare Drug Data Processing System (DDPS), 09-70-0553

Fraud Prevention System (FPS)

Unified Case Management (UCM) system

Electronic Submission of Medical Documentation System (eSMD)

CMSNet connection

CMS Enterprise Portal

CMS ARTS

Integrated Data Repository (IDR)

Compromised Numbers Checklist Database (CNC)

Recovery Audit Contract (RAC) Data Warehouse

http://fs1.eps.gov/privacyact/0502.pdf








National Plan Provider Enumeration System (NPPES)

H.9 EMPLOYMENT OF CMS PERSONNEL RESTRICTED In performing this contract, the Contractor shall not use as a consultant or employ (on either a full or part time basis) any CMS personnel (individual who was formerly or currently employed by CMS within the last 10 years) without the prior approval of the Contracting Officer. Such approval may be given only in circumstances where it is clear that no laws, regulations, or policies might possibly be violated and no appearance of a conflict of interest will exist.

H.10 APPROVAL OF CONTRACT ACQUIRED INFORMATION TECHNOLOGY (IT)

a. The Contractor must obtain the Contracting Officer’s written approval prior to the acquisition of any IT investments (see FAR Part 2.101, for definition of IT) to ensure compatibility and successful integration with CMS’s infrastructure/architecture.

b. In the performance of a system life cycle development project, the Contractor must submit to

the Contracting Officers Representative the technical specifications for each of the following incremental phase of the projected life cycle prior to the commencement of work:

1. Design and Engineering; 2. Development; and, 3. Testing;

c. Upon written approval from the Contracting Officer, the Contractor shall commence work

under the approved technical specification for the authorized incremental phase.

d. In either instance of an approved IT investment acquisition, or an incremental phase of a system life cycle development project, the contract shall be modified accordingly and the Contractor shall proceed.

e. CMS may disallow any contractor incurred cost that would not be allocated to the approved

IT investment acquisition.

H.11 HHSAR 352.239-73(b) ELECTRONIC AND INFORMATION TECHNOLOGY ACCESSIBILITY (JANUARY 2010)

(a) Section 508 of the Rehabilitation Act of 1973 (29 U.S.C. 794d), as amended by the Workforce Investment Act of 1998, and the Architectural and Transportation Barriers Compliance Board Electronic and Information (EIT) Accessibility Standards (36 CFR Part 1194), require that, unless an exception applies, all EIT products and services developed, acquired, maintained, or used by any federal department or agency permit—

(1) Federal employees with disabilities to have access to and use information and data that is comparable to the access and use of information and data by federal employees who are not individuals with disabilities; and

(2) Members of the public with disabilities seeking information or services from a federal agency to have access to and use of information and data that is comparable to the access and use of information and data by members of the public who are not individuals with disabilities.

http://www.law.cornell.edu/uscode/29/794d.html

http://ecfr.gpoaccess.gov/cgi/t/text/text-idx?c=ecfr&tpl=/ecfrbrowse/Title36/36cfr1194_main_02.tpl

http://ecfr.gpoaccess.gov/cgi/t/text/text-idx?c=ecfr&tpl=/ecfrbrowse/Title36/36cfr1194_main_02.tpl



(b) Accordingly, any vendor submitting a proposal/quotation/bid in response to this solicitation must demonstrate compliance with the established EIT accessibility standards. Information about Section 508 is available at http://www.section508.gov/. The complete text of Section 508 Final Provisions can be accessed at http://www.access-board.gov/sec508/standards.htm.

(c) The Section 508 accessibility standards applicable to this solicitation are identified in the Statement of Work/Specification/Performance Work Statement. In order to facilitate the Government’s evaluation to determine whether EIT products and services proposed meet applicable Section 508 accessibility standards, offerors must prepare an HHS Section 508 Product Assessment Template, in accordance with its completion instructions, and provide a binding statement of conformance. The purpose of the template is to assist HHS acquisition and program officials in determining that EIT products and services proposed support applicable Section 508 accessibility standards. The template allows vendors or developers to self-evaluate their products or services and document in detail how they do or do not conform to a specific Section 508 accessibility standard. Instructions for preparing the HHS Section 508 Evaluation Template may be found under Section 508 policy on the HHS Office on Disability website (http://www.hhs.gov/od/).

(d) Respondents to this solicitation must also provide any additional detailed information necessary for determining applicable Section 508 accessibility standards conformance, as well as for documenting EIT products or services that are incidental to the project, which would constitute an exception to Section 508 requirements. If a vendor claims its products or services, including EIT deliverables such as electronic documents and reports, meet applicable Section 508 accessibility standards in its completed HHS Section 508 Product Assessment Template, and it is later determined by the Government – i.e., after award of a contract/order, that products or services delivered do not conform to the described accessibility standards in the Product Assessment Template, remediation of the products or services to the level of conformance specified in the vendor’s Product Assessment Template will be the responsibility of the Contractor and at its expense.

H.12 SECURITY CLAUSE-BACKGROUND-INVESTIGATION FOR CONTRACTOR PERSONNEL

If applicable, Contractor personnel performing services for CMS under this contract, task order or delivery order shall be required to undergo a background investigation. CMS will initiate and pay for any required background investigation(s). After contract award, the CMS Contracting Officers Representative (COR) and the Security and Emergency Management Group (SEMG), with the assistance of the Contractor, shall perform a position-sensitivity analysis based on the duties contractor personnel shall perform on the contract, task order or delivery order. The results of the position-sensitivity analysis will determine first, whether the provisions of this clause are applicable to the contract and second, if applicable, determine each position’s sensitivity level (i.e., high risk, moderate risk or low risk) and dictate the appropriate level of background investigation to be processed. Investigative packages may contain the following forms:

1. SF-85, Questionnaire for Non-Sensitive Positions, 09/1995 2. SF-85P, Questionnaire for Public Trust Positions, 09/1995 3. OF-612, Optional Application for Federal Employment, 12/2002 4. OF-306, Declaration for Federal Employment, 01/2001 5. Credit Report Release Form 6. FD-258, Fingerprint Card, 5/99, and

http://www.section508.gov/

http://www.access-board.gov/sec508/standards.htm

http://www.hhs.gov/od/

http://www.gsa.gov/Portal/gsa/ep/formslibrary.do?viewType=DETAIL&formId=FC83C171AE71F90585256A730051C8AB

http://www.gsa.gov/Portal/gsa/ep/formslibrary.do?viewType=DETAIL&formId=25292D2D26D8B5EC85256A730051F924

http://www.gsa.gov/Portal/gsa/ep/formslibrary.do?viewType=DETAIL&formId=41A93F1A1771761B85256A720061344C

http://www.gsa.gov/Portal/gsa/ep/formslibrary.do?viewType=DETAIL&formId=047C39FC0226D01E85256AAB005DF2AD

http://www.opm.gov/extra/investigate/Fin-1998/fin9802.asp

http://www.fbi.gov/hq/cjisd/PDF/fpcardb.pdf



7. CMS-730A, Request for Physical Access to CMS Facilities (NON-CMS ONLY), 11/2003.

The Contractor personnel shall be required to undergo a background investigation commensurate with one of these position-sensitivity levels:

1) High Risk (Level 6) Public Trust positions that would have a potential for exceptionally serious impact on the integrity and efficiency of the service. This would include computer security of a major automated information system (AIS). This includes positions in which the incumbent’s actions or inaction could diminish public confidence in the integrity, efficiency, or effectiveness of assigned government activities, whether or not actual damage occurs, particularly if duties are especially critical to the agency or program mission with a broad scope of responsibility and authority. Major responsibilities that would require this level include:

a. development and administration of CMS computer security programs, including direction and control of risk analysis and/or threat assessment;

b. significant involvement in mission-critical systems; c. preparation or approval of data for input into a system which does not necessarily involve

personal access to the system but with relatively high risk of causing grave damage or realizing significant personal gain;

d. other responsibilities that involve relatively high risk of causing damage or realizing personal gain;

e. policy implementation; f. higher level management duties/assignments or major program responsibility; or g. independent spokespersons or non-management position with authority for independent

action.

Approximate cost of each investigation: $2,900

2) Moderate Risk (Level 5) Level 5 Public Trust positions include those involving policymaking, major program responsibility, and law enforcement duties that are associated with a “Moderate Risk.” Also included are those positions involving access to or control of unclassified sensitive, proprietary information, or financial records, and those with similar duties through which the incumbent can realize a significant personal gain or cause serious damage to the program or Department. Responsibilities that would require this level include:

a. the direction, planning, design, operation, or maintenance of a computer system and whose work is technically reviewed by a higher authority at the High Risk level to ensure the integrity of the system;

b. systems design, operation, testing, maintenance, and/or monitoring that are carried out under the technical review of a higher authority at the High Risk level;

c. access to and/or processing of information requiring protection under the Privacy Act of 1974;

d. assists in policy development and implementation; e. mid-level management duties/assignments; f. any position with responsibility for independent or semi-independent action; or g. delivery of service positions that demand public confidence or trust.

http://cmsnet.cms.hhs.gov/hpages/oics/formsloc/cms730af.pdf



Approximate cost of each investigation: $2,400

3) Low Risk (Level 1) Positions having the potential for limited interaction with the agency or program mission, so the potential for impact on the integrity and efficiency of the service is small. This includes computer security impact on AIS.

Approximate cost of each investigation: $550

The Contractor shall submit the investigative package(s) to SEMG within three (3) days after being advised by the SEMG of the need to submit packages. Investigative packages shall be submitted to the following address:

Centers for Medicare & Medicaid Services Office of Operations Management Security and Emergency Management Group Mail Stop SL-13-15 7500 Security Boulevard Baltimore, Maryland 21244-1850

The Contractor shall submit a copy of the transmittal letter to the Contracting Officer (CO). Contractor personnel shall submit a CMS-730A to the SEMG. The Contractor and the PO shall obtain all necessary signatures on the CMS-730A prior to any Contractor employee arriving for fingerprinting and badge processing. The Contractor must appoint a Security Investigation Liaison as a point of contact to resolve any issues of inaccurate or incomplete form(s). Where personal information is involved, SEMG may need to contact the contractor employee directly. The Security Investigation Liaison may be required to facilitate such contact. SEMG will fingerprint contractor personnel and send their completed investigative package to the Office of Personnel Management (OPM). OPM will conduct the background investigation. Badges will not be provided by SEMG until acceptable finger print results are received; until then the contractor employee will be considered an escorted visitor. The Contractor remains fully responsible for ensuring contract, task order or delivery order performance pending completion of background investigations of contractor personnel. SEMG shall provide written notification to the CO with a copy to the PO of all suitability decisions. The PO shall then notify the Contractor in writing of the approval of the Contractor’s employee(s), at that time the Contractor’s employee(s) will receive a permanent identification badge. Contractor personnel who the SEMG determines to be ineligible may be required to cease working on the contract immediately. The Contractor shall report immediately in writing to SEMG with copies to the CO and the PO, any adverse information regarding any of its employees that may impact their ability to perform under this contract, task order or delivery order. Reports should be based on reliable and substantiated information, not on rumor or innuendo. The report shall include the contractor employee’s name and social security number, along with the adverse information being reported. Contractor personnel shall be provided an opportunity to explain or refute unfavorable information found in an investigation to SEMG before an adverse adjudication is made. Contractor personnel may request,



in writing, a copy of their own investigative results by contacting:

Office of Personnel Management Freedom of Information Federal Investigations Processing Center PO Box 618 Boyers, PA 16018-0618

At the Agency’s discretion, if an investigated contractor employee leaves the employment of the contractor, or otherwise is no longer associated with the contract, task order, or delivery order within one (1) year from the date the background investigation was initiated by CMS, then the Contractor may be required to reimburse CMS for the full cost of the investigation. Depending upon the type of background investigation conducted, the cost could be approximately $550 to $2,900. The amount to be paid by the Contractor shall be due and payable when the CO submits a written letter notifying the Contractor as to the cost of the investigation. The Contractor shall pay the amount due within thirty (30) days of the date of the CO’s letter by check made payable to the “United States Treasury.” The Contractor shall provide a copy of the CO’s letter as an attachment to the check and submit both to the Office of Financial Management at the following address:

Centers for Medicare & Medicaid Services PO Box 7520 Baltimore, Maryland 21207

The Contractor must immediately provide written notification to SEMG (with copies to the CO and the PO) of all terminations or resignations of Contractor personnel working on this contract, task order or delivery order. The Contractor must also notify SEMG (with copies to the CO and the PO) when a Contractor’s employee is no longer working on this contract, task order or delivery order. At the conclusion of the contract, task order or delivery order and at the time when a contractor employee is no longer working on the contract, task order or delivery order due to termination or resignation, all CMS-issued parking permits, identification badges, access cards, and/or keys must be promptly returned to SEMG. Contractor personnel who do not return their government-issued parking permits, identification badges, access cards, and/or keys within 48 hours of the last day of authorized access shall be permanently barred from the CMS complex and subject to fines and penalties authorized by applicable federal and State laws. Work Performed Outside the United States and its Territories The contractor, and its subcontractors, shall not perform any activities under this contract at a location outside of the United States, including the transmission of data or other information outside the United States, without the prior written approval of the Contracting Officer. The factors that the Contracting Officer will consider in making a decision to authorize the performance of work outside the United States include, but are not limited to the following: 1. All contract terms regarding system security 2. All contract terms regarding the confidentiality and privacy requirements

for information and data protection 3. All contract terms that are otherwise relevant, including the provisions of the statement of work 4. Corporate compliance 5. All laws and regulations applicable to the performance of work outside the



United States 6. The best interest of the United States In requesting the Contracting Officer’s authorization to perform work outside the United States, the contractor must demonstrate that the performance of the work outside the United States satisfies all of the above factors. If, in the Contracting Officer’s judgment, the above factors are not fully satisfied, the performance of work outside the United States will not be authorized. Any approval to employ or outsource work outside of the United States must have the concurrence of the CMS SEMG Director or designee.

H.13 REVOKING SYSTEM ACCESS UPON EMPLOYEE DEPARTURE When an employee leaves a contractor, the guidelines in the following sources shall be followed when revoking system access:

ARS PS-4 – Personnel Termination (http://www.cms.gov/Research-Statistics-Data-and-Systems/CMS-Information-Technology/InformationSecurity/Info-Security-Library-Items/CMS1222632.html) ARS AC-2 – Account Management (http://www.cms.gov/Research-Statistics-Data-and-Systems/CMS-Information-Technology/InformationSecurity/Info-Security-Library-Items/CMS1222631.html) These sources can be accessed through CMS.gov, specifically the Information Security Library.

H.14 CONTRACTOR TERMINATION CMS BUILDING PASS In the event that the contractor terminates an employee working on this contract, or an employee working on this contract voluntarily leaves the employment of the contractor, and that employee has been issued a contractor's badge by CMS for access to CMS buildings, the contractor shall immediately take the following actions:

1. Secure the CMS contractor's badge from the employee; 2. Formally advise the Contracting Officer that the individual is no longer an employee of the

contractor; and, 3. Return the badge with the notification to the Contracting Officer.

H.15 ON-BOARDING PROCEDURES On-boarding can be done at any time at the discretion of the Contracting Officer (CO). The existence of on-boarding procedures does not ensure, nor guarantee these procedures will ever be used. However, it is the intent of the CO to periodically review the current competitive environment within the UPIC program. The CO will take into consideration contractor performance, Conflicts of Interest, task order competition, small business utilization, etc. and make a determination of whether or not it would be beneficial to open the MA IDIQ to new competitors.

While not guaranteed, it is the intent of the UPIC program to open the MA IDIQ to new competitors in year 5 of performance. Additionally, determinations of whether to renew current MA IDIQ contracts will be made based on contractors past performance, adequate competition among MA IDIQ holders, and small business utilization.

Goals:

http://www.cms.gov/Research-Statistics-Data-and-Systems/CMS-Information-Technology/InformationSecurity/Info-Security-Library-

http://www.cms.gov/Research-Statistics-Data-and-Systems/CMS-Information-Technology/InformationSecurity/Info-Security-Library-

http://www.cms.gov/Research-Statistics-Data-and-



1. Establish a streamlined procedure for bringing new contractors into the UPIC IDIQ competitive pool.

2. Provide a mechanism to ensure adequate competition for all task orders throughout the ten year period of performance for the MA IDIQ.

3. Provide opportunities for contractors who did not receive an initial MA IDIQ award to join the UPIC program.

4. Not renew MA IDIQ contractors who are not performing or participating.

Process:

1. A notice will be posted to FBO with our intent to conduct On-Boarding for the UPIC MA IDIQ contract.

2. This notice will include a complete solicitation with applicable sample task order and other requirements as deemed necessary by the Contracting Officer.

3. Potential Offerors will be afforded the opportunity to provide proposal submissions in response to the solicitation, those proposals will be evaluated in accordance with the procedures outlined in the solicitation.

4. New awards will be made and additional contractors will be brought into the competitive pool along with the established MA IDIQ contract holders.

H.16 CMS INFORMATION SECURITY (APR 2013) All CMS information shall be protected from unauthorized access, use, disclosure, duplication, modification, diversion, or destruction, whether accidental or intentional, in order to maintain the security, confidentiality, integrity, and availability of such information. Therefore, if this contract requires the contractor to provide services (both commercial and non-commercial) for Federal Information/Data, to include any of the following requirements:

• Process any Information/Data; or • Store any Information/Data (includes “Cloud” computing services); or • Facilitate the transport of Information/Data; or • Host/maintain Information/Data (including software and/or infrastructure developer/maintainers);

or • Have access to, or use of, Personally Identifiable Information (PII), including instances of remote

access to, or physical removal of, such information beyond agency premises or control, The contractor shall become and remain compliant with the requirements set forth at the CMS Information Security website at https://www.cms.gov/Research-Statistics-Data-and-Systems/CMS-Information-Technology/InformationSecurity/Info-Security-Library-Items/CMS-Information-Security-Contract-Clause-Provision.html. The requirements cover all CMS contracts and associated deliverables, which are required on a “per contractor” basis. The contractor shall ensure that the following Federal information security standards are met for all of its CMS contracts:

https://www.cms.gov/Research-Statistics-Data-and-Systems/CMS-Information-Technology/InformationSecurity/Info-Security-Library-Items/CMS-Information-Security-Contract-Clause-Provision.html





• Federal Information Security Management Act (FISMA) – FISMA information can be found at http://csrc.nist.gov/groups/SMA/fisma/index.html. FISMA requires each Federal agency to develop, document, and implement an agency-wide program to provide information security for the information and information systems that support the operations and assets of the agency, including those provided or managed by another agency, contractor, or other source; and,

• Federal Risk and Authorization Management Program (FedRAMP) – FedRAMP information can be found at http://www.gsa.gov/portal/category/102371. The FedRAMP is a government-wide program that provides a standardized approach to security assessment, authorization, and continuous monitoring for cloud products and services.

The Contractor shall include in all awarded subcontracts the FISMA/FedRAMP compliance requirements set forth at the CMS Information Security website at https://www.cms.gov/Research-Statistics-Data-and-Systems/CMS-Information-Technology/InformationSecurity/Info-Security-Library-Items/CMS-Information-Security-Contract-Clause-Provision.html






PART II – CONTRACT CLAUSES

SECTION I - CONTRACT CLAUSES I.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 the following Internet address http://www.acquisition.gov/far/

The following clauses apply to all task orders:

Clause No. Title Date

52.202-1 Definitions Nov 2013 52.203-3 Gratuities Apr 1984 52.203-5 Covenant Against Contingent Fees May 2014 52.203-6 Restrictions on Subcontractor Sales to the Government Sep 2006 52.203-7 Anti-Kickback Procedures May 2014

52.203-8 Cancellation, Recession, and Recovery of Funds for Illegal or Improper Activity May 2014

52.203-10 Price or Fee Adjustment for Illegal or Improper Activity May 2014 52.203-12 Limitation on Payments to Influence Certain Federal Transactions Oct 2010 52.203-13 Contractor Code of Business Ethics and Conduct Apr 2010 52.203-14 Display of Hotline Poster(s) Dec 2007 52.203-16 Preventing Personal Conflicts of Interest Dec 2011

52.203-17 Contractor Employee Whistleblower Rights and Requirement to Inform Employees of Whistleblower Rights Apr 2014

52.204-4 Printed or Copied Double-Sided on Postconsumer Fiber Content Paper May 2011

52.204-9 Personal Identity Verification of Contractor Personnel Jan 2011

52.204-10 Reporting Executive Compensation and First-Tier Subcontract Awards Jul 2013

52.204-12 Data Universal Numbering System Number Maintenance Dec 2012 52.204-13 System for Award Management Maintenance Jul 2013

52.204-15 Service Contract Reporting Requirements for Indefinite-Delivery Contracts Jan 2014

52.204-18 Commercial and Government Entity Code Maintenance Nov 2014

52.209-6 Protecting the Government's Interest When Subcontracting with Contractor's Debarred, Suspended, or Proposed for Debarment Aug 2013

52.209-9 Updates of Publicly Available Information Regarding Responsibility Matters Jul 2013

52.209-10 Prohibition on Contracting with Inverted Domestic Corporations Dec 2014 52.210-1 Market Research Apr 2011 52.215-2 Audit and Records- Negotiations Oct 2010 52.215-8 Order of Precedence-Uniform Contract Format Oct 1997 52.215-10 Price Reduction for Defective Certified Cost or Pricing Data Aug 2011 52.215-12 Subcontractor Certified Cost or Pricing Data Oct 2010




52.215-13 Subcontractor Cost Or Pricing Data – Modifications Oct 2010 52.215-15 Pension Adjustments and Asset Reversions Oct 2010 52.215-17 Waiver of Facilities Capital Cost of Money Oct 1997

52.215-18 Revision or Adjustment of Plans for Postretirement Benefits (PRB) Other than Pensions Jul 2005

52.215-19 Notification of Ownership Changes Oct 1997

52.215-21 Requirements for Certified Cost or Pricing Data and Data Other Than Certified Cost or Pricing Data - Modifications Oct 2010

52.215-23 Limitations on Pass Through Charges Oct 2009 52.217-8 Option to Extend Services Nov 1999

52.219-4 Notice of Price Evaluation Preference for HUBZone Small Business Concerns Oct 2014

52.219-8 Utilization of Small Business Concerns Oct 2014 52.219-9 Small Business Subcontracting Plan Oct 2014 52.219-16 Liquidated Damages-Subcontracting Plan Jan 1999 52.222-1 Notice to the Government of Labor Disputes Feb 1997 52.222-3 Convict Labor June 2003 52.222-17 Nondisplacement of Qualified Workers May 2014 52.222-21 Prohibition of Segregated Facilities Feb 1999 52.222-26 Equal Opportunity Apr 2015 52.222-35 Equal Opportunity Veterans Jul 2014 52.222-36 Equal Opportunity for Workers with Disabilities Jul 2014 52.222-37 Employment Reports on Veterans Jul 2014

52.222-40 Notification of Employee Rights Under the National Labor Relations Act Dec 2010

52.222-41 Service Contract Labor Standards May 2014

52.222-43 Fair Labor Standards Act and Service Contract Labor Standards--Price Adjustment (Multiple Year and Option Contracts) May 2014

52.222-49 Service Contract Labor Standards--Place of Performance Unknown May 2014 52.222-50 Combating Trafficking in Persons Mar 2015 52.222-54 Employment Eligibility Verification Aug 2013 52.222-55 Minimum Wages Under Executive Order 13658 Dec 2014 52.223-6 Drug-Free Workplace May 2001

52.223-18 Encouraging Contractor Policies to Ban Text Messaging While Driving Aug 2011

52.224-1 Privacy Act Notification Apr 1984 52.224-2 Privacy Act Apr 1984 52.225-13 Restrictions on Certain Foreign Purchases Jun 2008 52.227-1 Authorization and Consent Dec 2007 52.227-2 Notice and Assistance Regarding Patent and Copyright Infringement Dec 2007 52.227-3 Patent Indemnity Apr 1984 52.227-17 Rights in Data-Special Works Dec 2007 52.227-23 Rights to Proposal Data (Technical) Jun 1987 52.230-2 Cost Accounting Standards May 2014 52.230-3 Disclosure and Consistency of Cost Accounting Practices May 2014 52.230-6 Administration of Cost Accounting Standards Jun 2010 52.232-17 Interest May 2014 52.232-18 Availability of Funds Apr 1984 52.232-23 Assignment of Claims May 2014



52.232-25 Prompt Payment Jul 2013

52.232-33 Payment by Electronic Funds Transfer—System for Award Management Jul 2013

52.232-39 Unenforceability of Unauthorized Obligations Jun 2013 52.232-40 Providing Accelerated Payments to Small Business Subcontractors Dec 2013 52.233-1 Disputes May 2014 52.233-4 Applicable Law for Breach of Contract Claim Oct 2004 52.237-3 Continuity of Services Jan 1991 52.239-1 Privacy or Security Safeguards Aug 1996 52.242-1 Notice of Intent to Disallow Costs Apr 1984 52.242-3 Penalties for Unallowable Costs May 2014 52.242-13 Bankruptcy Jul 1995 52.244-2 Subcontracts Oct 2010 52.244-6 Subcontracts for Commercial Items Mar 2015 52.245-1 Government Property Apr 2012 52.245-9 Use and Charges Apr 2012 52.246-25 Limitation of Liability--Services Feb 1997 52.251-1 Government Supply Sources Feb 1998 52.253-1 Computer Generated Forms Jan 1991

The following clauses apply to cost reimbursement task orders:

Clause No. Title Date 52.216-7 Allowable Cost and Payment Jun 2013 52.216-8 Fixed Fee Jun 2011 52.216-10 Incentive Fee Jun 2011 52.216-11 Cost Contract-No Fee Apr 1984 52.216-12 Cost-Sharing Contract-No Fee Apr 1984 52.216-16 Incentive Price Revision-Firm Target Oct 1997 52.216-17 Incentive Price Revision-Successive Targets Oct 1997 52.216-26 Payments of Allowable Costs Before Definitization Dec 2002 52.222-2 Payment for Overtime Premiums Jul 1990 52.232-9 Limitation on Withholding of Payments Apr 1984 52.232-20 Limitation of Cost Apr 1984 52.232-22 Limitation of Funds Apr 1984 52.233-3 Protest after Award – Alternate I (Jun 1985) Aug 1996 52.242-4 Certification of Final Indirect Costs Jan 1997 52.243-2 Changes-Cost Reimbursement – Alternate I (Apr 1984) Aug 1987 52.244-2 Subcontracts – Alternate I (Jun 2007) Oct 2010 52.244-5 Competition in Subcontracting Dec 1996 52.249-6 Termination (Cost- Reimbursement) May 2004 52.249-14 Excusable Delays Apr 1984

The following clauses apply to firm fixed price task orders:


52.229-3 Federal, State, and Local Taxes Feb 2013 52.232-1 Payments Apr 1984 52.232-8 Discounts for Prompt Payment. Feb 2002



52.232-11 Extras Apr 1984 52.243-1 Changes--Fixed Price – Alternate I (Aug 1987) Aug 1987 52.249-2 Termination for Convenience of the Government (Fixed-Price) Apr 2012 52.249-8 Default (Fixed- Price Supply and Service) Apr 1984

I.2 DEPARTMENT OF HEALTH AND HUMAN SERVICES ACQUISITION REGULATIONS (HHSAR) CLAUSES INCORPORATED BY REFERENCE

This solicitation incorporates one or more clauses by reference, with the same force and effect as if they were provided in full text. Upon request, the Contracting Officer will provide the information in full text. The full text version of a clause is also available electronically at: http://www.hhs.gov/policies/hhsar


352.201-70 Paperwork Reduction Act Jan 2006 352.202-1 Definitions (DEVIATION) Jan 2006 352.203-70 Anti-Lobbying Jan 2006 352.219-72 Mentor-Protégé Program Reporting Requirements Jan 2010

352.222-70 Contractor Cooperation in Equal Employment Opportunity Investigations Jan 2010

352.223-70 Safety and Health Jan 2006 352.224-70 Privacy Act Jan 2006 352.239-71 Standard for Encryption Language Jan 2010

352.239-72 Security Requirements for Federal Information Technology Resources Jan 2010

The following HHSAR clauses apply to cost reimbursement task orders:


352.216-70 Additional Cost Principles Jan2006 352.233-71 Litigation and Claims Jan 2006 352.242-73 Withholding of Contract Payments Jan 2006 352.242-74 Final Decisions on Audit Findings Apr 1984

The following HHSAR clauses apply to firm fixed price task orders:


352.231-71 Pricing of Adjustments Jan 2001 352.232-72 Limitation of Government’s Obligation Jun 2010 I.3 FAR 52.216-18 ORDERING (OCT 1995)

(a) Any supplies and services to be furnished under this contract shall be ordered by issuance of delivery orders or task orders by the individuals or activities designated in the Schedule. Such orders may be issued from Date of Award through February 28, 2026. (b) All delivery orders or task orders are subject to the terms and conditions of this contract. In the event of conflict between a delivery order or task order and this contract, the contract shall control.

http://www.hhs.gov/policies/hhsar



(c) If mailed, a delivery order or task order is considered “issued” when the Government deposits the order in the mail. Orders may be issued orally, by facsimile, or by electronic commerce methods only if authorized in the Schedule.

I.4 FAR 52.216-19 ORDER LIMITATIONS (OCT 1995)

(a) Minimum order. When the Government requires supplies or services covered by this contract in an amount of less than $3,000, the Government is not obligated to purchase, nor is the Contractor obligated to furnish, those supplies or services under the contract. (b) Maximum order. The Contractor is not obligated to honor --

(1) Any order for a single item in excess of $750,000,000; (2) Any order for a combination of items in excess of $1,500,000,000; or (3) A series of orders from the same ordering office within the contract period that together call for quantities exceeding the limitation in subparagraph (b)(1) or (2) of this section.

(c) If this is a requirements contract (i.e., includes the Requirements clause at subsection 52.216-21 of the Federal Acquisition Regulation (FAR)), the Government is not required to order a part of any one requirement from the Contractor if that requirement exceeds the maximum-order limitations in paragraph (b) of this section. (d) Notwithstanding paragraphs (b) and (c) of this section, the Contractor shall honor any order exceeding the maximum order limitations in paragraph (b), unless that order (or orders) is returned to the ordering office within 30 days after issuance, with written notice stating the Contractor’s intent not to ship the item (or items) called for and the reasons. Upon receiving this notice, the Government may acquire the supplies or services from another source.

I.5 FAR 52.216-22 INDEFINITE QUANTITY (OCT 1995)

(a) This is an indefinite-quantity contract for the supplies or services specified and effective for the period stated in the Schedule. The quantities of supplies and services specified in the Schedule are estimates only and are not purchased by this contract. (b) Delivery or performance shall be made only as authorized by orders issued in accordance with the Ordering clause. The Contractor shall furnish to the Government, when and if ordered, the supplies or services specified in the Schedule up to and including the quantity designated in the Schedule as the “maximum.” The Government shall order at least the quantity of supplies or services designated in the Schedule as the “minimum.” (c) Except for any limitations on quantities in the Order Limitations clause or in the Schedule, there is no limit on the number of orders that may be issued. The Government may issue orders requiring delivery to multiple destinations or performance at multiple locations. (d) Any order issued during the effective period of this contract and not completed within that period shall be completed by the Contractor within the time specified in the order. The contract shall govern the Contractor’s and Government’s rights and obligations with respect to that order to the same extent as if the order were completed during the contract’s effective period; provided,



that the Contractor shall not be required to make any deliveries under this contract after 12 months.

I.6 FAR 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000)

(a) The Government may extend the term of this contract by written notice to the Contractor within the current performance period; provided that the Government gives the Contractor a preliminary written notice of its intent to extend at least 60 days before the contract expires. The preliminary notice does not commit the Government to an extension.

(b) If the Government exercises this option, the extended contract shall be considered to include this option clause.

(c) The total duration of this contract, including the exercise of any options under this clause, shall not exceed 10 years.

I.7 FAR 52.222-42 STATEMENT OF EQUIVALENT RATES FOR FEDERAL HIRES (MAY 2014)

In compliance with the Service Contract Labor Standards statute and the regulations of the Secretary of Labor (29 CFR part 4), this clause identifies the classes of service employees expected to be employed under the contract and states the wages and fringe benefits payable to each if they were employed by the contracting agency subject to the provisions of 5 U.S.C. 5341 or 5332.

This Statement is for Information Only: It is not a Wage Determination

Employee Class Monetary Wage -- Fringe Benefits

I.8 FAR 52.232-19 AVAILABILITY OF FUNDS FOR THE NEXT FISCAL YEAR (APR 1984)

Funds are not presently available for performance under this contract beyond FY 2016. The Government’s obligation for performance of this contract beyond that date is contingent upon the availability of appropriated funds from which payment for contract purposes can be made. No legal liability on the part of the Government for any payment may arise for performance under this contract beyond FY 2016, until funds are made available to the Contracting Officer for performance and until the Contractor receives notice of availability, to be confirmed in writing by the Contracting Officer.

I.9 FAR 52.252-4 ALTERATIONS IN CONTRACT (APR 1984)



Portions of this contract are altered as follows: _______________________________________________ _________________N/A__________________________ ______________________________________________

I.10 FAR 52.252-6 AUTHORIZED DEVIATIONS IN CLAUSES (APR 1984)

(a) The use in this solicitation or contract of any Federal Acquisition Regulation (48 CFR Chapter 1) clause with an authorized deviation is indicated by the addition of “(DEVIATION)” after the date of the clause.

(b) The use in this solicitation or contract of any _____. (48 CFR _____) clause with an authorized deviation is indicated by the addition of “(DEVIATION)” after the name of the regulation.

I.11 HHSAR 352.228-7 INSURANCE--LIABILITY TO THIRD PERSONS (DECEMBER 1991)

(a) (1) Except as provided in paragraph (a)(2) immediately following, or in paragraph (h) of this clause [if the clause has a paragraph (h)], the Contractor shall provide and maintain workers' compensation, employer's liability, comprehensive general liability (bodily injury), comprehensive automobile liability (bodily injury and property damage) insurance, and such other insurance as the Contracting Officer may require under this contract.

(2) The Contractor may, with the approval of the Contracting Officer, maintain a self-insurance program; provided that, with respect to workers' compensation, the Contractor is qualified pursuant to statutory authority.

(3) All insurance required by this paragraph shall be in form and amount and for those periods as the Contracting Officer may require or approve and with insurers approved by the Contracting Officer.

(b) The Contractor agrees to submit for the Contracting Officer's approval, to the extent and in the manner required by the Contracting Officer, any other insurance that is maintained by the Contractor in connection with performance of this contract and for which the Contractor seeks reimbursement.

(c) Except as provided in paragraph (h) of this clause [if the clause has a paragraph (h)], the Contractor shall be reimbursed— (1) For that portion of the reasonable cost of insurance allocable to this contract, and required or approved under this clause; and

(2) For certain liabilities (and expenses incidental to such liabilities) to third persons not compensated by insurance or otherwise within the funds available under the Limitation of Cost or the Limitation of Funds clause of this contract. These liabilities must arise out of the performance of this contract, whether or not caused by the negligence of the Contractor or the Contractor's agents, servants, or employees, and must be represented by final judgments or settlements approved in writing by the Government. These liabilities are for—



(i) Loss of or damage to property (other than property owned, occupied, or used by the Contractor, rented to the Contractor, or in the care, custody, or control of the Contractor); or (ii) Death or bodily injury.

(d) The Government’s liability under paragraph (c) of this clause is limited to the amounts reflected in final judgments, or settlements approved in writing by the Government, but in no event to exceed the funds available under the Limitation of Cost or Limitation of Funds clause of this contract. Nothing in this contract shall be construed as implying that, at a later date, the Government will request, or the Congress will appropriate, funds sufficient to meet any deficiencies.

(e) The Government shall not reimburse the Contractor for liabilities (and expenses incidental to such liabilities)—

(1) For which the Contractor is otherwise responsible under the express terms of any clause specified in the Schedule or elsewhere in the contract; (2) For which the Contractor has failed to insure or to maintain insurance as required by the Contracting Officer; or (3) That result from willful misconduct or lack of good faith on the part of the Contractor's directors, officers, managers, superintendents, or other representatives who have supervision or direction of — (i) All or substantially all of the Contractor's business;

(ii) All or substantially all of the Contractor's operations at any one plant or separate location in which this contract is being performed; or

(iii) A separate and complete major industrial operation in connection with the performance of this contract.

(f) The provisions of paragraph (e) of this clause shall not restrict the right of the Contractor to be reimbursed for the cost of insurance maintained by the Contractor in connection with the performance of this contract, other than insurance required in accordance with this clause; provided, that such cost is allowable under the Allowable Cost and Payment clause of this contract.

(g) If any suit or action is filed or any claim is made against the Contractor, the cost and expense of which may be reimbursable to the Contractor under this contract, and the risk of which is then uninsured or is insured for less than the amount claimed, the Contractor shall—

(1) Immediately notify the Contracting Officer and promptly furnish copies of all pertinent papers received;

(2) Authorize Government representatives to collaborate with counsel for the insurance carrier in settling or defending the claim when the amount of the liability claimed exceeds the amount of coverage; and

(3) Authorize Government representatives to settle or defend the claim and to represent the Contractor in or to take charge of any litigation, if required by the Government, when



the liability is not insured or covered by the bond. The Contractor may, at its own expense, be associated with the Government representatives in any such claim or litigation.

(End of clause)



PART III – LIST OF DOCUMENTS, EXHIBITS AND OTHER ATTACHMENTS SECTION J - LIST OF ATTACHMENTS AND EXHIBITS Attachments

J.1 Unified Program Integrity Contract (UPIC) Umbrella Statement of Work (USOW) J.2 Unified Program Integrity Contract (UPIC) Umbrella Statement of Work (USOW)

Appendices J.3 Report and Deliverable Templates

J.3.A UPIC Analytic Findings Report J.3.B UPIC Data Analysis Project Management Plan J.3.C UPIC Data Matching Protocol J.3.D UPIC Freedom of Information Act (FOIA) Log J.3.E UPIC Freedom of Information Act (FOIA) Request Log J.3.F UPIC Information Technology (IT) Systems Plan J.3.G UPIC Jurisdiction Implementation Project Plan J.3.H UPIC Monthly Status Report J.3.I UPIC Risk Management Plan J.3.J UPIC Regional Office (RO) Freedom of Information Act (FOIA) Form J.3.K UPIC State Education Report

J.4 Unified Program Integrity Contract (UPIC) Indefinite Delivery Indefinite Quantity (IDIQ)

Ordering Guide J.5 Reserved for Incorporation of Contractor’s Organizational Conflict Of Interest Certificate

(Incorporated by Reference) J.6 Unified Program Integrity Contract (UPIC) Jurisdiction 1 (J1) Task Order

J.6.A Unified Program Integrity Contract (UPIC) J1 Task Order Request for Proposal

(RFP) J.6.B Unified Program Integrity Contract (UPIC) J1 Task Order Statement of Work

(SOW) J.6.C Unified Program Integrity Contract (UPIC) J1 Task Order Statement of Work

(SOW) Attachment A J.6.D Small Business Subcontracting Plan

J.7 Unified Program Integrity Contract (UPIC) Technical Evaluation Scenarios J.8 Business Ethics, Conflict of Interest and Compliance Submission by Offeror/Contractor J.9 Personal Conflict of Interest Financial Disclosure J.10 Past Performance Questionnaire J.11 Responsibility Questionnaire



J.12 Virus Detection Certification J.13 Subcontract Checklist – Consent to Subcontract J.14 Unified Program Integrity Contract (UPIC) Map of Jurisdictions (Note: Also an Appendix (B)

to the USOW Appendices) J.15 Unified Program Integrity Contract (UPIC) Award Fee Plan

Exhibits

E.1 Unified Program Integrity Contract (UPIC) Prime Proposal Checklist E.1.A Unified Program Integrity Contract (UPIC) Subcontractor Proposal Checklist E.2 Unified Program Integrity Contract (UPIC) Jurisdiction 1 (J1) Business Proposal

Spreadsheets

E.2.A UPIC J1 Business Proposal Spreadsheet CLIN 0001 E.2.B UPIC J1 Business Proposal Spreadsheet CLIN 0002 E.2.C UPIC J1 Business Proposal Spreadsheet CLIN 0003 E.2.D UPIC J1 Business Proposal Spreadsheet CLIN 0004 E.2.E UPIC J1 Business Proposal Spreadsheet CLIN 0005

E.3 Unified Program Integrity Contract (UPIC) Questions Template E.4 Answers to Draft Solicitation Questions E.5 Draft Unified Case Management (UCM) Functional Requirements Document E.6 Draft Program Integrity Manual (PIM) Chapter 4 E.7 Draft Program Integrity Manual (PIM) Chapter 8 E.8 Draft Program Integrity Manual (PIM) Chapter 16



PART IV – REPRESENTATIONS AND INSTRUCTIONS

SECTION K - REPRESENTATIONS, CERTIFICATIONS, AND OTHER STATEMENTS OF OFFERORS OR QUOTERS

K.1 FAR 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB 1998)

This solicitation incorporates one or more solicitation provisions 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. The Offeror is cautioned that the listed provisions may include blocks that must be completed by the Offeror and submitted with its quotation or offer. In lieu of submitting the full text of those provisions, the Offeror may identify the provision by paragraph identifier and provide the appropriate information with its quotation or offer. Also, the full text of a solicitation provision may be accessed electronically at this/these address(es): http://www.acquisition.gov/far/

Provision No. Title Date 52.203-11 Certification And Disclosure Regarding Payments to Influence

Certain Federal Transactions Sep 2007

52.204-5 Women-Owned Business (Other Than Small Business) Oct 2014 52.209-2 Prohibition On Contracting with Inverted Domestic Corporations -

Representation Dec 2014

52.222-38 Compliance with Veterans' Employment Reporting Requirements Sep 2010 52.225-25 Prohibition on Contracting with Entities Engaging in Certain

Activities or Transactions Relating to Iran--Representation and Certifications

Dec 2012

52.237-8 Restriction on Severance Payments to Foreign Nationals Aug 2003

K.2 FINANCIAL INFORMATION – The Offeror shall complete the information below for

proposal submission:

a. Contractor: ______________________________________ ______________________________________

Address:* ______________________________________

______________________________________ ______________________________________ ______________________________________

Telephone No.____________________________________

Individual(s) to contact regarding this proposal:

___________________________________ ___________________________________

Dun & Bradstreet, Data Universal Numbering System (DUNS) No.________________________________ (See FAR 52.204-6 -- Data Universal Numbering System (DUNS) Number)




*If financial records are maintained at some other location, show the address of the place where the records are kept

b. Sales – Please provide the following information with regard to your organization’s annual sales:

Work distribution for the last complete fiscal accounting period:

Government cost reimbursement (includes T&M) type prime contracts and subcontracts: $_______________

Government fixed price prime contracts and subcontracts: $____________

Commercial Sales: $_______________

Total Sales: $_______________

c. Separate Entity or Segment: Is your organization a separate entity or separate segment of a parent corporation? __________________________________________________________ If a separate segment of a parent corporation, name parent company:

__________________________________________________________ __________________________________________________________ d. Manpower - Total number of organization employees:______________

e. Place of Performance:

The offeror shall perform the majority of work on this contract at the following location:

Place of Performance - (Name of Facility, Street Address, City, State, Zip) __________________________________________________________________ __________________________________________________________________

f. Estimating System: Has your cost estimating system been approved by any Government

agency? Yes_____No_____

If yes, give name and address of agency that approved the system: __________________________________________________________________ __________________________________________________________________

g. Accounting System – Has your accounting system been approved for use on

Government cost reimbursement contracts? Yes_____No_____ If yes, give name and address of agency that approved the system: __________________________________________________________________ __________________________________________________________________

What type of software does your organization utilize for its accounting system?



_________________________________________________

h. Property Control System - Has your property control system been approved by a Government agency? Yes____No____


i. Purchasing System - Has your purchasing system been approved by a Government

agency? Yes_____No_____


If no, are purchasing procedures written? Yes____No____

j. Compensation System – Has your compensation system been approved by a

Government agency? Yes____No____


Does your organization have an established written incentive compensation or bonus plan for all employees? Yes_____No_____ (If yes, specific policy(ies) may be required at a later date.) Does your organization comply with the limitations of FAR 31.205-6 Compensation for Personal Services? Yes_____No_____. If no, please explain. __________________________________________________________________

K.3 FAR 52.204-8 ANNUAL REPRESENTATIONS AND CERTIFICATIONS (DEC 2014)

(a) (1) The North American Industry classification System (NAICS) code for this acquisition is 541990.

(2) The small business size standard is $15,000,000.

(3) The small business size standard for a concern which submits an offer in its own name, other than on a construction or service contract, but which proposes to furnish a product which it did not itself manufacture, is 500 employees.

(b) (1) If the provision at 52.204-7, System for Award Management, is included in this solicitation, paragraph (d) of this provision applies.

(2) If the provision at 52.204-7 is not included in this solicitation, and the offeror is currently registered in the System for Award Management (SAM), and has completed the



Representations and Certifications section of SAM electronically, the offeror may choose to use paragraph (d) of this provision instead of completing the corresponding individual representations and certification in the solicitation. The offeror shall indicate which option applies by checking one of the following boxes:

[_] (i) Paragraph (d) applies.

[_] (ii) Paragraph (d) does not apply and the offeror has completed the individual representations and certifications in the solicitation.

(c) (1) The following representations or certifications in SAM are applicable to this solicitation as indicated:

(i) 52.203-2, Certificate of Independent Price Determination. This provision applies to solicitations when a firm-fixed-price contract or fixed-price contract with economic price adjustment is contemplated, unless—

(A) The acquisition is to be made under the simplified acquisition procedures in Part 13;

(B) The solicitation is a request for technical proposals under two-step sealed bidding procedures; or

(C) The solicitation is for utility services for which rates are set by law or regulation.

(ii) 52.203-11, Certification and Disclosure Regarding Payments to Influence Certain Federal Transactions. This provision applies to solicitations expected to exceed $150,000.

(iii) 52.204-3, Taxpayer Identification. This provision applies to solicitations that do not include the provision at 52.204-7, System for Award Management.

(iv) 52.204-5, Women-Owned Business (Other Than Small Business). This provision applies to solicitations that—

(A) Are not set aside for small business concerns;

(B) Exceed the simplified acquisition threshold; and

(C) Are for contracts that will be performed in the United States or its outlying areas.

(v) 52.209-2, Prohibition on Contracting with Inverted Domestic Corporations—Representation.

(vi) 52.209-5; Certification Regarding Responsibility Matters. This provision applies to solicitations where the contract value is expected to exceed the simplified acquisition threshold.



(vii) 52.214-14, Place of Performance--Sealed Bidding. This provision applies to invitations for bids except those in which the place of performance is specified by the Government.

(viii) 52.215-6, Place of Performance. This provision applies to solicitations unless the place of performance is specified by the Government.

(ix) 52.219-1, Small Business Program Representations (Basic & Alternate I). This provision applies to solicitations when the contract will be performed in the United States or its outlying areas.

(A) The basic provision applies when the solicitations are issued by other than DoD, NASA, and the Coast Guard.

(B) The provision with its Alternate I applies to solicitations issued by DoD, NASA, or the Coast Guard.

(x) 52.219-2, Equal Low Bids. This provision applies to solicitations when contracting by sealed bidding and the contract will be performed in the United States or its outlying areas.

(xi) 52.222-22, Previous Contracts and Compliance Reports. This provision applies to solicitations that include the clause at 52.222-26, Equal Opportunity.

(xii) 52.222-25, Affirmative Action Compliance. This provision applies to solicitations, other than those for construction, when the solicitation includes the clause at 52.222-26, Equal Opportunity.

(xiii) 52.222-38, Compliance with Veterans' Employment Reporting Requirements. This provision applies to solicitations when it is anticipated the contract award will exceed the simplified acquisition threshold and the contract is not for acquisition of commercial items.

(xiv) 52.223-1, Biobased Product Certification. This provision applies to solicitations that require the delivery or specify the use of USDA-designated items; or include the clause at 52.223-2, Affirmative Procurement of Biobased Products Under Service and Construction Contracts.

(xv) 52.223-4, Recovered Material Certification. This provision applies to solicitations that are for, or specify the use of, EPA- designated items.

(xvi) 52.225-2, Buy American Certificate. This provision applies to solicitations containing the clause at 52.225-1.

(xvii) 52.225-4, Buy American--Free Trade Agreements--Israeli Trade Act Certificate. (Basic, Alternates I, II, and III.) This provision applies to solicitations containing the clause at 52.225- 3.

(A) If the acquisition value is less than $25,000, the basic provision applies.



(B) If the acquisition value is $25,000 or more but is less than $50,000, the provision with its Alternate I applies.

(C) If the acquisition value is $50,000 or more but is less than $79,507, the provision with its Alternate II applies.

(D) If the acquisition value is $79,507 or more but is less than $100,000, the provision with its Alternate III applies.

(xviii) 52.225-6, Trade Agreements Certificate. This provision applies to solicitations containing the clause at 52.225-5.

(xix) 52.225-20, Prohibition on Conducting Restricted Business Operations in Sudan--Certification. This provision applies to all solicitations.

(xx) 52.225-25, Prohibition on Contracting with Entities Engaging in Certain Activities or Transactions Relating to Iran—Representation and Certification. This provision applies to all solicitations.

(xxi) 52.226-2, Historically Black College or University and Minority Institution Representation. This provision applies to solicitations for research, studies, supplies, or services of the type normally acquired from higher educational institutions.

(2) The following certifications are applicable as indicated by the Contracting Officer:

__X_ (i) 52.204-17, Ownership or Control of Offeror.

___ (ii) 52.222-18, Certification Regarding Knowledge of Child Labor for Listed End Products.

___ (iii) 52.222-48, Exemption from Application of the Service Contract Labor Standards to Contracts for Maintenance, Calibration, or Repair of Certain Equipment--Certification.

___ (iv) 52.222-52 Exemption from Application of the Service Contract Labor Standards to Contracts for Certain Services--Certification.

___ (v) 52.223-9, with its Alternate I, Estimate of Percentage of Recovered Material Content for EPA-Designated Products (Alternate I only).

___ (vi) 52.227-6, Royalty Information.

___ (A) Basic.

___ (B) Alternate I.

___ (vii) 52.227-15, Representation of Limited Rights Data and Restricted Computer Software.



(d) The offeror has completed the annual representations and certifications electronically via the SAM Web site accessed through https://www.acquisition.gov . After reviewing the SAM database information, the offeror verifies by submission of the offer that the representations and certifications currently posted electronically that apply to this solicitation as indicated in paragraph (c) of this provision have been entered or updated within the last 12 months, are current, accurate, complete, and applicable to this solicitation (including the business size standard applicable to the NAICS code referenced for this solicitation), as of the date of this offer and are incorporated in this offer by reference (see FAR 4.1201); except for the changes identified below [offeror to insert changes, identifying change by clause number, title, date]. These amended representation(s) and/or certification(s) are also incorporated in this offer and are current, accurate, and complete as of the date of this offer.

FAR Clause Title Date Change

Any changes provided by the offeror are applicable to this solicitation only, and do not result in an update to the representations and certifications posted on SAM.

(End of Provision) K.4 FAR 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (JUL 2013)

(a) Definitions. As used in this provision—

“Administrative proceeding” means a non-judicial process that is adjudicatory in nature in order to make a determination of fault or liability (e.g., Securities and Exchange Commission Administrative Proceedings, Civilian Board of Contract Appeals Proceedings, and Armed Services Board of Contract Appeals Proceedings). This includes administrative proceeding at the Federal and State level but only in connection with performance of a Federal contract or grant. It does not include agency actions such as contract audits, site visits, corrective plans, or inspection of deliverables. “Federal contracts and grants with total value greater than $10,000,000” means—

(1) The total value of all current, active contracts and grants, including all priced options; and (2) The total value of all current, active orders including all priced options under indefinite-delivery, indefinite-quantity, 8(a), or requirements contracts (including task and delivery and multiple-award Schedules). “Principal” means an officer, director, owner, partner, or a person having primary management or supervisory responsibilities within a business entity (e.g., general manager; plant manager; head of a division or business segment; and similar positions).

(b) The offeror [_] has [_] does not have current active Federal contracts and grants with total value greater than $10,000,000.

https://www.acquisition.gov/



(c) If the offeror checked “has” in paragraph (b) of this provision, the offeror represents, by submission of this offer, that the information it has entered in the Federal Awardee Performance and Integrity Information System (FAPIIS) is current, accurate, and complete as of the date of submission of this offer with regard to the following information:

(1) Whether the offeror, and/or any of its principals, has or has not, within the last five years, in connection with the award to or performance by the offeror of a Federal contract or grant, been the subject of a proceeding, at the Federal or State level that resulted in any of the following dispositions:

(i) In a criminal proceeding, a conviction. (ii) In a civil proceeding, a finding of fault and liability that results in the payment of a monetary fine, penalty, reimbursement, restitution, or damages of $5,000 or more. (iii) In an administrative proceeding, a finding of fault and liability that results in—

(A) The payment of a monetary fine or penalty of $5,000 or more; or (B) The payment of a reimbursement, restitution, or damages in excess of $100,000.

(iv) In a criminal, civil, or administrative proceeding, a disposition of the matter by consent or compromise with an acknowledgment of fault by the Contractor if the proceeding could have led to any of the outcomes specified in paragraphs (c)(1)(i), (c)(1)(ii), or (c)(1)(iii) of this provision.

(2) If the offeror has been involved in the last five years in any of the occurrences listed in (c)(1) of this provision, whether the offeror has provided the requested information with regard to each occurrence.

(d) The offeror shall post the information in paragraphs (c)(1)(i) through (c)(1)(iv) of this provision in FAPIIS as required through maintaining an active registration in the System for Award Management database via https://www.acquisition.gov (see 52.204-7).

K.5 FAR 52.230-1 COST ACCOUNTTING STANDARDS NOTICES AND CERTIFICATIONS

(MAY 2012) Note: This notice does not apply to small businesses or foreign governments. This notice is in three parts, identified by Roman numerals I through III. Offerors shall examine each part and provide the requested information in order to determine Cost Accounting Standards (CAS) requirements applicable to any resultant contract. If the offeror is an educational institution, Part II does not apply unless the contemplated contract will be subject to full or modified CAS coverage pursuant to 48 CFR 9903.201-2(c)(5) or 9903.201-2(c)(6), respectively. I. Disclosure Statement -- Cost Accounting Practices and Certification



(a) Any contract in excess of $700,000 resulting from this solicitation will be subject to the requirements of the Cost Accounting Standards Board (48 CFR Chapter 99), except for those contracts which are exempt as specified in 48 CFR 9903.201-1. (b) Any offeror submitting a proposal which, if accepted, will result in a contract subject to the requirements of 48 CFR Chapter 99 must, as a condition of contracting, submit a Disclosure Statement as required by 48 CFR 9903.202. When required, the Disclosure Statement must be submitted as a part of the offeror’s proposal under this solicitation unless the offeror has already submitted a Disclosure Statement disclosing the practices used in connection with the pricing of this proposal. If an applicable Disclosure Statement has already been submitted, the offeror may satisfy the requirement for submission by providing the information requested in paragraph (c) of Part I of this provision.

Caution: In the absence of specific regulations or agreement, a practice disclosed in a Disclosure Statement shall not, by virtue of such disclosure, be deemed to be a proper, approved, or agreed-to practice for pricing proposals or accumulating and reporting contract performance cost data.

(c) Check the appropriate box below:

* (1) Certificate of Concurrent Submission of Disclosure Statement. The offeror hereby certifies that, as a part of the offer, copies of the Disclosure Statement have been submitted as follows:

(i) Original and one copy to the cognizant Administrative Contracting Officer (ACO) or cognizant Federal agency official authorized to act in that capacity (Federal official), as applicable; and (ii) One copy to the cognizant Federal auditor. (Disclosure must be on Form No. CASB DS-1 or CASB DS-2, as applicable. Forms may be obtained from the cognizant ACO or Federal official and/or from the loose-leaf version of the Federal Acquisition Regulation.) Date of Disclosure Statement: __________________ Name and Address of Cognizant ACO or Federal Official Where Filed: _________________________ The offeror further certifies that the practices used in estimating costs in pricing this proposal are consistent with the cost accounting practices disclosed in the Disclosure Statement.

* (2) Certificate of Previously Submitted Disclosure Statement. The offeror hereby certifies that the required Disclosure Statement was filed as follows:

Date of Disclosure Statement: __________________ Name and Address of Cognizant ACO or Federal Official Where Filed: ________________________



The offeror further certifies that the practices used in estimating costs in pricing this proposal are consistent with the cost accounting practices disclosed in the applicable Disclosure Statement.

* (3) Certificate of Monetary Exemption. The offeror hereby certifies that the offeror, together with all divisions, subsidiaries, and affiliates under common control, did not receive net awards of negotiated prime contracts and subcontracts subject to CAS totaling $50 million or more in the cost accounting period immediately preceding the period in which this proposal was submitted. The offeror further certifies that if such status changes before an award resulting from this proposal, the offeror will advise the Contracting Officer immediately. * (4) Certificate of Interim Exemption. The offeror hereby certifies that

(i) the offeror first exceeded the monetary exemption for disclosure, as defined in (3) of this subsection, in the cost accounting period immediately preceding the period in which this offer was submitted and (ii) in accordance with 48 CFR 9903.202-1, the offeror is not yet required to submit a Disclosure Statement. The offeror further certifies that if an award resulting from this proposal has not been made within 90 days after the end of that period, the offeror will immediately submit a revised certificate to the Contracting Officer, in the form specified under subparagraph (c)(1) or (c)(2) of Part I of this provision, as appropriate, to verify submission of a completed Disclosure Statement.

Caution: Offerors currently required to disclose because they were awarded a CAS-covered prime contract or subcontract of $50 million or more in the current cost accounting period may not claim this exemption (4). Further, the exemption applies only in connection with proposals submitted before expiration of the 90-day period following the cost accounting period in which the monetary exemption was exceeded.

II. Cost Accounting Standards -- Eligibility for Modified Contract Coverage

If the offeror is eligible to use the modified provisions of 48 CFR 9903.201-2(b) and elects to do so, the offeror shall indicate by checking the box below. Checking the box below shall mean that the resultant contract is subject to the Disclosure and Consistency of Cost Accounting Practices clause in lieu of the Cost Accounting Standards clause. * The offeror hereby claims an exemption from the Cost Accounting Standards clause under the provisions of 48 CFR 9903.201-2(b) and certifies that the offeror is eligible for use of the Disclosure and Consistency of Cost Accounting Practices clause because during the cost accounting period immediately preceding the period in which this proposal was submitted, the offeror received less than $50 million in awards of CAS-covered prime contracts and subcontracts. The offeror further certifies that if such status changes before an award resulting from this proposal, the offeror will advise the Contracting Officer immediately. Caution: An offeror may not claim the above eligibility for modified contract coverage if this proposal is expected to result in the award of a CAS-covered contract of $50 million



or more or if, during its current cost accounting period, the offeror has been awarded a single CAS-covered prime contract or subcontract of $50 million or more.

III. Additional Cost Accounting Standards Applicable to Existing Contracts

The offeror shall indicate below whether award of the contemplated contract would, in accordance with subparagraph (a)(3) of the Cost Accounting Standards clause, require a change in established cost accounting practices affecting existing contracts and subcontracts. * yes * no

K.6 FAR 52.230-7 PROPOSAL DISCLOSURE – COST ACCOUNTING PRACTICE

CHANGES (APR 2005) The offeror shall check “yes” below if the contract award will result in a required or unilateral change in cost accounting practice, including unilateral changes requested to be desirable changes.

[ ] Yes [ ] No If the offeror checked “Yes” above, the offeror shall--

(1) Prepare the price proposal in response to the solicitation using the changed practice for the period of performance for which the practice will be used; and

(2) Submit a description of the changed cost accounting practice to the Contracting Officer and the Cognizant Federal Agency Official as pricing support for the proposal.



SECTION L - INSTRUCTIONS, CONDITIONS, AND NOTICES TO OFFERORS OR RESPONDENTS

L.1 FAR 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB 1998)

This solicitation incorporates one or more solicitation provisions 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. The Offeror is cautioned that the listed provisions may include blocks that must be completed by the Offeror and submitted with its quotation or offer. In lieu of submitting the full text of those provisions, the Offeror may identify the provision by paragraph identifier and provide the appropriate information with its quotation or offer. Also, the full text of a solicitation provision may be accessed electronically at this/these address(es): http://www.acquisition.gov/far/ Provision No. Title Date 52.204-7 System for Award Management Jul 2013 52.215-3 Request for Information or Solicitation For Planning Purposes Oct 1997 52.215-16 Facilities Capital Cost of Money Jun 2003

52.215-22 Limitations on Pass-Through Charges – Identification of Subcontract Effort Oct 2009

52.216-27 Single or Multiple Awards Oct 1995 52.222-24 Preaward On-Site Equal Opportunity Compliance Evaluation Feb 1999 52.222-46 Evaluation of Compensation for Professional Employees Feb 1993 52.237-10 Identification of Uncompensated Overtime Mar 2015

L.2 DEPARTMENT OF HEALTH AND HUMAN SERVICES ACQUISITION REGULATIONS (HHSAR) PROVISIONS INCORPORATED BY REFERENCE

This solicitation incorporates one or more provisions by reference, with the same force and effect as if they were provided in full text. Upon request, the Contracting Officer will provide the information in full text. The full text version of a provision is also available electronically at: http://www.hhs.gov/policies/hhsar Provision No. Title Date 352.219-70 Mentor-Protégé Program Jan 2010

L.3 FAR 52.215-1 INSTRUCTIONS TO OFFERORS - COMPETITIVE ACQUISITION (JAN

2004) (DEVIATION)

(a) Definitions. As used in this provision-

"Discussions" are negotiations that occur after establishment of the competitive range that may, at the Contracting Officer's discretion, result in the Offeror being allowed to revise its proposal. "In writing," "writing," or "written" means any worded or numbered expression that can be read, reproduced, and later communicated, and includes electronically transmitted and stored information.


http://www.hhs.gov/policies/hhsar



"Proposal modification" is a change made to a proposal before the solicitation's closing date and time, or made in response to an amendment, or made to correct a mistake at any time before award.

"Proposal revision" is a change to a proposal made after the solicitation closing date, at the request of or as allowed by a Contracting Officer as the result of negotiations. "Time," if stated as a number of days, is calculated using calendar days, unless otherwise specified, and will include Saturdays, Sundays, and legal holidays. However, if the last day falls on a Saturday, Sunday, or legal holiday, then the period shall include the next working day.

(b) Amendments to solicitations. If this solicitation is amended, all terms and conditions

that are not amended remain unchanged. Offerors shall acknowledge receipt of any amendment to this solicitation by the date and time specified in the amendment(s).

(c) Submission, modification, revision, and withdrawal of proposals.

(1) The first page of the proposal must show-

(i) The solicitation number; (ii) The name, address, and telephone and facsimile numbers of the Offeror (and electronic address if available); (iii) A statement specifying the extent of agreement with all terms, conditions, and provisions included in the solicitation and agreement to furnish any or all items upon which prices are offered at the price set opposite each item; (iv) Names, titles, and telephone and facsimile numbers (and electronic addresses if available) of persons authorized to negotiate on the Offeror's behalf with the Government in connection with this solicitation; and (v) Name, title, and signature of person authorized to sign the proposal. Proposals signed by an agent shall be accompanied by evidence of that agent's authority, unless that evidence has been previously furnished to the issuing office.

(2) Submission, modification, revision, and withdrawal of proposals.

(i) Offerors are responsible for submitting proposals, and any modifications or revisions, so as to reach the Government office designated in the solicitation by the time specified in the solicitation. If no time is specified in the solicitation, the time for receipt is 4:30 p.m., local time, for the designated Government office on the date that proposal or revision is due. (ii)(A) Any proposal, modification, or revision received at the Government office designated in the solicitation after the exact time specified for receipt of offers is "late" and will not be considered unless it is received before award is made, the Contracting Officer determines that accepting the late



offer would not unduly delay the acquisition; and-

(1) If it was transmitted through an electronic commerce method authorized by the solicitation, it was received at the initial point of entry to the Government infrastructure not later than 5:00 p.m. one working day prior to the date specified for receipt of proposals; or (2) There is acceptable evidence to establish that it was received at the Government installation designated for receipt of offers and was under the Government's control prior to the time set for receipt of offers; or (3) It is the only proposal received.

(B) However, a late modification of an otherwise successful proposal that makes its terms more favorable to the Government will be considered at any time it is received and may be accepted.

(iii) Acceptable evidence to establish the time of receipt at the Government installation includes the time/date stamp of that installation on the proposal wrapper, other documentary evidence of receipt maintained by the installation, or oral testimony or statements of Government personnel. (iv) If an emergency or unanticipated event interrupts normal Government processes so that proposals cannot be received at the office designated for receipt of proposals by the exact time specified in the solicitation, and urgent Government requirements preclude amendment of the solicitation, the time specified for receipt of proposals will be deemed to be extended to the same time of day specified in the solicitation on the first work day on which normal Government processes resume. (v) Proposals may be withdrawn by written notice received at any time before award. Oral proposals in response to oral solicitations may be withdrawn orally. If the solicitation authorizes facsimile proposals, proposals may be withdrawn via facsimile received at any time before award, subject to the conditions specified in the provision at 52.215-5, Facsimile Proposals. Proposals may be withdrawn in person by an Offeror or an authorized representative, if the identity of the person requesting withdrawal is established and the person signs a receipt for the proposal before award.

(3) Unless otherwise specified in the solicitation, the Offeror may propose to provide any item or combination of items.

(4) Offerors shall submit proposals in response to this solicitation in English, unless otherwise permitted by the solicitation, and in U.S. dollars, unless the provision at FAR 52.225-17, Evaluation of Foreign Currency Offers, is included in the solicitation.

(5) Offerors may submit modifications to their proposals at any time before the solicitation closing date and time, and may submit modifications in response to an amendment, or to correct a mistake at any time before award.



(6) Offerors may submit revised proposals only if requested or allowed by the Contracting Officer.

(7) Proposals may be withdrawn at any time before award. Withdrawals are effective upon receipt of notice by the Contracting Officer.

(d) Offer expiration date. Proposals in response to this solicitation will be valid for the

number of days specified on the solicitation cover sheet (unless a different period is proposed by the Offeror).

(e) Restriction on disclosure and use of data.

(1) The proposal submitted in response to this request may contain data (trade secrets; business data (e.g., commercial information, financial information, cost and pricing data); and technical data) which the offeror, including its prospective subcontractor(s), does not want used or disclosed for any purpose other than for evaluation of the proposal. The use and disclosure of any data may be so restricted; provided, that the Government determines that the data is not required to be disclosed under the Freedom of Information Act, 5 U.S.C. 552, as amended, and the offeror marks the cover sheet of the proposal with the following statements, specifying the particular portions of the proposal which are to be restricted:

‘‘Unless disclosure is required by the Freedom of Information Act, 5 U.S.C. 552, as amended, (the Act) as determined by Freedom of Information (FOI) officials of the Department of Health and Human Services (HHS), data contained in the portions of this proposal which the offeror has specifically identified by page number, paragraph, etc. as containing restricted information shall not be used or disclosed except for evaluation purposes.

The offeror acknowledges that HHS may not be able to withhold a record (e.g., data, document, etc.) nor deny access to a record requested pursuant to the Act and that the HHS’ FOI officials must make that determination. The offeror hereby agrees that the Government is not liable for disclosure if HHS has determined that disclosure is required by the Act.

If a contract is awarded to the offeror as a result of, or in connection with, the submission of this proposal, the Government shall have the right to use or disclose the data to the extent provided in the contract. Proposals not resulting in a contract remain subject to the Act.

The offeror also agrees that the Government is not liable for disclosure or use of unmarked data and may use or disclose the data for any purpose, including the release of the information pursuant to requests under the Act. The data subject to this restriction are contained in pages (insert page numbers, paragraph designations, etc. or other identification).’’

(2) In addition, the offeror must mark each page of data it wishes to restrict with the following statement:

‘‘Use or disclosure of data contained on this page is subject to the restriction on the cover

http://www.law.cornell.edu/uscode/5/552.html

http://www.law.cornell.edu/uscode/5/552.html



sheet of this proposal or quotation.’’

Offerors are cautioned that proposals submitted with restrictive statements or statements differing in substance from those cited above may not be considered for award. The Government reserves the right to reject any proposal submitted with nonconforming statement(s).

(f) Contract award.

(1) The Government intends to award a contract or contracts resulting from this

solicitation to the responsible Offeror(s) whose proposal(s) represents the best value after evaluation in accordance with the factors and subfactors in the solicitation.

(2) The Government may reject any or all proposals if such action is in the Government's

interest.

(3) The Government may waive informalities and minor irregularities in proposals received.

(4) The Government intends to evaluate proposals and award a contract without

discussions with Offerors (except clarifications as described in FAR 15.306(a)). Therefore, the Offeror's initial proposal should contain the Offeror's best terms from a cost or price and technical standpoint. The Government reserves the right to conduct discussions if the Contracting Officer later determines them to be necessary. If the Contracting Officer determines that the number of proposals that would otherwise be in the competitive range exceeds the number at which an efficient competition can be conducted, the Contracting Officer may limit the number of proposals in the competitive range to the greatest number that will permit an efficient competition among the most highly rated proposals.

(5) The Government reserves the right to make an award on any item for a quantity less

than the quantity offered, at the unit cost or prices offered, unless the Offeror specifies otherwise in the proposal.

(6) The Government reserves the right to make multiple awards if, after considering the

additional administrative costs, it is in the Government's best interest to do so.

(7) Exchanges with Offerors after receipt of a proposal do not constitute a rejection or counteroffer by the Government.

(8) The Government may determine that a proposal is unacceptable if the prices proposed

are materially unbalanced between line items or subline items. Unbalanced pricing exists when, despite an acceptable total evaluated price, the price of one or more contract line items is significantly overstated or understated as indicated by the application of cost or price analysis techniques. A proposal may be rejected if the Contracting Officer determines that the lack of balance poses an unacceptable risk to the Government.

(9) If a cost realism analysis is performed, cost realism may be considered by the source

selection authority in evaluating performance or schedule risk.



(10) A written award or acceptance of proposal mailed or otherwise furnished to the successful Offeror within the time specified in the proposal shall result in a binding contract without further action by either party.

(11) If a post-award debriefing is given to requesting Offerors, the Government shall

disclose the following information, if applicable:

(i) The agency's evaluation of the significant weak or deficient factors in the debriefed Offeror's offer.

(ii) The overall evaluated cost or price and technical rating of the successful and the debriefed Offeror and past performance information on the debriefed Offeror. (iii) The overall ranking of all Offerors, when any ranking was developed by the agency during source selection. (iv) A summary of the rationale for award. (v) For acquisitions of commercial items, the make and model of the item to be delivered by the successful Offeror. (vi) Reasonable responses to relevant questions posed by the debriefed Offeror as to whether source-selection procedures set forth in the solicitation, applicable regulations, and other applicable authorities were followed by the agency.

L.4 FAR 52.215-20 REQUIREMENTS FOR COST OR PRICING DATA OR INFORMATION OTHER THAN COST OR PRICING DATA (OCT 2010)—ALT IV (OCT 2010)

(a) Submission of certified cost or pricing data is not required.

(b) Provide information as described in sections L.13 – Business Proposal Instructions.

L.5 FAR 52.216-1 TYPE OF CONTRACT (APR 1984) The Government anticipates the award of a Multiple Award Indefinite Delivery Indefinite Quantity (IDIQ) Contract to multiple vendors in addition to the award of a Cost-Plus-Award-Fee (CPAF) Task Order (See FAR 16.305) resulting from this solicitation. However, the Contracting Officer reserves the right to choose another contract type if it is in the best interest of the Government to do so. L.6 FAR 52.233-2 SERVICE OF PROTEST (SEP 2006)

a. Protests, as defined in section 33.101 of the Federal Acquisition Regulation, that are filed directly with an agency, and copies of any protests that are filed with the Government Accountability Office (GAO), shall be served on the Contracting Officer, Centers for Medicare and Medicaid Services

OAGM/ASG/Division of Program Integrity and Financial Management Contracts Attn: Mr. Michael J. Connors, Contracting Officer 7111 Security Boulevard, M/S B2-12-15 Baltimore, MD 21244-1850



by obtaining written and dated acknowledgment of receipt from Mr. Michael Connors located at the above address.

b. The copy of any protest shall be received in the office designated above within one day of filing a

protest with the GAO.

L.7 52.252-3 ALTERATIONS IN SOLICITATION (APR 1984)

Portions of this solicitation are altered as follows: __________________N/A________________________ _____________________________________________

L.8 52.252-5 AUTHORIZED DEVIATIONS IN PROVISIONS (APR 1984)

(a) The use in this solicitation of any Federal Acquisition Regulation (48 CFR Chapter 1) provision

with an authorized deviation is indicated by the addition of “(DEVIATION)” after the date of the provision.

(b) The use in this solicitation of any ______________ (48 CFR Chapter ______) provision with an authorized deviation is indicated by the addition of “(DEVIATION)” after the name of the regulation.

L.9 SUBMISSON OF QUESTIONS AND INTENT TO SUBMIT A PROPOSAL

a. Questions

Date: Questions must be submitted no later than July 27, 2015, at 11:00am (local time, Baltimore, MD).

Address: Questions on this RFP shall be submitted using Exhibit 3, UPIC Questions Template, electronically Mr. David Hochendoner, Contract Specialist, at [email protected] and Ms. Gina Romano, Contract Specialist, at [email protected].

Submission of questions shall include, at a minimum, company name, address, point of contact, phone number and be submitted in the Exhibit 3 format and shall be limited to information contained in the current solicitation. Answers to questions that CMS determines to be necessary for proposal preparation may be conveyed in the form of a solicitation amendment and posted on the Federal Business Opportunities website (www.fbo.gov). Technical questions submitted by telephone or verbally will not be honored. Please note that answers to questions submitted for the draft solicitation are included in Exhibit 4 and are provided purely for informational purposes. CMS will not entertain follow on questions to those answers. Information contained in this solicitation document shall supersede any discrepancy between information in Exhibit 4 and this solicitation.

b. Intent to Submit a Proposal The Offeror shall indicate its intent to submit a proposal no later than close of business on August 3, 2015. This notice shall be submitted via e-mail to Mr. David Hochendoner, Contract





Specialist, at [email protected] and Ms. Gina Romano, Contract Specialist, at [email protected].

The Subject of the email shall be “Intent to Submit a Proposal for UPIC – HHSM-500-2015-RFP- 0122.” NOTE: Please be advised that intent to submit a proposal is not binding on the Offeror and is for planning/scheduling purposes only.

L.10 GENERAL

The Government anticipates the award of a Multiple Award Indefinite Delivery Indefinite Quantity (MA IDIQ) Contract to multiple vendors in addition to the award of a Cost-Plus-Award-Fee (CPAF) Task Order for Jurisdiction 1 which encompasses the following states: Minnesota, Wisconsin, Illinois, Indiana, Michigan, Ohio and Kentucky, Kansas, Missouri, Ohio, Nebraska, Iowa. All Offeror’s are required to propose to Jurisdiction 1. The evaluation of the Offeror’s technical approach and cost/price information will form the basis of the decision to award an Offeror an IDIQ contract for the UPIC procurement in addition to determining which Offeror shall receive the initial task order award (Jurisdiction 1). Not all Offeror’s however may want to be considered for the award of the Jurisdiction 1 task order, and may only want to be considered for an IDIQ award. Offerors shall clearly state within their executive summary (see L.13, Section D, D.2) whether they wish to be considered for both an IDIQ award and the initial task order award. Offerors only interested in an IDIQ award must still submit a technical and cost proposal for Jurisdiction 1 for evaluation.

a. Performance of Work: It is the Government’s intention that all work under this contract shall be performed within the United States, unless the Offeror can demonstrate that performance of work outside the United States satisfies the requirements specified in Section H.

b. Proposals Included in the Official Contract File: Offerors are advised that its proposal will become part of the official contract file.

c. Costs for Proposal Submission: This solicitation does not commit the Government to pay any cost for the preparation and submission of a proposal. In addition, the Contracting Officer is the only individual who can legally commit the Government to the expenditure of public funds in connection with the proposed acquisition.

d. Award without Discussion: Offerors are advised that award may be made without discussions. (See also FAR 52.215-1, Instructions to Offerors – Competitive Acquisition (Solicitation Section L.3.)). Offeror’s are cautioned it is the Government intent, if determined to be in the Government’s best interest, to award on INITIAL PROPOSAL SUBMISSIONs. Proposals should be submitted initially on the most favorable terms from a price/cost and technical standpoint.

e. Late Proposals: Late proposals will be handled in accordance with FAR 52.215-1, Instructions to Offerors Competitive Acquisition (JAN 2004) (Solicitation Section L.3).

f. Signature: The proposal shall be signed by an official authorized to bind its organization.

g. Amendment/Cancellation: CMS reserves the right to amend or cancel the solicitation as necessary to meet CMS requirements.





h. Communications Prior To Contract Award: Offerors shall direct all communications to the attention of the Contract Specialist/Contracting Officer cited in the solicitation unless otherwise amended. Communications with other officials may compromise the integrity of this acquisition and result in cancellation of the requirement.

L.11 PROPOSAL SUBMISSION AND DELIVERY

A. Offerors shall submit their proposals in accordance with Block 9 of the SF-33 (page 1) to the address below as prescribed in Section L:

Centers for Medicare & Medicaid Services (MAILING ADDRESS) Office of Acquisition and Grants Management Division of Program Integrity and Financial Management Contracts ATTN: David Hochendoner, Contract Specialist M/S: B3-30-03 7500 Security Boulevard, Baltimore, Maryland 21244-1850

Centers for Medicare and Medicaid Services (PHYSICAL LOCATION) OAGM/ASG/DPIFMC ATTN: David Hochendoner, Contract Specialist 7111 Security Boulevard Baltimore, MD 21244-1850 Phone: (410) 786-6648 E-mail: [email protected] Cube location: B2-13-04

Alternate Point of Contact: Michael J. Connors Contracting Officer (410) 786-1554

NOTE: Offerors are hereby advised that the place for submission of proposals (CMS at 7111 Security Boulevard, Baltimore (Woodlawn, Maryland), is a secure building. Please be advised that CMS Security Guards will not accept proposals for CMS staff. Proposal delivery must be made to the exact location stated in this RFP solicitation on or before the date and time specified. The proposal is not considered to be delivered until it is in the hands of the Contract Specialist/Contracting Officer.

If planning to send a proposal vial mail, Offerors are advised that all mail addressed to the CMS Contracting Office is delivered to the CMS mail room (including overnight mail) located at the main CMS complex (7500 Security Boulevard). When utilizing overnight mail carriers you are cautioned that overnight carriers do not deliver to the 7111 Security Boulevard location. Therefore, if using an overnight carrier, the date of the proposal receipt will be the date the overnight package was signed for by CMS at the CMS mailroom. When using regular first class mail, the date of proposal receipt will be the date the proposal is received by the Contract Specialist/Contracting Officer. Offerors are cautioned that it may take several days for mail to be delivered to the Contract Specialist/Contracting Officer from the CMS mailroom. Proposals delivered by a mail carrier service other than the U.S. Postal Service are not




accepted in the CMS mailroom and therefore, Offerors’ proposals may not be delivered timely to the location specified in this RFP. Offerors are advised to take that possibility into consideration in determining when and how a proposal must be received at the specified location to meet the date and time requirements. Offerors are also advised to make sure that the proposal is clearly marked as to:

• The RFP number, • The date and time for receipt, • The intended mail stop, • The intended recipient, and • The telephone number of the intended recipient.

B. Late Proposals: Late proposals will be handled in accordance with FAR 52.215-1,

Instructions to Offerors – Competitive Acquisition. For this provision, a proposal includes all proposal submissions from the Offeror and its subcontractors (i.e., electronic copies/submissions) to all recipients identified in this solicitation. If any portion of the proposal (Prime Contractor AND Subcontractor) is not received by the above specified date and time, you will be contacted and advised that the proposal may not be accepted for consideration.

L.12 GENERAL PROPOSAL INSTRUCTIONS The following information shall be provided based on the terms and conditions of the solicitation, the SOW at Attachment J.1, entitled “Unified Program Integrity Contract Statement of Work,” the Task Order SOW at Attachment J.6.B, and the instructions provided in Section L and Section M. Offerors’ proposals that simply repeat the requirements or state “we will conform to the requirements as stated” are not acceptable and will be considered non-responsive.

1. General

The following instructions will establish the acceptable minimum requirements for the format and contents of the proposal. The proposal shall be organized to clearly identify the contents within each volume and the files on each CD (e.g. Index). The Offeror’s proposal submission shall consist of the following separate volumes:

Volume I Business Proposal Volume II Technical Proposal Volume III Conflict of Interest and Compliance Program The Offeror shall submit: Hard Copies

• One original and three copies of Volume I, Business Proposal;

• One original and three copies of Volume II, Technical Proposal;

• One original and three copies of Volume III, the Conflict of Interest and Compliance Program signed by an official authorized to bind your organization.



Electronic Copies (CDs)

• Two (2) copies of Volume I, Business Proposal;

• Two (2) copies of Volume II, Technical Proposal;

• Two (2) copies of Volume III, the Conflict of Interest and Compliance Program signed by an official authorized to bind your organization.

Each of the volumes shall be separate and complete in and of itself so that the evaluation of one may be accomplished independently of the evaluation of the other. The term electronic format as it pertains to this solicitation means compact disc (CD).

2. Format a. Page size shall be 8.5 by 11 inches unless otherwise indicated. b. The proposal shall be page numbered. c. Type size shall not be less than 11 point font type Times New Roman. d. Charts, graphs, and tables may be no less than 8-point font Times New Roman. e. Each page shall be single-spaced and shall not be compressed. f. Each page shall have a 1” margin on all 4 sides; header and footer information may be

contained within the 1” area. g. Signed documents such as conflict of interest may be submitted in Adobe Acrobat or

“PDF” format. Organizational charts may be provided in PowerPoint. h. Cost proposal spreadsheets shall be submitted in Microsoft Excel. i. Excel scaling may not be less than 75% for printed pages.

Electronic Proposals: All submissions should be fully functional (except PDF’s) and should not contain blocked or hidden content. Each proposal shall be compatible with Microsoft Office 2010. Offerors shall submit the electronic proposals as follows:

• Each proposal shall be submitted on a CD-ROM submitted in Microsoft Office Word, unless otherwise noted.

• Each CD shall clearly identify each volume, copy number (i.e., copy 2 of 4),

Jurisdiction number, solicitation number, Offeror’s name, address and contact information.

• If the material for a volume requires more than one CD, than that volume shall be

labeled with the name and number of the volume and CD number (i.e., Technical Proposal, Volume I, CD 1 of 2). The original of each Volume shall be marked ORIGINAL and all other copies shall be marked COPY # ___ of ___.

• CMS will not be liable for the inability to read and/or evaluate a proposal that is incompatible with Microsoft Office Suite 2010.

• Signatures: The proposal documents requiring a signature(s) shall be submitted electronically (e.g. scanned). The Offeror is encouraged to include language regarding the distribution and/or permission(s) of individual electronic signatures.

• IT Security: The Offeror shall certify that each electronic submission (CD) has been



checked for viruses using a current version (no older than 6 months) of virus detection software and is virus free. The certification shall identify the virus detection software and version (refer to J.12).

• CMS will not be liable for the failure to read and/or evaluate a proposal that contains a virus, corrupt files, or similar problem. Offerors are encouraged to test each disc prior to sending in proposals to ensure that all files are functional.

• CMS will not accept electronic copies (submission) that are opened, cracked and/or

manipulated from either the US Postal Service and/or through hand delivery. Hard Copy Proposals: Each submission shall have an exterior label with the Offeror’s name, Jurisdiction number, the solicitation number, proposal volume/title, date of submission and version i.e. original, copy or final revised (when applicable). The original of each Volume shall be marked ORIGINAL and all other copies shall be marked COPY # ___ of ___.

Assumptions: The Offerors shall assume the following in the preparation of proposals:

1. Four states will participate in Medi-Medi in the base year: Ohio, Iowa, Nebraska, and Missouri;

2. Two additional Medi-Medi states will be added in Option Year one: Kentucky and Indiana;

3. No additional Medi-Medi states are expected to be added in Option Years two, three and four.

4. Contractors will not be eligible for an Excellence award until Option Year one. 5. Offerors should assume $35,000 a year for file transfer/storage costs. 6. A valid CMS ID is required to access OnePI and use its business intelligence tools. 7. Contractors will begin the process to gain CMS IDs for staff needing access to CMS

systems immediately after contract award. 8. Users must complete training in OnePI tools in order to access data through OnePI. 9. OnePI training classes are held monthly. 10. At the maximum, all contractor staff that will use OnePI will travel to Baltimore,

Maryland for up to three (3) two-day training sessions. 11. Assumptions associated with the Draft Unified Case Management (UCM) Functional

Requirements Document (FRD) (Exhibit E.5): a. The UCM FRD is not a final version and continues to be updated. b. The UCM FRD provides details on what will be contained in the UCM System,

as well as the expectations for those who will be entering information in the UCM System.

c. The UCM FRD is provided for proposal preparation purposes only. 12. Assumptions associated with draft revisions to IOM 100-08 Program Integrity Manual

(PIM) (Exhibits E.6, E.7, and E.8): a. CMS is in the process of revising the language in IOM 100-08 currently available

at http://www.cms.gov/manuals. b. Draft revisions to Chapters 4, 8, and 16 provided in Exhibits E.6, E.7, and E.8 are

not final and may undergo further revisions prior to being finalized. c. The draft PIM documents are provided for proposal preparation purposes only.

L.13 BUSINESS PROPOSAL (VOLUME I) INSTRUCTIONS Follow the below format to the best degree possible and TAB AND LABEL EACH SECTION (and any

http://www.cms.gov/manuals



applicable subsections) INCLUDING TITLE as designated below. The Offeror shall identify, in the header or the footer throughout the proposal, the Offeror’s name and the solicitation number for which the Offeror is submitting the proposal. The Offeror may submit the entire Business Proposal on one CD, if feasible, but each part must be separated and labeled accordingly. The Business Proposal is unlimited in page count. The Offeror’s business proposal shall be organized as follows: VOLUME I - BUSINESS PROPOSAL: Please follow the below format to the best degree possible and TAB AND LABEL EACH SECTION (and subsections as applicable) INCLUDING THE TITLE. The Business Proposal shall consist of the following elements, at a minimum:

I. PART I - IDIQ

Section A: Table of Contents

Offerors shall include a Table of Contents that identifies and clearly labels the various business proposal sections for Part I - IDIQ.

Section B: Contract Forms and Representations and Certifications (Prime Only)

The SF-33 and the Representations and Certifications contained in Section K must be executed by an official authorized to bind the Offeror and provided by the Prime Contractor. In addition, Sections B, G and H of the RFP shall be completed where applicable.

B.1 SF-33, Solicitation, Offer and Award B.2 RFP Section B B.3 RFP Section G B.4 RFP Section H B.5 RFP Section K Section C: Indirect Cost Rate Agreements and Rate History

1. The Offeror is instructed to provide any approved provisional / indirect billing rates by a cognizant Government agency. The Offeror is instructed to provide a copy of any forward pricing rate agreements and government approved indirect cost rate agreements used in pricing herein (if available).

2. If the Contractor has no prior history of government approved indirect cost rates or if

the Offeror is proposing indirect rates which significantly deviate from current actuals, then the Offeror SHALL provide support documentation for the prior 3 years consisting of their current year operating budget and a forecast covering the anticipated period of performance. The budget should also detail the indirect expenses and show the relationship of direct labor (or other indirect expenses allocation bases) to sales projections. (Source: DCAAP 7641.90) The Offeror shall also provide all data (Bases and Pools), methodology (accounting practices), and relevant information that supports the proposed indirect rates as fair and reasonable. For more information on the data points that need to be provided to enable the Government to able to review the Offeror’s calculations for the proposed indirect rates see FAR Part 31 and FAR Appendix A, Cost Accounting Standards.



3. Indirect Cost Rates: In accordance with FAR 42.707, entitled “Cost Sharing Rates and Limitations on Indirect Cost Rates,” CMS will establish indirect cost ceilings in the contract. Ceiling rates will be no more than 10% higher than current provisional rates or current actual indirect rates.

For example and Overhead rate of 55% shall be no higher than (.55*.1=.055) .055+.55= ceiling rate of 60.5%. Or for example a G&A rate of 9% can be no higher than (.09*.1=.009) .009+.09= a ceiling rate of 9.9%.

Reimbursement will be limited to the negotiated indirect cost ceilings established in the contract. The Government has no obligation to pay any additional amount to the contractor should the final indirect cost rates exceed the negotiated ceilings as stated in the contract.

Section D: Other Administrative Data

D.1 General The Offeror’s proposal must stipulate that it is predicated upon all the terms and conditions of this RFP. In addition, it must contain a statement to the effect that it is firm for a period of at least 240 days from the date specified for receipt of offers by the Government.

D.2 Executive Summary (15 page limit)

All Offeror’s are required to propose to Jurisdiction 1. The evaluation of the Offeror’s technical approach and cost/price information will form the basis of the decision to award an Offeror an IDIQ contract for the UPIC procurement in addition to determining which Offeror shall receive the initial task order award (Jurisdiction 1). Not all Offeror’s however may want to be considered for the Jurisdiction 1 task order award and may only want to be considered for an IDIQ award. Offerors shall clearly state within their executive summary whether they wish to be considered for both an IDIQ award and the Jurisdiction 1 task order award. Offerors only interested in an IDIQ award must still submit a technical and cost proposal for Jurisdiction 1 for evaluation.

Additionally, to assess the competitive market for the MA IDIQ all Offerors must state which jurisdictions the Offeror intends to bid for in the future. This does not commit either the Government to issue an RFP or the Offeror to submit a bid in the future. This information will be used as the basis for determining how many IDIQ awards need to be made to ensure adequate competition for future task orders. For each Jurisdiction an Offeror expresses an interest in the Offeror needs to address the following in the executive summary:

1. List all jurisdictions the Offeror intends to submit a proposal;

2. Provide evidence that the Offeror has the financial capability to operate in multiple jurisdictions, if intending to bid on more than one jurisdiction;

3. Provide evidence / corporate experience showing the Offeror has managed multiple projects of similar size and scope equivalent to the number of jurisdictions which the Offeror has expressed an interest; and



4. Ensure the Offeror’s OCI submission addresses all the areas which the Offeror expresses an interest.

Note: If the Offeror expresses an interest in either all jurisdictions or possible nationwide task orders, the Offeror must address each of the above questions on a national scale.

D.3 Statement on the Offeror's Financial Capability

The Offeror’s proposal must indicate whether it has the necessary financial capacity, working capital, and other resources to perform the contract without assistance from any outside source (If not, indicate the amount required and the anticipated source). The Offeror shall provide a letter from an established banking institution confirming the Offerors financial capability.

D.4 Financial Statements

Include a copy of your audited financial statements for the past three fiscal years. If an audited financial statement is not available, provide the most recent revised, compiled or internally prepare financial statement. Offeror’s that are newly formed shall submit the financial statements of the “parent” company (ies).

D.5 Disclosure Statement Offerors (other than small business) shall submit a Disclosure Statement in accordance with FAR Part 30 (See also Section K). An Offeror, other than a small business, is not excluded from this requirement. D.6 Adequate Accounting and Estimating Systems Offerors shall have accounting and estimating systems that are in compliance with applicable Contract Cost Principles and Procedures of FAR Part 31, Contract Cost Principles and Procedures, as well as FAR Appendix A, Cost Accounting Standards (CAS) in order to be considered for award of a Cost type task order. Offerors shall state if their practices used in estimating costs are consistent with their cost accounting practices used in accumulating, segregating and reporting costs.

The Contractor shall state whether or not they have a government approved accounting system as identified in Section K. The subcontractor(s) shall also submit this information if the proposed subcontract agreement arrangement is cost reimbursable. In the event that the Contractor does not have a government approved accounting system and/or have never had a government cost reimbursement contract, the following information is required:

a. A Provisional Indirect Rate Submission package shall be prepared in accordance with

(b) below. It should include all schedule detail and explanation for the basis and rational of the indirect rates proposed.

b. The schedule and detail prescribed in the Publication DCAAP 7641.90 dated June

2012, titled “Information for Contractors’ published by the Defense Contract Audit Agency.” This publication is only a guide and the specific contractor’s situation must be used in preparing the Provisional Rate Package. Specific examples of the detail required are covered in Chapter 5 of the aforementioned document. Failure to



comply with this requirement will result in the proposed provisional indirect rates being classified as “deferrable allowable cost” reimbursable pending validation of the indirect rates.

c. Provide information that describes the basis and relationships of the proposed indirect

expense rates including overhead, general and administrative, material and fringe benefits amounts, if applicable.

Note: Time and Material Contracts are considered Cost Reimbursement Contracts; therefore, any Offeror or subcontractor proposing this type of contracting arrangement is required to have an accounting system which has been deemed adequate by the Offeror’s cognizant audit agency prior to receiving contract award.

D.7 Uncompensated Overtime (FAR 52.237-10 (Mar 2015)) The Offeror is required to include a copy of its policy on “uncompensated overtime” with its proposal. Uncompensated overtime is defined as “…hours worked without additional compensation in excess of an average of 40 hours per week by direct charge employees who are exempt from the Fair Labor Standards Act.” D.8 Total Compensation Plan (FAR 52.222-46 (Feb 1993)) The Offeror shall submit a total compensation plan setting forth proposed salaries and fringe benefits for professional employees working on the contract. Supporting information will include data, such as recognized national and regional compensation surveys and studies of professional, public and private organizations, used in establishing the total compensation structure.

D.9 Responsibility Questionnaire (Attachment J.11) The Offeror shall submit Attachment J.11 filled out in its entirety.

D.10 Virus Detection Certification (Attachment J.12) The Offeror shall submit Attachment J.12 and it must be executed by an official authorized to bind the Offeror. D.11 Cost Accounting Standards (CAS) Offeror’s are instructed to state whether they are subject to CAS in accordance with FAR Part 30. If the Offeror is subject to CAS requirements, the Offeror shall provide an attestation affirming the latest version of the Offeror’s CAS Disclosure Statement. Additionally, Offerors subject to CAS SHALL provide the most recent DCAA report or similar report from the Offeror’s cognizant auditing agency affirming the adequacy and the Offeror’s current status with regard to the Offeror’s compliance with their CAS disclosure practices.

Section E: Subcontracts

The Offeror’s business proposal narrative submission shall include the following subcontract information to be evaluated for each subcontractor that is performing under the contract:



a. Representation and Certifications Verification of SAM registration, if applicable Certification of small business size standard for the appropriate NAICS.

b. A copy of the subcontract agreement which includes, at a minimum:

(1) The supplies or services to be subcontracted with identification of associated SOW tasks for the specific task order;

(2) Identification of the type of subcontract to be used (e.g. Time and Material, Firm Fixed Price);

(3) Proposed subcontract price (inclusive of rationale providing the negotiation memorandum supporting the proposed cost or price as reasonable); and,

(4) Flow down of appropriate FAR and prime contract clause from prime contractor.

c. Certificate of Current Cost or Pricing Data; as appropriate,

d. Subcontract Negotiation Memorandum It is incumbent on the prime contractor to demonstrate their subcontractor proposal is fair and reasonable. The prime must establish why it accepted the proposed cost and demonstrate, based on the contracting arrangement (cost reimbursement, firm fixed price, etc.), that appropriate due diligence has been done and all proposed costs are supported (See FAR 15.404 for more information).

(1) The principal elements of the subcontract price negotiations; (2) The most significant considerations controlling establishment of initial or revised prices;

(3) The reason cost or pricing data were or were not required; (4) The extent, if any, to which the Offeror relied on the subcontractor’s cost or pricing data in determining the price objective and in negotiating the final price; (5) The extent to which it was recognized in the negotiation that the subcontractor’s cost and pricing data were not accurate, complete or current; the action taken by the Offeror and the subcontractor; and the effect of any such defective data on the total price negotiated; (6) The reasons for any significant difference between the Offeror’s price objective and the price negotiated; and, (7) A complete explanation of the incentive fee or profit plan when incentives are used. The explanation shall identify each critical performance element, management decision used to quantify each incentive element, reasons for the incentives, and a summary of all trade-off possibilities considered. (8) A complete explanation for why the agreed to price /cost (including all proposed cost elements (Labor Rates, ODCs, etc.)) were considered fair and reasonable.

It should be clear how the prime contractor found the proposed subcontractor costs to be fair and reasonable. In addition it should clearly state what type of analysis was conducted (Cost or Price), the outcome of the analysis, and any supporting data



(market research, quote information, etc.) that supports the Prime’s rationale for excepting the proposed cost or price.

Each Subcontractor Negotiation Memorandum shall be attached and clearly labeled with a TAB.

e. Extent to which adequate price competition was obtained, or justification for its absence. If competitive procedures were used, the Offeror is instructed to provide the supporting quotes, proposals, and rationale explaining the Offeror’s selection of the particular subcontractor.

f. Statement as to whether the proposed subcontractor is on the List of Parties Excluded

from Federal Procurement and Non-procurement Programs.

g. Subcontract Checklist (Attachment J.13)

II. PART II - TASK ORDER FOR JURISDICTION 1 Section A: Table of Contents Offerors shall include a Table of Contents that identifies and clearly labels the various business proposal sections for Part II – Task Order for Jurisdiction 1.

Section B: Task Order Forms (Prime Only)

The Offeror shall complete the following sections of the Task Order (TO) Request for Proposal (RFP), Attachment J.6.A:

A.1 TO RFP Section B

A.2 TO RFP Section G A.3 TO RFP Section H Section C: Business Proposal Spreadsheets (Exhibit E.2)

Proposal submission is required to be in the format prescribed in the business proposal spreadsheet – Exhibit E.2. In addition, FAR 15.408, Table 15-2 provides instructions on preparing a proposal and the supporting documentation required. For assistance in proposal preparation, see publication DCAAP 7641.90 dated June 2012 entitled “Information for Contractors” published by the Defense Contract Audit Agency. The full text of this publication is available on the Internet at http://www.dcaa.mil.

Business proposals shall be submitted following the instructions included in Table 15-2 at FAR 15.408, the CLIN structure provided with the solicitation, Exhibit E.2 and in accordance with the Statement of Work (SOW).

The business proposal is presumed to represent an Offeror’s best effort to respond to the solicitation. Any significant inconsistency, if not explained, raises a fundamental issue of the understanding of the nature and scope of the work required and of the Offeror’s financial ability to perform the contract and may be grounds for rejection of the offer. The burden of proof for cost credibility is with the Offeror.

http://www.dcaa.mil/



Prospective Offerors, at a minimum, must submit a business proposal supported by information other than cost and pricing data (see FAR 15.4) adequate to establish the reasonableness and realism of the proposed business proposal.

Facilities Capital Cost of Money: Pursuant to HHSAR 315.404-4, when facilities capital cost of money (cost of capital committed to facilities) is included as an item of cost, a reduction in the profit objective shall be made in an amount equal to the amount of facilities capital cost of money proposed/claimed. This effectively makes the inclusion of cost of money in a proposal as an element of cost irrelevant.

The Offeror shall use the business proposal spreadsheet (see Exhibit E.2) provided. The business proposal spreadsheet indicates the levels of proposed costs that are to be provided to the extent that an Offeror’s accounting system is able to capture cost data for that particular section. These spreadsheets serve the purpose of providing the breakout of all cost elements in the prime and subcontractor’s proposals. Offerors are instructed not to re-create the entire proposal through excel print outs in their hard copy proposal submission. The only cost breakout information that should be provided in the hard copy proposal is a document demonstrating the summary of proposed costs by CLIN, Cost Category, and period of performance.

• The Offeror shall not make the business proposal spreadsheets submitted “Read Only” • All spreadsheets will be in Office 2010 excel format, be fully functional, and unlocked. • The Offeror SHALL submit excel documents with active formulas that can be reviewed

and traced using Microsoft excel functions • Offerors are instructed to review all excel formulas for accuracy prior to submitting a

proposal, as the Offerors are responsible for the accuracy of all formulas within the spread sheet provided.

• The Offeror’s Spreadsheet TAKES PRECEDENT FOR COST INFORMATION. • Offerors are instructed NOT to print excel sheets as part of their business proposal

submission. It is only necessary to provide these with the electronic copies of your business proposal.

• In every excel “cell” no number shall go beyond two decimal places

The Offeror and each subcontractor shall use the business proposal spreadsheet (Exhibit E.2), including all tabs, for all cost/price and shall include the following:

a. Labor: Offerors shall provide labor rates for all labor categories that are expected to be

used in the performance of the contract. For each labor category please show the “number of labor hours times hourly labor rate equals resultant total dollar amount” by year. Subcontract direct labor shall be shown in the same manner (“number of labor hours times hourly labor rate equals resultant total dollar amount”), however, under the subcontract line item. Such labor rates shall be projected for the base year and all option years. The Offerors are also requested to provide the following:

o For each labor category in a separate column provide the projected Full Time Equivalent (FTE) level. This is to help CMS understand the total number of FTES when multiple staff is accommodated in one line item.



o The productive labor hours (yearly) for exempt and non-exempt employees used to calculate FTEs for the prime and each subcontractor. For example (1850 = 1 FTE, or 1920 = 1 FTE, etc.)

b. Travel: All travel costs proposed shall be reimbursed on a cost reimbursement basis in accordance with the Federal Travel Regulation (FTR). The Contractor shall consolidate travel costs into one line item. However, a separate schedule (tab within Exhibit E.2) shall be provided for travel cost breakdown of proposed travel expenses consisting of the following: “From” and “To” cities, number, types and purpose of trips, number of travelers including labor category title and head count if known, duration of trip for each destination, mileage, per diem, air fare, and miscellaneous expenses. A similar break out is required for any subcontractor that proposes travel expenses (this information may be provided in either a sealed package sent separately to CMS or be a part of the prime’s proposal submission).

c. Other Direct Costs (ODCs): These include materials, equipment, etc. The Offeror shall consolidate ODCs into one line item. However, a separate schedule (tab within Exhibit E.2) shall be provided to breakdown ODCs. The separate schedule shall provide a detailed itemization of each ODC along with supporting quotes. . A similar break out is required for any subcontractor that proposes Other Direct Costs (ODCs) (this information may be provided in either a sealed package sent separately to CMS or be a part of the primes proposal submission).

d. Subcontracts: The Offeror shall provide subcontract cost information per subcontractor as prescribed above under “Labor.” In addition, all proposed subcontractors shall submit a separate and complete business proposal spreadsheet in the same format as the Offeror’s business proposal spreadsheet no matter the dollar value. Subcontractors may submit their business proposal spreadsheet showing the breakdown of costs, buildup of fully burdened rates, etc. to CMS in a separately sealed package.

e. Indirect Rates: The Offeror shall provide the indirect rates as applicable along with the relative percentages on the business proposal spreadsheet.

f. Fee: The Offeror shall provide each fee separately along with the relative percentages on the business proposal spreadsheet.

g. Summary Rollup of All Costs: In addition to the individual contract line item summaries, the Offeror shall include a summary sheet inclusive of all costs, FTEs, hours and period of performance (tab within Exhibit E.2).

Section D: Business Proposal Narrative Organization

D.1 Prime and Subcontractor Proposal Checklist(s) (Exhibit E.1 & E.1.A) D.2 Business Proposal Assumptions

Offerors shall provide all proposal assumptions in detail that are used in preparing their business proposal spreadsheet submission. Assumptions should include rationale for all business proposal elements. For example, why was the labor category chosen, why the number of FTEs proposed for that labor category, etc.?

D.3 Base of Estimate (BOE)



For all proposed costs (direct labor, indirect, ODC’s, Subcontract Costs, etc.) it is incumbent on the Offeror to clearly describe the BOE used to establish those estimates as fair and reasonable. This includes providing all assumptions used to establish proposed costs, if historical actuals were used an explanation as to why those actuals are still accurate, and any and all empirical data which can provide further support to the proposed costs as fair and reasonable.

D.3.A Direct Labor Rates & Escalation

The Offeror’s proposed labor rates shall be supported with payroll information, letters of intent or salary survey information (market research supporting proposed rates as fair and reasonable). If the Offeror proposes bid rates or composite rates, the breakdown of the rate and explanation supporting the fairness and reasonableness of the rate must be provided. Additionally, the Offeror should include the location of each individual proposed by state.

Note: It is not enough to simply state that proposed costs are based on market research. The Offeror needs to provide the market research data, analysis, and conclusion.

If the labor rates are escalated, the Offeror shall provide the escalation rate and the rationale for the proposed escalation rate.

The Offeror’s productive labor hours for exempt and non-exempt employees used to calculate the FTEs.

The Offeror shall provide detailed labor rationale by labor category and should describe how the basis of the hours was determined (e.g. historical data, technical experience, etc.).

The Offeror, along with all proposed subcontractors, shall provide a matrix aligning the Offeror’s proposed rates to same or similar labor categories provided by the Bureau of Labor Statistics (BLS) (http://www.bls.gov/oes/current/oes_nat.htm). This matrix shall be formatted in the following manner and must provide the appropriate BLS labor category number, BLS labor rate (Median, Mean, 25th percentile, 75th percentile, etc.), proposed labor category, proposed labor rate, and justification for why this rate is same or similar. The Offeror is instructed, whenever possible, to use data that is specific to the proposed area /state or municipality. It is not appropriate for an Offeror to select a same or similar rate based solely on the dollar value of that rate. Same or similar determinations shall be made based on the alignment of the skill set of the individual required to meet this requirement and the BLS labor category description provided for each labor category.

For Example:

Proposed Labor

Category

Proposed Labor Rate

BLS Labor Category / Number / (State,

National, Municipality)

BLS Rate (Percentile if applicable)

Justification – Supporting Same or Similar and selection of (25th

Percentile, Median, Mean, 75th Percentile, etc.)

*Lead Aerospace Engineer

$55.00* Aerospace Engineers – 17-2011- Michigan

**$49.02 – 75th Percentile

*Based on the Offeror’s review of the labor category 17-2011, it is the labor category which best captures the duties and skills set required for the proposed labor category of “Lead Aerospace Engineer”. This individual is proposed in the state of Michigan and as a result the offeror

http://www.bls.gov/oes/current/oes_nat.htm



utilized BLS labor rate data specific to the state of Michigan. The individual proposed for this effort is intended to fulfill a team lead position and as a result the offeror believes these extra duties justify a labor rate closer to 75th percentile rather than the mean or median rate for Michigan for an Aerospace Engineer.

*Represents an example to further demonstrate the required information for each proposed labor category. ** BLS rates need to be adjusted to current rate using the posted ECI calculator (http://data.bls.gov/timeseries/CIU2010000000000A) D.3.B Indirect Rates (Overhead Rate, General & Administrative, Fringe, etc. as

appropriate) The Offeror shall provide the indirect cost rate percentages and what the rate is applied to, i.e. Fringe is applied to Direct Labor.

D.3.C Travel The Offeror shall provide the basis of the estimate and detailed rationale for all travel including the detailed rationale for the chosen labor categories traveling. CMS should be able to understand from this narrative the reason for, rationale for and importance of the travel (i.e. Command Center Mission)

The Offeror shall submit affidavit stating their corporate policy in no way contradicts the Federal Travel Regulation.

The Offeror shall provide a brief explanation of how travel costs are reimbursed to employees within its organization, i.e. per diem allowance versus submitting receipts, etc.

The Offeror is instructed not to propose “commuting costs” as these travel expenses are not considered “official company business” expenses. Commuting costs may not become indirect costs unless there is a company policy, offered to all employees, in which it is a company benefit (fringe pool) that the company pays or stipends commuter costs. Otherwise such costs may not be included as indirect, as they are unallowable. Commuting costs are defined as travel costs used to move individuals from their place of residence to their place of work.

D.3.D Other Direct Costs (ODCs)

The Offeror shall provide the basis of estimate and detailed rationale for each item of ODC. This detailed rationale should clearly explain as to why costs are fair and reasonable and should accompany supporting documentation like market research analysis, quotes, etc.

Note: It is not enough to simply state that proposed costs are based on market research or quotes. The Offeror needs to provide the market research data, analysis, and conclusion. In the case of quotes, the Offeror is instructed to provide the actual quotes to support the proposed cost or price.

http://data.bls.gov/timeseries/CIU2010000000000A



D.3.E Fee

The Offeror shall provide the basis of estimate and detailed rationale for each proposed fee. Offerors shall ensure their proposed fees are appropriate to the fee parameters described in the Award Fee Plan. The Offeror shall also disclose if any fees are added to the subcontractors.

D.4 Subcontracts The subcontract information provided under the IDIQ, Section E of Part I – IDIQ, will be utilized to verify that the Offeror demonstrates that the subcontractor’s proposals are fair and reasonable. The prime must establish why they accepted the proposed cost and demonstrate, based on the contracting arrangement (cost reimbursement, firm fixed price, etc.), that appropriate due diligence has been done and all proposed costs are supported (FAR 15.404). All proposed subcontracts need to be supported by negotiation memorandums provided in Part I – IDIQ, Section E.

Section E: Equipment and Property (if applicable)

(a) Equipment to be purchased: If additional equipment must be acquired, you must include in your business proposal the description and estimated cost of each item and whether you propose to furnish the item with your own funds.

(b) Government Property:

1. It is the Department of Health and Human Services’ (HHS) policy that contractors provide all equipment and facilities necessary for performance of the contract; however, in some instances, an exception may be granted to furnish government owned property or to authorize a purchase with contract funds.

2. You must identify all government-owned property in your possession and all property acquired from federal funds, to which you have title, which is proposed to be used in the performance of the prospective contract.

3. The management and control of government property must be in accordance with HHS Publication OS-686 entitled, "Contractor's Guide to Control of Government Property” (2007).

Section F: Service Contract Act

The Offeror should identify those proposed labor categories subject to the Service Contract Act of 1965, as Amended (FAR 22.10) and provide a crosswalk to the labor category including the Wage Determination number in the applicable Wage Determination for their place of performance. The Offeror may obtain Wage Determinations at www.wdol.gov (click on “selecting SCA WDs” to obtain wage determination).

Section G: Small Business Subcontracting Plan

All Offerors (except Small Businesses) are required to submit a Small Business Subcontracting Plan (See Attachment J.6.D).

http://www.wdol.gov/



L.14 TECHNICAL PROPOSAL (VOLUME II) INSTRUCTIONS Offerors must adhere to the page limits defined below. Pages provided beyond the limit will be discarded and not reviewed or evaluated. The Offeror shall submit the Technical Proposal as prescribed below, it shall be separated and labeled accordingly. At a minimum, the Offeror shall present its technical proposal in response to each of the factors and sub-factors identified below and in Section M. The flow of the Technical Proposal shall be as follows:

TECHNICAL EVALUATION CRITERIA Page Limit A. Table of Contents Unlimited B. Accomplishing & Integrating Functional Requirements – Scenario

Responses 18

C. Technical Understanding and Approach 1. Approach to Transitioning Health Care PI Operations 3 2. Approach to Meeting Quality Assurance Program Requirements 3 3. Approach and Plan on Performance 2 4. Approach to Meeting Information Technology and Security

Requirements 5

D. Past Performance 3 E. Corporate Experience 3 F. Key Personnel and Staffing Plan 3 G. Small Business Utilization Unlimited H. Attestations Unlimited I. Technical Justification for Specific Cost Elements not included in the Staffing Plan Unlimited

TOTAL PAGES 40

Please follow the below format and TAB AND LABEL EACH SECTION (and subsections as applicable) INCLUDING THE TITLE. If the Section is “All Inclusive” and there is additional information than the Offeror should delineate between them with a labeled tab under that section. The Technical Proposal shall consist of the following ONLY:

Section A: Table of Contents (Unlimited Pages)

Offerors shall include a Table of Contents that identifies and clearly labels the various technical proposal sections.

Section B: Accomplishing & Integrating Functional Requirements – Scenario Responses

(Each scenario shall not exceed three pages – Page limit: 18 pages)

The Offeror shall provide narrative descriptions of activities to be undertaken, milestones, and other items that reflect your approach to addressing the following for the USOW and TO SOW:

The Contractor shall provide its approach to accomplishing and integrating the UPIC functional requirements. Technical evaluation scenarios have been presented (see Attachment J.7,“UPIC-Technical Evaluation Scenarios”) to assess the Offeror’s understanding, approach, and likelihood of being able to successfully perform the work expected of the Unified Program Integrity Contractor. The Offeror’s responses shall include, at a minimum, the following:



i. Relevant facts and/or assumptions to support the Offeror’s approach to scenarios;

ii. Relevant data points to support the Offeror’s approach to scenarios; iii. Applicable determination regarding compliance with state and federal regulations

and policies; and iv. Applicable approaches that are pursued to all possible relevant findings.

Section C: Technical Understanding and Approach (See page limits for each sub-factor) The Offeror shall provide narrative descriptions of activities to be undertaken, milestones, and other items that reflect your approach to addressing the following criteria for the USOW and TO SOW:

1. Approach to Transitioning Health Care Program Integrity (PI) Operations (Page limit: 3

pages)

In accordance with the UPIC USOW and the TO SOW, the Offeror shall provide an approach to transitioning health care PI Operations:

i. Transition and implementation activities and plans; ii. Anticipated risks and risk mitigation, including but not limited to risks associated

with transitioning and implementing multiple Medi-Medi Programs, and working with multiple ZPICs/PSCs/MICs and other stakeholders. Education of providers, states, and other stakeholders on the role of the UPIC;

iii. Facility preparedness and contingency plan; and iv. Continuity of operations including, but not limited to, potential fraud

investigations and Requests for Information (RFIs).

2. Approach to Meeting Quality Assurance Program Requirements (Page limit: 3 pages) Provide an approach and plan for meeting Quality Assurance Program Requirements that adequately address the following:

a. Implementing a thorough quality assurance program which is oriented toward continuous quality improvement and covers every component of operations including, but not limited to:

i. customer service; ii. communications; iii. training; iv. staffing; v. adherence to deliverable schedules; vi. completeness of documents; and vii. quality and timeliness of deliverables.

b. Assuring the quality of service/products by subcontractors, if applicable; and

c. Ensuring that quality assurance plans demonstrate how the Offeror will guarantee

that Medical Reviewers and Program Integrity analysts make quality and timely decisions.



3. Approach and Plan on Performance (Page limit: 2 pages)

Provide an approach and plan on performance:

a. Based upon the UPIC requirements, explain your organization’s performance goals for six (6) months, and one (1) year after contract award;

b. How does your organization intend to achieve goals at those increments within the contract?

c. What do you see as the biggest risks to meeting performance objectives? What mitigation strategies do you have to deal with those risks? What aspects of this requirement do you not control and will need support from CMS?

d. Are there any other contract or technical performance related risks that you have identified? If so, what do you recommend that your organization and/or CMS do in order to mitigate and minimize these risks?

e. Does your company utilize a continued process improvement strategy? If so, what are your goals specific to this contract? What areas do you think will show the greatest improvement? What do you have in place to assure there are continual improvements in process output (quality) and efficiency?

4. Approach to Meeting Information Technology and Security Requirements (Page limit: 5

pages with the exception of the architecture diagram and capacity plan which have no page limit)

Provide an approach and plan for to meeting Information Technology and security requirements for the following areas:

1. Facility security (i.e. a stand-alone building, rented space with other tenants);

2. Securing and configuring the facility floor plan, computer files, faxes, telephones, paper files, shredding of sensitive materials, etc.

3. IT security, including an architecture diagram, (no page limit) that depicts all hardware, software, network connectivity, security and firewalls, and authentication protocols, including relevant levels of revisions or patches that the Offeror will be using to complete UPIC work;

4. Physical and IT security for subcontractors, if applicable;

5. Meeting USOW security requirements; 6. Integrating with the Unified Case Management (UCM) system, One PI, and

other required CMS systems; and

7. Capacity plan that the Offeror will be using to support UPIC work (no page limit).

Section D: Past Performance (Page limit: 3 pages)



INSTRUCTIONS FOR SUBMITTING PAST PERFORMANCE INFORMATION

1. Definitions:

Relevant – Relevant past performance information is described in FAR 42.1501, General. For the purposes of this solicitation, ‘relevant’ is also past performance information which is similar in size, scope and complexity to this contract.

Significant Subcontractor – A subcontractor performing major or critical aspects of the requirement which have a direct impact on the contracts performance is considered significant.

2. Instructions:

The Offeror and all its significant subcontractor(s) identified in the proposal are required to provide a summary to disclose all of the following for the past performance information with a period of performance end date within the last 3 years of the date of this solicitation:

a. All CMS contracts/task orders greater than the simplified acquisition threshold.

b. All relevant contracts/orders entered into with:

o Other Federal Government Agencies, o State Agencies, o Local Governments, and o Commercial Customers

c. The Offeror’s and proposed significant subcontractor(s) summary shall provide the

following information.

1. Customer or Agency 2. Contract number (if applicable); 3. Point of Contact (Contracting Officer or other for Commercial Contract); 4. Approximate total contract value; 5. Contract period of performance, by base and option year(s); 6. Description of contracted services/supplies; and, 7. Relevant (Y/N)

o If the past performance is relevant, how the disclosed contract’s past performance information is relevant to the subject solicitation.

8. Additional Info: If performance was documented as less than satisfactory, the Offeror shall provide a summary of the identified issues, steps taken to resolve the problem and processes in place to improve future performance.

The below table should be used when providing a summary of the past performance information (Table will be provided in Microsoft Excel and will not be counted towards the page limit):

Customer (Agency)

Contract #

POC Total Contract

Value

Period of Performance

Description of Services/Supplies

Relevant (Y/N)

Additional Info



Offerors and proposed significant subcontractors without relevant Federal government past performance experience may ask customers to submit no more than three (3) Past Performance Questionnaire (PPQ) for the same or similar work directly to the Contracting Officer (See Attachment J.10). It is the responsibility of the Offeror to ensure timely return of any/all PPQs to the Contracting Officer in accordance with the proposal due date and time established within this solicitation. Contracts may include those entered into with the State/Local Governments and/or commercial customers.

Section E: Corporate Experience (Page limit: 3 pages)

The Offeror shall provide examples of when and how the Offeror has successfully completed projects of similar size, scope, complexity, and requiring similar coordination (Minimum of three (3) examples).

The Offeror’s submission shall include relevant and recent (last 3 years) corporate experience to include, but not limited to, the following:

A. Interfacing with Law Enforcement;

B. Interacting with State(s) Medicaid agencies;

C. Interpreting Medicare and State(s) Medicaid policies and regulations;

D. Accurately projecting project costs and working within and under projected budgets;

E. Using proactive health care fraud fighting tactics to include predictive analytic systems such, or similar to the Fraud Prevention System (FPS);

F. Interfacing with very large and complex health care claims processing, enrollment, case

management and data analysis processes/systems;

G. Managing subcontractors within proposed budgets while maximizing the use of small business.

H. The Offeror is also requested to provide two (2) examples of a project of a similar size,

scope, complexity, requiring similar coordination where a challenge was experienced that required your company to implement corrective action, risk mitigation strategy, etc.

• How quickly did you respond and how quickly was the issue resolved? What did

your organization learn from the experience?

• How do the lessons learned apply to this effort? Section F: Key Personnel and Staffing Plan (Page limit: 3 pages with the exception of the

organizational charts) (Those only proposing for the MA IDIQ, see below *)

1. Key Personnel

The Offeror shall provide an overview of the qualifications; addressing specifically what value the Key Personnel bring to this specific contract. The Offeror shall address the following questions:



a. Why were these individuals chosen for these Key Personnel positions?

b. What benefit do they provide to your organization and how do you intend to use these individuals to achieve the contract’s stated goals?

c. What experience does the individual have working on a project of similar size and scope? Additionally, how is that experience expected to translate into a benefit for the Government?

d. How will their experience help them meet or exceed the Government’s requirement?

*FOR THOSE OFFERORS ONLY INTERESTED IN AWARD OF THE MA IDIQ: CMS recognizes that it is unrealistic to expect those Offerors only interested in the MA IDIQ and not the task order award of Jurisdiction 1 to have Key Personnel. Therefore, those that indicate in their Executive Summary interest in the MA IDIQ only shall not propose Key Personnel. The Offeror will not be favorably or unfavorably evaluated on Key Personnel under this Factor.

2. Staffing Plan

The Offeror shall submit a staffing plan that outlines the total proposed staffing (inclusive of existing staff, direct and indirect labor, projected hires, inter-organizational transfers, subcontractors, etc., as applicable) to perform the work from implementation through contract end. The Offeror shall, at a minimum, provide the following information:

a. Identify the total number of FTEs required for all CLINs and contract periods of performance inclusive of both the prime and subcontractor(s) broken out by labor category;

b. Provide an explanation that clearly links the proposed labor categories, FTEs, and Subcontracting Plan to meet the goals outlined in the Offeror’s technical approach;

c. If the staffing plan includes hiring additional employees, subcontracting work, or any other form of labor acquisition, give examples of similar situations where you have been successful in acquiring the necessary labor to successfully perform a contract of similar size and complexity;

d. The organizational charts (no page limit) shall be sufficient to provide an understanding of the roles and responsibilities and placement of proposed personnel. In the event that the Offeror utilizes subcontractors, the organizational chart shall identify which staff are subcontractors. In summary, the organizational chart shall identify the organization of work for the UPIC effort, including, but not limited to the following:

i. Hierarchy of responsibility; ii. Designation of labor categories proposed with the names, at a minimum,

of Key Personnel responsible for each Division of Work, while ensuring all Key Personnel are identified as one full FTE for each year of the proposed contract period of performance;

iii. FTE represented by each individual;



iv. Designation as to whether the identified positions are prime or subcontractor staff; and

v. Location of each individual – city, state.

e. An explanation supporting the proposed FTE’s (hours) per labor category as reasonable and realistic for the required effort.

For example purposes only:

CLIN Labor Category

FTE per year

Hours Name Duties Rationale Prime/ Subcontractor

0001 Project

Manager 1 1,880 John Doe

(Baltimore, MD)

<provide position

description>

<why is this position needed & why are the

proposed FTE’s/hours reasonable and

realistic> Section G: Small Business Utilization (Unlimited Pages)

The Offeror must submit a subcontracting plan in accordance with the terms of the clause entitled "Small Business Subcontracting Plan," FAR 52.219-9. CMS will perform a subjective assessment based on consideration of all relevant facts and circumstances. The Government is seeking to determine whether the Offeror has demonstrated a commitment to use Small Businesses for the work that it will assign and oversee as the prime contractor. The Offeror will need to address the following in a narrative:

B. What is the rational for the proposed Subcontracting Plan? This explanation should focus on the Offeror’s core competencies and how their small business strategy compliments these competencies and enhances the overall value proposition for the Government.

C. How does this strategy fit in with your overall organizational structure and strengths?

D. Show the dollar value of the Subcontracting Plan and the percentage of subcontracting dollar value to proposed cost. How does the Offeror plan to increase both of these figures? What are your growth targets for the life of the contract?

E. The stated goals and proposed plan should also be supported by the past performance information submitted in accordance with Section L of the solicitation. It is essential for the proposed strategy to be supported by evidence the Offeror has in the past actually been able to meet small business goals in the past.

Section H: Attestations (Unlimited Pages) The following attestations shall be submitted:



1. ISO registration or a plan for obtaining ISO registration within one year of contract award;

2. Acceptance of all USOW and TO SOW requirements 3. All proposed Key Personnel meet all SOW requirements including location requirements.

Section I: Technical Justification for Specific Cost Elements not included in the Staffing

Plan (NO COST DATA should be incorporated into this section) (Unlimited Pages)

1. Travel: The Offeror shall list all proposed travel, for each CLIN, number of individuals

proposed, list who will be attending and why, the purpose of the trip, proposed number of days.

2. Other Direct Costs (ODC’s): The Offeror shall list all proposed ODC’s, for each CLIN, a description of the item or services being purchased, the items or services purposes, and why the item or service is necessary to meet the stated requirements.

3. Business / Technical Assumptions: The Offeror shall list all assumptions, both technical and business, made by the Offeror that impact performance of the contract and are key to understanding the Offeror’s approach to meeting the requirement and how the Offeror structured its pricing approach.

4. The Offeror should provide a brief explanation summarizing why the proposed number of hours, ODCs, Travel, Subcontracting approach, etc. are realistic to meet to meet the Government’s requirement.

L.15 BUSINESS ETHICS, ORGANIZATIONAL AND PERSONAL CONFLICTS OF INTEREST (HEREINAFTER COLLECTIVELY OR INDIVIDUALLY REFERRED TO AS COI) AND COMPLIANCE (MAY 2015) (VOLUME III) INSTRUCTIONS

General: In accordance with FAR 9.5, the Government must ensure that an Offeror and its proposed Subcontractor(s) is/are free of all COIs. The Business Ethics, Organizational and Personal Conflicts of Interest and Compliance information is so material to the award of this contract that a proposal failing to provide the requirements identified in Attachment J.8, Business Ethics, Organizational and Personal Conflicts Of Interest and Compliance Submission by Offeror/Contractor, may be ineligible for award. Volume III: The Offeror/Subcontractor(s) shall submit Volume III, Business Ethics, Conflict of Interest and Compliance, with its proposal.* Attachment J.8 Business Ethics, Organizational and Personal Conflicts of Interest and Compliance Submission by Offeror/Contractor(s) and Attachment J.9, Personal Conflicts of Interest Financial Disclosure, contain the proposal submission requirements for Volume III. The Offeror/Subcontractor(s) must provide adequate substantive detail in order for the Government to conduct an independent analysis of the provided information. Where the Offeror/Subcontractor(s) indicates that no COI exists for a given contract, then for each indication, the Offeror/ Subcontractor(s) shall provide rationale and facts in support of said indication. *Subcontractor(s): The same information shall be submitted in Volume III, Appendices, for each subcontractor.



SECTION M – EVALUATION FACTORS FOR AWARD M.1 FAR 52.217-5 EVALUATION OF OPTIONS (JUL 1990) Except when it is determined in accordance with FAR 17.206(b) not to be in the Government’s best interests, the Government will evaluate offers for award purposes by adding the total price for all options to the total price for the basic requirement. Evaluation of options will not obligate the Government to exercise the option(s).

(End of Provision) M.2 EVALUATION METHODOLOGY The Government will use a Best Value Tradeoff Process as described in FAR part 15.101-1 “Tradeoff Process.” This trade-off technique allows the Government to consider award to other than the lowest priced/cost Offeror or other than the highest technically rated Offeror. It permits tradeoffs among cost/price and non-cost/price evaluation factors. In making this comparison the Government is more concerned with obtaining superior technical/management features than with making an award at the lowest overall cost to the Government. However, the Government will not make an award at a significantly higher overall cost to the Government to achieve slightly or moderately superior technical or management features. The Government intends to award multiple IDIQ contracts to establish the MA IDIQ competitive pool and one task order award for Jurisdiction 1. An Offeror’s demonstrated ability or inability to meet the requirements of the Jurisdiction 1 task order will assist in determining whether or not that Offeror is awarded an IDIQ contract. The Offeror who presents the overall best value for Jurisdiction 1 will be awarded an IDIQ contract and the task order award. Offerors that are not considered the “Best Value” for Jurisdiction 1 but demonstrated, through their technical and cost proposal, a technically sound and competitively priced approach, will be considered for a potential IDIQ award. Based on the evaluation of the proposals submitted, the CO reserves the right to award an IDIQ to as many Offerors as necessary to ensure competition on future task orders. Overall Technical Rating: Technical proposals will be assessed on how well the Offeror’s proposal meets the solicitation requirements and the risks associated with the Offeror’s approach. Offerors will receive one overall technical rating for the non-cost proposal evaluation factors which takes into consideration every aspect of their technical proposal and weighs the strengths, weaknesses, significant weaknesses, deficiencies, risks and their relative value to the Government.

Risk is defined as the likelihood that the Government will be negatively impacted by the Offeror’s failure to meet the negotiated business, technical, management, schedule performance and cost. Risk is associated with an Offeror’s proposed approach in meeting the Government’s needs and requirements. The evaluation team will assess risk and integrate their assessment into the overall rating of each Offeror. Assessment of risk is an integral component of the evaluation. It will serve to inform the evaluators of the likelihood that the Offeror’s proposed solutions would successfully meet the requirements of this solicitation, within reasonable time frames and funding profiles, without placing unreasonable risk on the Government. In analyzing the risk of the Offeror’s proposed solutions, the Government will also consider the Offeror’s willingness to share in this risk.

Technical Justification for Specific Cost Elements not included in the Staffing Plan: Information provided by the Offeror for Section L.14, Section I, may be used in the overall technical evaluation score



as a contributor to the perceived risk of an Offeror’s technical proposal; however, this will not receive an adjectival rating and will predominantly be for the cost realism analysis. Future Competition: Offeror’s who demonstrate the ability and willingness to be able to compete in multiple jurisdictions may be considered favorable due to perceived increase in competition for future task orders. There is no pre-set limit on either the number of awards, or the amount of workload any one entity would be eligible to win under this solicitation. M.3 RELEVANCE OF EVALUATION FACTORS All factors other than cost or price, when combined, are significantly more important than cost or price. The evaluation will be conducted based on the relative importance of factors, in descending order, as follows:

1. Accomplishing & Integrating Functional Requirements.

2. Technical Understanding and Approach (each sub-factor is of equal importance) and Past Performance are of equal importance.

3. Corporate Experience, Key Personnel & Staffing Plan and Small Business Utilization are of equal importance.

4. Attestations. (Please note that “Attestations” is a “Pass/Fail” rating.)

Technical Evaluation Factors/ Sub-factors and Relevance

1 Accomplishing & Integrating Functional Requirements – Scenario Responses (Factor)

2 Technical Understanding and Approach (Factor) & Past Performance (Factor)

1. Approach to Transitioning Health Care program Integrity (PI) Operations (Sub Factor)

2. Approach to Meeting Quality Assurance Program Requirements (Sub Factor)

3. Approach and Plan on Performance (Sub Factor)

4. Approach to Meeting Information Technology and Security Requirements (Sub Factor)

3 Corporate Experience (Factor) &

Key Personnel and Staffing Plan (Factor) &

Small Business Utilization (Factor)

4 Attestations (Factor) (Pass/Fail)



M.4 TECHNICAL PROPOSAL EVALUATION Offerors shall demonstrate, overall, within each Factor and Sub-factor, their understanding and knowledge of, approach to, and processes and procedures (describing how) for completing the IDIQ-USOW and TO SOW requirements, and will be evaluated based on, at a minimum, the following:

I. Accomplishing & Integrating Functional Requirements – Scenario Responses

The Offeror will be evaluated on their probability of successfully accomplishing and integrating the UPIC functional requirements. The technical evaluation scenarios (Attachment J.7) will be evaluated on, at a minimum, the following:

1. How well the Offeror supports the relevant facts and/or assumptions in their approach;

2. How well the rrelevant data points support the Offeror’s approach; 3. The strength of the Offeror’s determination in regards to compliance with state and

federal regulations and policies; and 4. Feasibility and strength for determining and choosing the approaches that are pursued

for all possible relevant findings.

II. Technical Understanding and Approach A. Approach to Transitioning Health Care Program Integrity (PI) Operations

The Offeror will be evaluated on their ability to demonstrate their plan and approach to the transitioning of health care PI operations to include, at a minimum, the following:

1. Transition and implementation activities and strategy; 2. What risks and risk mitigation, including, but not limited to, risks associated with

transitioning and implementing multiple Medi-Medi Programs and working with multiple ZPICs/PSCs/MICs and other stakeholders, are anticipated and how well they will be proactive or reactive, if necessary, in resolving, diminishing or eliminating these risks;

3. The Offeror’s ability to promptly and thoroughly educate providers, states, and other stakeholders on the role of the UPIC;

4. The Offeror’s facility preparedness and their contingency plan; and 5. The Offeror’s strength of maintaining a successful continuity of operations including,

but not limited to, potential fraud investigations and Requests for Information (RFIs). B. Approach to Meeting Quality Assurance Program Requirements

The Offeror will be evaluated on meeting Quality Assurance Program Requirements that successfully address, at a minimum, the following:

1. Their ability in implementing a thorough and effectual quality assurance program which is oriented toward continuous quality improvement and covers every component of operations including, but not limited to:

i. customer service; ii. communications; iii. training;



iv. staffing; v. adherence to deliverable schedules; vi. completeness of documents; and vii. quality and timeliness of deliverables.

2. Demonstration of maximum assurance that subcontractors will provide quality of

service/product, if applicable; and

3. How well the Offeror can demonstrate through their quality assurance plan that Medical Reviewers and Program Integrity analysts will make quality and timely decisions.

C. Approach and Plan on Performance

The Offeror will be evaluated on their approach and plan on performance, at a minimum, the following:

1. Based upon the UPIC requirements, if the Offeror adequately and clearly explained realistic and relevant organizational performance goals for six (6) months, and one (1) year after contract award; This includes the Offeror’s ability to thoroughly explain their organization’s plan to achieve goals at those increments within the contract.

2. How well did the Offeror explain what they believe are the biggest risks to meeting performance objectives? How well did the Offeror explain their mitigation strategies to deal with those risks? Was the Offeror able to clearly identify the aspects of this requirement out of their control and will need support from CMS?

3. The Offeror’s recommendation for mitigating and minimizing these risks explain any other contract or technical performance related risks that they have identified? If so, how well did the Offeror explain their?

4. If the Offeror utilizes a continued process improvement strategy, how well did they explain the following:

i. What are their goals specific to this contract? ii. What areas does the Offeror believe will show the greatest improvement?

iii. What does the Offeror have in place to assure there are continual improvements in process output (quality) and efficiency?

D. Approach to Meeting Information Technology and Security Requirements

The Offeror will be evaluated on their successful approach and plan to meet Information Technology and security requirements, at a minimum, for the following areas:

1. Facility security (i.e. a stand-alone building, rented space with other tenants);

2. Securing and configuring the facility floor plan, computer files, faxes, telephones, paper files, shredding of sensitive materials, etc.

3. IT security, including the architecture diagram which depicts all hardware, software, network connectivity, security and firewalls, and authentication protocols, including



relevant levels of revisions or patches that the Offeror will use to complete UPIC work;Physical and IT security for subcontractors, if applicable;

4. USOW security requirements;

5. Unified Case Management (UCM) system, One PI, and other required CMS systems; and

6. Capacity plan to support UPIC work. III. Past Performance

CMS will evaluate the Offeror’s and proposed significant subcontractor(s) past performance information (See submission for definitions of relevant and significant subcontractor), which is expected to demonstrate the likelihood that the prospective contract will be performed successfully. The CO reserves the right to limit its review of past performance information to what he/she has been determined to be relevant. The Offeror is advised that the Contracting Officer, using sound business judgment, may consider Federal contract past performance to be more relevant than State Agencies, Local Government or Commercial Customer performance assessments. In the case of an Offeror without a record of relevant past performance, or for which information on past performance is not available, the Offeror’s Past Performance may not be evaluated favorably or unfavorably.

IV. Corporate Experience

Based on the examples in which the Offeror successfully completed projects of similar size, scope, complexity, and requiring similar coordination, the Offeror will be evaluated on its experience and success in, at a minimum, the following:

A. Interfacing with Law Enforcement; B. Interacting with State(s) Medicaid agencies; C. Interpreting Medicare and State(s) Medicaid policies and regulations; D. Accurately projecting project costs and working within and under projected budgets; E. Using proactive health care fraud fighting tactics to include predictive analytic systems

such as, or similar to the Fraud Prevention System (FPS); F. Interfacing with very large and complex health care claims processing, enrollment, case

management and data analysis processes/systems; G. Managing subcontractors within proposed budgets while maximizing the use of small

business; and H. The Offeror’s response in their submission of challenges that were experienced requiring

implementation of corrective action, risk mitigation, or other remedial efforts. Evaluation will include how well and speedily the Offeror resolved the issue and how lessons learned were implemented and successful. Also, how will this experience apply to this effort?

V. Key Personnel and Staffing

A. Key Personnel (Those only proposing for the MA IDIQ, see below *)



The Offeror will be evaluated the proposed Key Personnel to include, at a minimum, the following:

1. Qualifications; 2. Unique contribution to the UPIC; 3. Rationale for choosing this individual; 4. The benefits and skills they bring in relation to the UPIC; 5. Previous experience related to a project of similar size and scope; and 6. Experience giving a higher level of success to the UPIC.

*FOR THOSE OFFERORS ONLY INTERESTED IN AWARD OF THE MA IDIQ: CMS recognizes that it is unrealistic to expect those Offerors only interested in the MA IDIQ to have Key Personnel. Therefore, Offerors that indicate in their Executive Summary interest in the MA IDIQ only shall not propose Key Personnel. The Offeror will not be favorably or unfavorably evaluated on Key Personnel under this Factor.

B. Staffing Plan The Offeror will be evaluated on how well their staffing plan provides the required information and, at a minimum, the following:

1. How well the proposed labor categories, FTEs, and Subcontracting Plan meet the Offeror’s technical approach;

2. Demonstrated experience in successfully acquiring necessary labor to perform on a project of similar size and complexity; this includes subcontracting, hiring and overall labor acquisition.

3. Comprehensible organizational charts to sufficiently gain an understanding of the roles and responsibilities and placement of proposed personnel; including subcontractors. And how this chart depicts a reasonable and realistic organization of management for the UPIC.

VI. Small Business Utilization The Offeror will be evaluated on their small business subcontracting plan submission to the extent of how realistic and committed the Offeror is in utilizing various types of small business concerns. At a minimum, the Offeror will be evaluated on the following:

A. The Offeror’s rationale for their small business allocations, how it relates to their core competencies and how it enhances the overall value proposition for the Government.

B. How well does the proposed strategy fit with their overall organizational structure and strengths?

C. How well the stated goals and proposed plan are supported by the past performance information submitted in accordance with Section L of the solicitation.

D. The Offeror's success in meeting previous small business goals.

VII. Attestations The Offeror will be evaluated on a Pass/Fail basis as to their attestation to all of the below. Please note that a “Pass” is given only if all items are submitted and all items are sufficiently addressed.



A. ISO registration or a plan for obtaining ISO registration within one year of contract award;

B. IT Security Requirement Compliance; C. Acceptance of all USOW, TO SOW, and solicitation requirements: and D. All proposed Key Personnel meet all USOW and SOW requirements including location

requirements.

M.5 BUSINESS PROPOSAL EVALUATION The business proposals will be analyzed and evaluated by the Government to determine the reasonableness and the realism of the proposed cost/price. The purpose of this cost realism analysis will be to determine if the Offeror’s proposed costs demonstrate the Offeror understands the Government’s requirements and if the proposed costs are consistent with the various elements of the Offeror’s technical proposal. In addition, all other areas of the Business Proposal will be evaluated for both the IDIQ award and Jurisdiction 1 task order. The Offeror’s Business Proposal will also be evaluated based on the Offeror’s potential impact to the competitive pool and risk (financial, etc.). M.6 CONFLICTS OF INTEREST (OCI) EVALUATION CONFLICT OF INTEREST REVIEW

1. In the event that Business Ethics, Organizational and Personal Conflicts of Interest (hereinafter collectively or individually referred to as COI) and/or Compliance information is required and/or submitted, it will be reviewed for the apparent successful Offeror, but not receive a score/rating. Business Ethics, Conflict of Interest and Compliance Submission by Offeror/Contractor, Attachment J.8 (and J.9 as applicable), and the information contained therein, will be reviewed by the Contracting Officer, in accordance with contract section H.1 and Section L.15 of this solicitation, in order to make a determination whether the Offeror meets the COI requirements. Additionally, the Contracting Officer may use other information, besides that disclosed by the Offeror, in the Contracting Officer’s evaluation of conflicts of interest.

2. In accordance with FAR 9.504(e), “The contracting officer shall award the contract to the apparent successful Offeror unless a conflict of interest is determined to exist that cannot be avoided, neutralized or mitigated. Before determining to withhold award based on conflict of interest considerations, the contracting officer shall notify the contractor, provide the reasons therefor, and allow the contractor a reasonable opportunity to respond.”

3. CMS will not enter into a contract with an entity that CMS determines has, or has the potential for, an unresolved COI unless CMS determines that it is in the Government’s best interest to do so. If the Contracting Officer finds that it is in the best interest of the United States to award the contract, notwithstanding an unresolved conflict of interest, a request for waiver shall be submitted by the Contracting Officer in accordance with FAR 9.503.

4. In cases where conflicts of interest cannot be avoided, neutralized, or mitigated satisfactorily, or waived when it is in the Government’s best interest to do so, the Contracting Officer shall preclude the Offeror from consideration for contract award.

M.7 CLARIFICATION/COMMUNICATIONS WITH OFFERORS BEFORE

ESTABLISHMENT OF THE COMPETITIVE RANGE



In accordance with FAR 15.306, Exchanges with Offerors after Receipt of Proposals, the Government may conduct clarifications and/or communications with the Offeror prior to the establishment of the Competitive Range. Discussions, as defined in FAR 15.306(d) may be conducted after establishment of the Competitive Range.

An Offeror should not assume that the Contracting Officer will independently obtain information necessary to evaluate its proposal and should therefore supply all information required to evaluate its proposal. Failure to provide the information required in order to evaluate a proposal could result in a rejection of the proposal as being technically unacceptable.

M.8 COMPETITIVE RANGE Based on the ratings of each proposal against all evaluation criteria and other requirements of the solicitation, the Contracting Officer may establish a Competitive Range and/or the Jurisdiction 1 task order which will be comprised of all of the most highly rated proposals unless the range is reduced for purposes of efficiency (see below) or unless award is made without discussions.

The Competitive Range will be determined based on the following:

• Scoring of the written technical proposal(s) for the IDIQ, Task Order 0001; • Evaluation of past performance information; • Evaluation of the business proposal; • Evaluation of other business proposal components; and • A preliminary responsibility determination (See FAR 9.1 Responsible Prospective Contractors).

Note: At this point in the procurement cycle the responsibility determination is preliminary. The responsibility determination process will continue up to the time of award.

Further, if the Contracting Officer determines that the number of proposals that would otherwise be in the Competitive Range exceeds the number at which an efficient competition can be conducted, the Contracting Officer may limit the number of proposals in the Competitive Range to the greatest number that will permit an efficient competition among the most highly rated proposals. Offerors will be notified by letter whether or not each has been included in the Competitive Range. Offerors not in the Competitive Range will be eliminated from further consideration for award. Offerors excluded or otherwise eliminated from the Competitive Range may request a debriefing in accordance with FAR 15.505, Pre-award Debriefing of Offerors. M.9 DISCUSSIONS If a Competitive Range is established, upon completion of discussions in accordance with FAR 15.3, a request for final revised proposals will be issued to all Offerors still within the Competitive Range. If, after discussions have begun, an Offeror originally in the Competitive Range is no longer considered to be among the most highly rated Offerors being considered for award, that Offeror may be eliminated from the Competitive Range whether or not all material aspects of the proposal have been discussed, or whether or not the Offeror has been afforded an opportunity to submit a proposal revision.

After receipt and evaluation of a final revised proposal, an Offeror may be selected for award and may be involved in final negotiations. The content of such negotiations would not have any bearing on the selection process and would be in accordance with HHSAR 315-370, “Finalization of details with the



selected source.”

However, the Contracting Officer reserves the right to make award of a contract(s) without regard to “discussions.” If the Government awards without discussions, a competitive range will not be established. Therefore, it is in the best interest of the Offeror to submit the most advantageous proposal to the Government with the initial submission.

You are reminded that inclusion in the Competitive Range is not a guarantee for award of a contract. Offerors eliminated from the Competitive Range will be notified in accordance with FAR 15.503, Notice to Unsuccessful Offerors.

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